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1

Leptin increases growth of primary ossification centers in fetal mice  

PubMed Central

The effect of peripheral leptin on fetal primary ossification centers during the early phases of bone histogenesis was investigated by administration of leptin to pregnant mice. Fourteen pregnant mice were divided into two groups. The treated pregnant group was subcutaneously injected in the intrascapular region with supraphysiologic doses (2 mg kg?1) of leptin (Vinci Biochem, Firenze, Italy) in a volume of 0.1 mL per 10 g body weight, at the 7th, 9th and 11th day of gestation. The control group was treated with physiological solution in the same manner and same times as the treated group. The new-born mice were killed 1 day after birth and the primary ossification centers were stained with Alizarin Red S after diaphanizing the soft tissues in 1% potassium hydroxide. The development of both endochondral and intramembranous ossification centers was morphometrically analysed in long bones. The results showed that the ossification centers of mice born by mothers treated with leptin grow more rapidly in both length and cross-sectional area compared with mice born by the untreated mothers. As the development of long bones depends on endochondral ossification occurring at proximal and distal epiphyseal plates as well as on intramembranous ossification along the periosteal surface, it appears that leptin activates the differentiation and proliferation of both chondrocytes and osteoblasts. The role of leptin as a growth factor of cartilage and bone is discussed in the light of the data reported in the literature.

Bertoni, Laura; Ferretti, Marzia; Cavani, Francesco; Zavatti, Manuela; Resca, Elisa; Benelli, Augusta; Palumbo, Carla

2009-01-01

2

FGFR3 promotes synchondrosis closure and fusion of ossification centers through the MAPK pathway  

PubMed Central

Activating mutations in FGFR3 cause achondroplasia and thanatophoric dysplasia, the most common human skeletal dysplasias. In these disorders, spinal canal and foramen magnum stenosis can cause serious neurologic complications. Here, we provide evidence that FGFR3 and MAPK signaling in chondrocytes promote synchondrosis closure and fusion of ossification centers. We observed premature synchondrosis closure in the spine and cranial base in human cases of homozygous achondroplasia and thanatophoric dysplasia as well as in mouse models of achondroplasia. In both species, premature synchondrosis closure was associated with increased bone formation. Chondrocyte-specific activation of Fgfr3 in mice induced premature synchondrosis closure and enhanced osteoblast differentiation around synchondroses. FGF signaling in chondrocytes increases Bmp ligand mRNA expression and decreases Bmp antagonist mRNA expression in a MAPK-dependent manner, suggesting a role for Bmp signaling in the increased bone formation. The enhanced bone formation would accelerate the fusion of ossification centers and limit the endochondral bone growth. Spinal canal and foramen magnum stenosis in heterozygous achondroplasia patients, therefore, may occur through premature synchondrosis closure. If this is the case, then any growth-promoting treatment for these complications of achondroplasia must precede the timing of the synchondrosis closure.

Matsushita, Takehiko; Wilcox, William R.; Chan, Yuk Yu; Kawanami, Aya; Bukulmez, Hulya; Balmes, Gener; Krejci, Pavel; Mekikian, Pertchoui B.; Otani, Kazuyuki; Yamaura, Isakichi; Warman, Matthew L.; Givol, David; Murakami, Shunichi

2009-01-01

3

BMP2 induces segment-specific skeletal regeneration from digit and limb amputations by establishing a new endochondral ossification center.  

PubMed

Bone morphogenetic proteins (BMPs) are required for bone development, the repair of damage skeletal tissue, and the regeneration of the mouse digit tip. Previously we showed that BMP treatment can induce a regeneration response in mouse digits amputated at a proximal level of the terminal phalangeal element (P3) (Yu et al., 2010). In this study, we show that the regeneration-inductive ability of BMP2 extends to amputations at the level of the second phalangeal element (P2) of neonatal digits, and the hindlimb of adult limbs. In these models the induced regenerative response is restricted in a segment-specific manner, thus amputated skeletal elements regenerate distally patterned skeletal structures but does not form joints or more distal skeletal elements. Studies on P2 amputations indicate that BMP2-induced regeneration is associated with a localized proliferative response and the transient expression of established digit blastema marker genes. This is followed by the formation of a new endochondral ossification center at the distal end of the bone stump. The endochondral ossification center contains proliferating chondrocytes that establish a distal proliferative zone and differentiate proximally into hypertrophic chondrocytes. Skeletal regeneration occurs from proximal to distal with the appearance of osteoblasts that differentiate in continuity with the amputated stump. Using the polarity of the endochondral ossification centers induced by BMP2 at two different amputation levels, we show that BMP2 activates a level-dependent regenerative response indicative of a positional information network. In summary, our studies provide evidence that BMP2 induces the regeneration of mammalian limb structures by stimulating a new endochondral ossification center that utilizes an existing network of positional information to regulate patterning during skeletal regeneration. PMID:23041115

Yu, Ling; Han, Manjong; Yan, Mingquan; Lee, Jangwoo; Muneoka, Ken

2012-10-03

4

Ossification sequence heterochrony among amphibians.  

PubMed

Heterochrony is an important mechanism in the evolution of amphibians. Although studies have centered on the relationship between size and shape and the rates of development, ossification sequence heterochrony also may have been important. Rigorous, phylogenetic methods for assessing sequence heterochrony are relatively new, and a comprehensive study of the relative timing of ossification of skeletal elements has not been used to identify instances of sequence heterochrony across Amphibia. In this study, a new version of the program Parsimov-based genetic inference (PGi) was used to identify shifts in ossification sequences across all extant orders of amphibians, for all major structural units of the skeleton. PGi identified a number of heterochronic sequence shifts in all analyses, the most interesting of which seem to be tied to differences in metamorphic patterns among major clades. Early ossification of the vomer, premaxilla, and dentary is retained by Apateon caducus and members of Gymnophiona and Urodela, which lack the strongly biphasic development seen in anurans. In contrast, bones associated with the jaws and face were identified as shifting late in the ancestor of Anura. The bones that do not shift late, and thereby occupy the earliest positions in the anuran cranial sequence, are those in regions of the skull that undergo the least restructuring throughout anuran metamorphosis. Additionally, within Anura, bones of the hind limb and pelvic girdle were also identified as shifting early in the sequence of ossification, which may be a result of functional constraints imposed by the drastic metamorphosis of most anurans. PMID:24074280

Harrington, Sean M; Harrison, Luke B; Sheil, Christopher A

2013-09-01

5

Three-dimensional polycaprolactone scaffold-conjugated bone morphogenetic protein-2 promotes cartilage regeneration from primary chondrocytes in vitro and in vivo without accelerated endochondral ossification.  

PubMed

As articular cartilage is avascular, and mature chondrocytes do not proliferate, cartilage lesions have a limited capacity for regeneration after severe damage. The treatment of such damage has been challenging due to the limited availability of autologous healthy cartilage and lengthy and expensive cell isolation and expansion procedures. Hence, the use of bone morphogenetic protein-2 (BMP-2), a potent regulator of chondrogenic expression, has received considerable attention in cartilage and osteochondral tissue engineering. However, the exact role of BMP-2 in cartilage repair has been postulated to promote both cartilage formation and subsequent cartilage degradation through hypertrophy and endochondral ossification. Furthermore, it is likely that the manner in which BMP-2 is presented to chondrocytes will influence the physiologic pathway (repair vs. degeneration). This study investigates the relative influence of BMP-2 on cartilage matrix and potential subsequent bone matrix production using primary chondrocytes seeded on designed 3D polycaprolactone (PCL) scaffolds with chemically conjugated BMP-2. The results show that chemically conjugated BMP-2 PCL scaffolds can promote significantly greater cartilage regeneration from seeded chondrocytes both in vitro and in vivo compared with untreated scaffolds. Furthermore, our results demonstrate that the conjugated BMP-2 does not particularly accelerate endochondral ossification even in a readily permissible and highly vascular in vivo environment compared with untreated PCL scaffolds. This study not only reveals the potential use of the BMP-2 conjugation delivery method for enhanced cartilage tissue formation but also gives new insights for the effects of conjugated BMP-2 on cartilage regeneration and osteochondral ossification. PMID:22615065

Jeong, Claire G; Zhang, Huina; Hollister, Scott J

2012-05-21

6

Multifactorial refractory heterotopic ossification.  

PubMed

Ectopic bone formation or "heterotopic ossification" can follow surgery, trauma, or neurologic injury, but the process is usually self-limited, localized to the site of injury, and responds to surgical treatment when necessary. Aggressive, systemic forms of heterotopic ossification exist that generate lesions that often resist surgical treatment and produce a high rate of recurrence. These entities typically manifest during infancy as genetic syndromes such as fibrodysplasia ossificans progressiva or progressive osseous heteroplasia. The authors describe a case of aggressive, systemic heterotopic ossification in an adult that followed a motor vehicle accident and multiple surgeries. The patient developed a large nonhealing wound around a focus of ectopic bone. Skin grafts failed as a result of the recurrence of ectopic bone, and the patient eventually required aggressive debridement and delayed rotational flap closure. A brief review of the clinical features and surgical treatment of heterotopic ossification is outlined. PMID:15156990

Gear, Andrew J L; Buckley, Claire; Kaplan, Fred; Vanbeek, Alan

2004-03-01

7

Paravertebral ligamentous ossification: DISH, OPLL and OLF  

Microsoft Academic Search

This is an overview of paravertebral ligamentous ossification based on our 5-year experience in ossification of posterior longitudinal ligament (109 cases) and ossification of ligamentum flavum (18 cases). Paravertebral ligamentous ossification is designated as the disorder caused by frequently coexisting ossification of paravertebral ligaments, DISH, OPLL, and OLF. The frequency of the occurrence of isolated ossification of PLL and OLF

Shigeru Ehara; Tadashi Shimamura; Ryuji Nakamura; Ken Yamazaki

1998-01-01

8

Intrauterine growth restriction decreases endochondral ossification and bone strength in female rats.  

PubMed

Intrauterine growth restriction (IUGR) modifications to postnatal skeletal growth may increase adult fracture, especially in females who have greater risk of osteoporosis. Little is known about the effect of IUGR on the patterns of postnatal endochondral ossification and bone development. Here for the first time we reveal bone formation, mineralization, and strength in IUGR female rats during early postnatal life and adulthood. Endochondral ossification rate of the hypertrophic zone (HZ) and hypertrophic cell length (HCL) at distal femur and proximal tibia, and primary ossification center (POC) of the whole femur and tibia were quantified at birth to day 21. Bone area (BA), bone mineral content (BMC), and bone density by dual-energy X-ray absorptiometry and bone strength determined from three-point bending were measured at days 21 and 120. IUGR femur and tibia HZ, HCL, and POC were significantly diminished at birth to day 21. IUGR decreased BA and BMC as well as femur/tibia diameter, length, stiffness, and peak load values at days 21 and 120. Our findings demonstrate a negative long-term effect of IUGR on bone size, mineral content, and strength in weanling and adult female rats. We speculate that IUGR decreases endochondral ossification responsiveness, and in turn, postnatal linear skeletal growth, mineralization, and strength in female rats. PMID:22875655

Chen, Haiyan; Miller, Scott; Lane, Robert H; Moyer-Mileur, Laurie J

2012-08-08

9

A 2020 vision of patient-centered primary care  

Microsoft Academic Search

Patient-centered care has received new prominence with its inclusion by the Institute of Medicine as 1 of the 6 aims of quality.\\u000a Seven attributes of patient-centered primary care are proposed here to improve this dimension of care: access to care, patient\\u000a engagement in care, information systems, care coordination, integrated and comprehensive team care, patient-centered care\\u000a surveys, and publicly available information.

Karen Davis; Stephen C. Schoenbaum; Anne-Marie Audet

2005-01-01

10

Calcification and Ossification  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Cutaneous calcification or ossification is the result of a disruption of the normal calcium regulatory pathway in the skin\\u000a by local or systemic events.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a \\u000a Calcifying disorders of the skin can be divided into four groups: dystrophic calcinosis secondary to localized or diffuse\\u000a tissue alterations; metastatic calcinosis, including calciphylaxis, due to impaired calcium-phosphate metabolism; idiopathic\\u000a calcinosis, and iatrogenic calcinosis.

Maxime Battistella; Bernard Cribier

11

Blast Injuries And Heterotopic Ossification.  

National Technical Information Service (NTIS)

Heterotopic ossification (HO) is perhaps the single most significant obstacle to independence, functional mobility, and return to duty for combat- injured veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Recent research into the cause(s...

B. K. Potter J. A. Forsberg K. A. Alfieri

2012-01-01

12

Primary photochemistry of reaction centers from the photosynthetic purple bacteria  

Microsoft Academic Search

Photosynthetic organisms transform the energy of sunlight into chemical potential in a specialized membrane-bound pigment-protein complex called the reaction center. Following light activation, the reaction center produces a charge-separated state consisting of an oxidized electron donor molecule and a reduced electron acceptor molecule. This primary photochemical process, which occurs via a series of rapid electron transfer steps, is complete within

Christine Kirmaier; Dewey Holten

1987-01-01

13

Women of Polygamous Marriages in Primary Health Care Centers  

Microsoft Academic Search

Clinical implications for working with polygamous families are discussed following a report of research among a sample of 126 Bedouin-Arab women from polygamous marriages who were being seen in primary health care centers. Of these, 94 were senior wives who were followed by another wife in the marriage, and 32 were junior wives, the most recent wife joining the marriage.

Alean Al-Krenawi

1999-01-01

14

A model for patient-centered Army primary care.  

PubMed

This pilot evaluated a novel method of primary care delivery in a military family practice setting. A registered nurse, registered nurse case manager, and primary care provider formed the patient management team. Approximately 2,500 empanelled patients participated in a pilot program that applied a patient-centered approach to primary care. The pilot tracked outcome measures, which included (1) panel size, (2) access to care, (3) care utilization, (4) continuity of care, (5) nurse and provider productivity, (6) Healthcare Effectiveness Data and Information Set measures, and (7) satisfaction measures. When compared to the standard family practice clinic, the patients in the pilot were able to access the family practice clinic more frequently (p < 0.05), were less seen in the urgent care (p < 0.05), and had a lower no-show rate (p < 0.001) for scheduled appointments. The providers were able to see their own empanelled patients significantly more frequently (p < 0.05) and virtually all Healthcare Effectiveness Data and Information Set markers improved with colon cancer screening, low-density lipoprotein annual exams, low-density lipoprotein control, and breast cancer screening/mammogram being significantly improved over the comparison group (p < 0.05). These results suggest a change in staffing and a focus on patient-centered care can significantly improve outpatient care access and population health maintenance. PMID:23397696

Lewis, Paul C; Holcomb, Barbara

2012-12-01

15

BREASTFEEDING PRACTICE AMONG WOMEN ATTENDING PRIMARY HEALTH CENTERS IN RIYADH  

PubMed Central

Objectives: (1) To study the patterns of breastfeeding of last children, duration, factors and reasons for it. (2) To study the factors affecting breastfeeding among mothers who are breastfeeding and the reasons for continuing or failure to continue, at the primary health care centers (PHC) in Riyadh. Method: A cross-sectional study was conducted by distributing 1000 questionnaires in 10 PHC centers. The breastfeeding practices were categorized on WHO terms. Results: Most of the studied last children (95.1%) were breastfed. Exclusive breastfeeding rate from birth was 62.9%, for up to four months was 13.2% and for six months was 3.3% . The mixed breastfeeding rate from birth was 32.2%, up to age of four months was 53.1% and for children more than six months old it was 20.3%. The mean age of the introduction of solid food was 4.6 ±1.4 months. Artificial feeding rate was 4.9% at birth , 30.3% up to four months and 49.7% for children more than six months old. The most frequent reason for the continuation of breastfeeding was Quranic instruction (55.1%) and its failure was inadequate milk (60.8%). The exclusive breastfeeding and the duration of breastfeeding had statistically significant association with the mothers’ residence, marital status, number of children alive, occupation and the level of education. In addition, there was significant association of exclusive breastfeeding and the non-introduction of artificial feeding at the hospital but not with health education on breastfeeding at the centers . Recommendations: To promote the education of mothers on breastfeeding, promote the training of PHC center health professionals and modify the policy of hospitals in the Kingdom on the feeding of newborns.

Al-Amoud, Maysoon M.

2003-01-01

16

Primary charge separation in isolated photosystem II reaction centers  

SciTech Connect

Primary charge-separation in isolated bacterial reaction center (RC) complex occurs in 2.8 ps at room temperature and 0.7--1.2 ps at 10 K. Because of similarities between the bacterial and photosystem II (PSII) RCs, it has been of considerable interest to obtain analogous charge-separation rates in the higher plant system. Our previous femtosecond transient absorption studies used PSII RC material stabilized with PEG or by exchanging dodecyl maltoside (DM) for Triton in the isolation procedure. These materials gave charge-separation 1/e times of 3.0 [plus minus] 0.6 ps at 4[degree]C and 1.4[plus minus] 0.2 ps at 15 K based on the risetime of transient absorption kinetics at 820 nm. These values were thought to represent the time required for formation of the P680[sup +]-Pheo[sup [minus

Seibert, M.; Toon, S. (National Renewable Energy Lab., Golden, CO (United States)); Govindjee (Illinois Univ., Urbana, IL (United States)); O'Neil, M.P.; Wasielewski, M.R. (Argonne National Lab., IL (United States))

1992-08-24

17

Care of asthmatic patients in primary health care centers.  

PubMed

This is a retrospective study of the medical records of asthamtics using a predesigned form. The purpose of the study is to define the number of patients registered as asthamatics at a random selection of primary health care centers (PHCCs) in Riyadh and to describe sociodemographic, clinical and management characteristics of this population of asthmatics with a view to recommending changes which might improve the care for asthma patients. Patients from 60 primary health care centers were studied. There were 2081 asthamatic patients found in the studied PHCCs (out of 255,145 surveyed), giving a rate of 0.8%. Out of all the patients, 32.8% were children 16 years of age or below and 24.7% were above 5 years of age. The male to female ratio was 1.2:1. The presenting symptoms were cough in 82.3% and shortness of breath 64.8%. Atopic disorders such as eczema and allergic rhinitis were recorded in 27.7%. PHCCs diagnosed 61.9% depending on history and clinical examination. Out of all patients, 10.6% did not utilize a PHCC, 29.5% were referred to a specialist and 8.7% needed admission to the hospital one or more times. Oral salbutamol was used in more than 45.7% of the patients. The number of registered bronchial asthma patients at the PHCCs was very low. Even when registered, asthmatic patients are getting suboptimal care. The present study provides a basis for intervention and a baseline from which to measure the benefits of intervention. It also provides the strongest possible support for the Ministry of Health, who recently initiated a National Asthma Program. PMID:17372397

Al-Shammari, S A; Khoja, T A; Al-Ansary, L A; Al-Yamani, M J

1996-01-01

18

Extensive ossification of thymoma in a child.  

PubMed

A case of thymoma with extensive ossification in an 8-year-old female child is presented. The presence of extensive ossification in the stroma of the thymoma is an extremely rare feature. To date, there is a single report of ossifying thymoma in children. This report represents the second known case in a child in the worldwide literature. PMID:23706464

Chaturvedi, Madhu; Kalgutkar, Alka D; Khandekar, Jayant V

2013-06-01

19

The role of morphogens in endochondral ossification  

Microsoft Academic Search

The formation of bone occurs normally by one of two developmental processes: intramembranous or endochondral ossification. Endochondral ossification occurs in the morphogenesis of the limb buds and growth plates, and in the regeneration of bone following injury (fracture callus). Two classes of diffusible morphogen-like molecules (MLMs) involved in limb development are the bone morphogenetic proteins (BMPs) and retinoic acid (RA).

John T. Campbell; Frederick S. Kaplan

1992-01-01

20

Heterotopic Ossification: An Unusual Presentation  

PubMed Central

Heterotopic ossification (HO) is usually seen after-trauma, following traumatic injuries, surgeries involving major joints, neurogenic injury, and burns; however, atraumatic cases have also been reported. HO tends to cause pain, swelling, and limitation of joint movements. HO has been reported in adults as well as in pediatric cases, however, our search in the English literature has not revealed a single case in the infratemporal region, especially in children of developing age, where HO tends to affect the development and growth of adjacent bones. We are reporting a case of HO in close proximity to TMJ affecting the development of mandible and maxilla.

Patil, Satish G.; Siddiqua, Aaisha; Joshi, Udupi Krishna; Deshmukh, Pallavi K.; Patil, Bindu S.; Mangalgi, Anand

2012-01-01

21

Primary charge separation in isolated photosystem II reaction centers  

SciTech Connect

Primary charge-separation in isolated bacterial reaction center (RC) complex occurs in 2.8 ps at room temperature and 0.7--1.2 ps at 10 K. Because of similarities between the bacterial and photosystem II (PSII) RCs, it has been of considerable interest to obtain analogous charge-separation rates in the higher plant system. Our previous femtosecond transient absorption studies used PSII RC material stabilized with PEG or by exchanging dodecyl maltoside (DM) for Triton in the isolation procedure. These materials gave charge-separation 1/e times of 3.0 {plus_minus} 0.6 ps at 4{degree}C and 1.4{plus_minus} 0.2 ps at 15 K based on the risetime of transient absorption kinetics at 820 nm. These values were thought to represent the time required for formation of the P680{sup +}-Pheo{sup {minus}} state. Recent results of Hastings et al. obtained at high data acquisition rates and low flash intensities, suggest that the Pheo{sup {minus}} state may form more slowly. In light of this work, we have carried out additional time domain studies of both electron transport and energy transfer phenomena in stabilized DM PSII RCs at room temperature. We used a 1-kHz repetition rate femtosecond transient absorption spectrometer with a 200 fs instrumental time resolution and compared the results with those obtained by others using frequency domain hole-burning techniques.

Seibert, M.; Toon, S. [National Renewable Energy Lab., Golden, CO (United States); Govindjee [Illinois Univ., Urbana, IL (United States); O`Neil, M.P.; Wasielewski, M.R. [Argonne National Lab., IL (United States)

1992-08-24

22

Ossification of the petrotympanic fissure: morphological analysis and clinical implications.  

PubMed

The petrotympanic fissure, a narrow slit in the temporal bone, allows the temporomandibular joint (TMJ) and the middle ear to communicate. Both the chorda tympani and the ligament cross the fissure between the posterior region of the joint disk and the malleolar ossicle. The parasympathetic fibers of the chorda tympani spread into the major salivary glands and are responsible for the taste sensibility on the anterior two-thirds of the tongue. After chronological identification of 30 human skulls, petrotympanic fissures were macroscopically and stereomicroscopically analyzed for the presence and disposition of ossification areas. Digitalized images were analyzed using computer program UTHSCSA ImageTool 3.0 (developed by the Department of Dental Diagnostic Science at The University of Texas Health Science Center, San Antonio, Texas). The total extension of the fissures and ossification areas was measured. The macroscopic analysis did not constitute an appropriated method for this evaluation and the ossification of the fissures increased with aging, suggesting its influence on the causes of otalgia in cases of TMJ dysfunction. PMID:22128668

Monteiro, João Carlos Castro; Ennes, Jussara Peixoto; Zorzatto, José Roberto

2011-10-01

23

Blast injuries and heterotopic ossification  

PubMed Central

Heterotopic ossification (HO) is perhaps the single most significant obstacle to independence, functional mobility, and return to duty for combat-injured veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Recent research into the cause(s) of HO has been driven by a markedly higher prevalence seen in these wounded warriors than encountered in previous wars or following civilian trauma. To that end, research in both civilian and military laboratories continues to shed light onto the complex mechanisms behind HO formation, including systemic and wound specific factors, cell lineage, and neurogenic inflammation. Of particular interest, non-invasive in vivo testing using Raman spectroscopy may become a feasible modality for early detection, and a wound-specific model designed to detect the early gene transcript signatures associated with HO is being tested. Through a combined effort, the goals of early detection, risk stratification, and development of novel systemic and local prophylaxis may soon be attainable.

Alfieri, K. A.; Forsberg, J. A.; Potter, B. K.

2012-01-01

24

The Primary Cilium: A Signaling Center During Vertebrate Development  

PubMed Central

The primary cilium has recently stepped into the spotlight, as a flood of data demonstrate that this organelle has crucial roles in vertebrate development and human genetic diseases. Cilia are required for the response to developmental signals, and evidence is accumulating that the primary cilium is specialized for Hedgehog (Hh) signal transduction. Formation of cilia, in turn, is regulated by other signaling pathways, possibly including the planar cell polarity pathway. The cilium therefore represents a nexus for signaling pathways during development. The connections between cilia and developmental signaling have begun to clarify the basis of human diseases associated with ciliary dysfunction.

Goetz, Sarah C.

2011-01-01

25

Teaching primary care in community health centers: addressing the workforce crisis for the underserved.  

PubMed

Universal coverage and multiple initiatives to improve health care delivery are crucial components of health care reform. However, the missing link has been a plan to rapidly address the primary care workforce crisis for the underserved. The authors propose a link between primary care graduate medical education and care for the underserved in community health centers, where expansion will be necessary for the anticipated increase in Medicaid and insured patients. This can be achieved by establishing primary care teaching health centers in expanded community health centers, which have established a patient-centered medical home practice environment. Residents would receive their final year of training in these centers, and then have the incentive of National Health Service Corps debt repayment if they subsequently practice in an underserved area. Primary care residents being trained in this setting would immediately increase the clinical capacity of community health centers and ultimately expand the primary care physician workforce. This proposal addresses the primary care physician workforce crisis and the associated key problems of limited access for the underserved and suboptimal primary care graduate medical education. PMID:20008743

Rieselbach, Richard E; Crouse, Byron J; Frohna, John G

2009-12-14

26

Primary Cardiac Tumours: A Single-Center 41-Year Experience  

PubMed Central

Primary cardiac tumours are extremely rare with the most commonest being left atrial myxomas. In general, surgical resection is indicated, whenever the tumour formation is mobile and embolization can be suspected. Within 17280 patients receiving heart surgery at the Innsbruck Medical University, 78 patients (0.45%) underwent tumourectomy of primary cardiac tumours. The majority of patients (63) suffered from a left or right atrial myxoma, 12 showed a papillary fibroelastoma of the valves at echocardiographical or histological examination, 1 suffered from a hemangioma, 1 from a chemodectoma, and another one from a rhabdomyosarcoma. The mean age of cardiac tumour patients was 54.29?±?13.28 years (ranging from 18 to 83 years). 67.95% of the patients were female and 32.05% were male. The majority of tumours were found incidentally; 97.44% of the patients showed no tumour recurrence.

Steger, Christina Maria; Hager, Thomas; Ruttmann, Elfriede

2012-01-01

27

Nurse Managed Center: Access to Primary Health Care for Urban Native Americans  

Microsoft Academic Search

Urban Native Americans represent a small, diverse minority with unique health needs. The purposes of this descriptive retrospective study were to describe (a) the characteristics and primary health problems of urban Native Americans who receive primary health care at an urban nurse managed center (NMC) and (b) the nursing interventions provided at an urban NMC to urban Native Americans. A

Donna Felber Neff; Elizabeth S. Kinion; Christen Cardina

2007-01-01

28

Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis  

ERIC Educational Resources Information Center

Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

2011-01-01

29

Study to Determine Patient Preferences for Primary Care at Dwight David Eisenhower Army Medical Center.  

National Technical Information Service (NTIS)

This study was done to determine patient preferences for primary care at Dwight David Eisenhower Army Medical Center, Fort Gordon, GA. The author concluded by stating several facts to improve the operation; Patients would like a choice in their primary ca...

K. J. Johnson

1986-01-01

30

A practice-centered intervention to increase screening for domestic violence in primary care practices  

Microsoft Academic Search

BACKGROUND: Interventions to change practice patterns among health care professionals have had mixed success. We tested the effectiveness of a practice centered intervention to increase screening for domestic violence in primary care practices. METHODS: A multifaceted intervention was conducted among primary care practice in North Carolina. All practices designated two individuals to serve as domestic violence resources persons, underwent initial

Denise E Bonds; Shellie D Ellis; Shana L Palla; Peter Lichstein

2006-01-01

31

Regulation of embryonic endochondral ossification by Smurf2.  

PubMed

Smurf2 is an E3 ubiquitin ligase that targets TGF-beta receptor activated Smad2 and Smad3 for the proteasome in primary articular chondrocytes, thus stimulating their hypertrophic differentiation. Comparatively, how Smurf2 functions in growth plate chondrocytes in a developing long bone is an open question. In this study, we measured the mRNA levels of endogenous Smurf2 and type X collagen in chick growth plate at different embryonic stages to monitor the correlation between the level of Smurf2 expression and chondrocyte maturational stage. We found that high levels of Smurf2 were associated with the differentiative and proliferative stages, while Smurf2 levels were thereafter decreased as the chondrocytes matured toward hypertrophy. In addition, we injected Smurf2-RCAS into chick wing buds at HH stage 20-23 and examined how the ectopic overexpression of Smurf2 in condensing chondrogenic mesenchyme affects the subsequent process of chondrocyte maturation and ossification during embryonic development. Histological analysis showed that overexpression of Smurf2 in a developing wing bud accelerated chondrocyte maturation and endochondral ossification, which may result from a decrease in TGF-beta signaling in the infected chondrocytes with Smurf2-RCAS. PMID:18176945

Wu, Qiuqian; Wang, Meina; Zuscik, Michael J; Chen, Di; O'Keefe, Regis J; Rosier, Randy N

2008-05-01

32

Contribution of the anterior longitudinal ligament to ossification and growth of the vertebral body: an immunohistochemical study using the human fetal lumbar vertebrae  

Microsoft Academic Search

Using 15 mid-term human fetuses, we examined the role of the spine anterior and posterior longitudinal ligaments (ALL, PLL)\\u000a in ossification of the lumbar vertebral body. By 18 weeks, a pair of calcified tissue or cortical walls had developed on the\\u000a anterior and posterior sides of the ossification center. These calcified cortical walls were more highly eosinophilic than\\u000a trabecular or woven

Zhe Wu Jin; Kyung Jin Song; Nae Ho Lee; Takuo Nakamura; Mineko Fujimiya; Gen Murakami; Baik Hwan Cho

2011-01-01

33

Giant cranionasal and cystic-solid craniopharyngioma associated with extensive bone erosion and ossification.  

PubMed

Craniopharyngioma (CP), a rare benign and slow-growing epithelial tumor, is mainly located within the sellar/parasellar region. Primary CP involving the nasal cavity and the sellar region with extensive erosion of the skull base and ossification simultaneity has not been described previously. The authors report a 23-year-old man who presented to our institute with complaints of repeated nasal cavity bloodshed, liquid flow, and progressive visual loss. A neuroimaging examination showed a giant cranionasal and cystic-solid CP extending from the suprasellar region to the nasopharynx with inhomogeneous enhancement, which is associated with extensive erosion of the skull base and ossification. The patient underwent a transsphenoidal surgery to resect the nasopharyngeal component of CP and a subfrontal craniotomy with a total removal of intracranial component by grinding 3 months later. A histopathologic examination revealed characteristic features of adamantinomatous CP associated with ossification. The current study demonstrates that CP can exhibit cranionasal growth pattern and arise from residue of craniopharyngeal duct. Extensive erosion of the skull base, calcification, and ossification can present in tumor simultaneity. A 2-stage stratagem is important for its total removal because of the peculiar hardness. Postsurgical course is unevenly and should be dealt with carefully. PMID:23851734

Chen, Haifeng; Zhou, Liangxue; Luo, Linli; Jiang, Su; Guo, Gang; You, Chao

2013-07-01

34

Quantitative Analyses of Pediatric Cervical Spine Ossification Patterns Using Computed Tomography  

PubMed Central

The objective of the present study was to quantify ossification processes of the human pediatric cervical spine. Computed tomography images were obtained from a high resolution scanner according to clinical protocols. Bone window images were used to identify the presence of the primary synchondroses of the atlas, axis, and C3 vertebrae in 101 children. Principles of logistic regression were used to determine probability distributions as a function of subject age for each synchondrosis for each vertebra. The mean and 95% upper and 95% lower confidence intervals are given for each dataset delineating probability curves. Posterior ossifications preceded bilateral anterior closures of the synchondroses in all vertebrae. However, ossifications occurred at different ages. Logistic regression results for closures of different synchondrosis indicated p-values of <0.001 for the atlas, ranging from 0.002 to <0.001 for the axis, and 0.021 to 0.005 for the C3 vertebra. Fifty percent probability of three, two, and one synchondroses occurred at 2.53, 6.97, and 7.57 years of age for the atlas; 3.59, 4.74, and 5.7 years of age for the axis; and 1.28, 2.22, and 3.17 years of age for the third cervical vertebrae, respectively. Ossifications occurring at different ages indicate non-uniform maturations of bone growth/strength. They provide an anatomical rationale to reexamine dummies, scaling processes, and injury metrics for improved understanding of pediatric neck injuries

Yoganandan, Narayan; Pintar, Frank A.; Lew, Sean M.; Rao, Raj D.; Rangarajan, Nagarajan

2011-01-01

35

Primary Health Care in Community Health Centers and Comparison with Office-Based Practice  

Microsoft Academic Search

We examine the roles of nurse practitioners (NPs), physician assistants (PAs), and nurse midwives (CNMs) in community health\\u000a centers (CHCs). We also compare primary care physicians in CHCs with office-based physicians. Estimates are from the National\\u000a Ambulatory Medical Care Survey, a nationally representative annual survey of nonfederal, office-based patient care physicians\\u000a and their visits. Analysis of primary care delivery in

Esther HingRoderick; Roderick S. Hooker; Jill J. Ashman

2011-01-01

36

Heterotopic ossification of the abdominal wall  

PubMed Central

INTRODUCTION Heterotopic ossification is a rare, benign condition which occurs when bone develops in tissues that do not normally ossify. PRESENTATION OF CASE We herein report the case of a 73-year-old gentleman who underwent a laparotomy for a large splenic flexure tumour considered unresectable at initial intervention. Following delivery of chemotherapy, he was referred for a second opinion and the tumour with adjacent structures was removed at a subsequent laparotomy. A segment of abnormal hard tissue present in the abdominal wall was also excised. Histopathology revealed metaplastic bone deposition. DISCUSSION Heterotopic ossification may occur at various sites and is a recognised but exceedingly infrequent sequela of abdominal surgery. CONCLUSION This case highlights clinical, aetiological and histopathological features of this rare finding.

Hogan, Niamh M.; Caffrey, Emer; Curran, Stephanie; Sheehan, Margaret; Joyce, Myles R.

2012-01-01

37

Florid bronchial cartilage ossification: a case report with literature revisited.  

PubMed

Pulmonary ossification is a rare phenomenon which has been observed in the lungs of patients with chronic obstructive pulmonary disease, pulmonary fibrosis, and tuberculosis. It has also been observed as a part of aging process. Approximately 130 cases of pulmonary ossification have been reported in literature so far. We report here an unusual autopsy case of bone and bone marrow metaplasia in the bronchial wall and discuss theories related to the development of metaplastic ossification. PMID:23629403

Desai, Heena Maulek; Amonkar, Gayathri Prashant

2013-06-01

38

Effect of arsenic in endochondral ossification of experimental animals.  

PubMed

Arsenic (As) toxicity is a global health problem affecting millions of people, the most toxic forms being Arsenites [As(III)] and Arsenates [As(V)]. Arsenic intoxication can occur through different exposure routes. The aim of the present work was to determine the effect of As on endochondral ossification and bone remodeling in experimental animals, by means of biochemical, histologic, and histomorphometric determinations. Sixteen male Wistar rats, 100g body weight (b.w.), were divided into two groups: experimental group (n=8), treated with 10mg/l of NaAsO(2) in their drinking water, receiving 0.21mg/kgb.w./day during 45 days; and control group (n=8) remained untreated. On day 45, blood samples were obtained by cardiac puncture to perform hematologic blood counts and biochemical determination. The animals were killed, the tibiae, femurs, kidneys and livers were resected, fixed in formalin and processed histologically. Tibia and femur sections were obtained and stained with H&E. The following histomorphometric parameters were determined on tibia and femur sections: bone volume (BV/TV), thickness of growth plate cartilage (GPC.Th) and thickness of hypertrophic zone (HpZ.Th). Biochemical determinations showed that experimental animals exhibited neutrophilia and a decrease in lymphocytes and monocytes. As levels were below 1 microg/dl in both groups. The femur sections of the experimental group showed (1) a statistically significant increase in total growth cartilage plate thickness (p<0.05) at the expense of the hypertrophic zone (p<0.05); (2) subchondral trabecular bone sealed to the growth plate with a non-significant increase in primary spongiosa bone volume. These results suggest that As alters endochondral ossification. PMID:19447590

Odstrcil, Ana Del Carmen Aybar; Carino, Silvia Norma; Ricci, Juan Carlos Diaz; Mandalunis, Patricia Mónica

2009-05-17

39

Primary Diffuse Large B-Cell Lymphoma of the Oral Cavity: Germinal Center Classification  

Microsoft Academic Search

Primary lymphomas of the oral cavity are rare and the most frequent type is diffuse large B-cell lymphoma (DLBCL). Recently,\\u000a several reports have highlighted the value of classifying DLBCL into prognostically important subgroups, namely germinal center\\u000a B-cell like (GCB) and non-germinal center B-cell like (non-GCB) lymphomas based on gene expression profiles and by immunohistochemical\\u000a expression of CD10, BCL6 and MUM-1.

Indraneel BhattacharyyaHardeep; Hardeep K. Chehal; Donald M. Cohen; Samer Z. Al-Quran

2010-01-01

40

Thoracic spinal cord compression by ligamentum flavum ossifications  

Microsoft Academic Search

Thoracic Spinal Cord Compression by Ligamentum Flavum Ossifications. Ossification of the ligamentum flavum is common in Japan but rare in Western countries. Myelopathy of variable severity is a possible complication. Extension of the lesions over several levels at the thoracic spine is exceedingly rare.  We report a new case in a 50-year-old man who had slowly progressive spinal cord compression

Ali Akhaddar; Abdelaziz Mansouri; Ibtissame Zrara; Miloudi Gazzaz; Mohamed Maftah; Brahim Mostarchid; Said Benomar; Mohamed Boucetta

2002-01-01

41

Hemifacial mass with extensive intralesional ossification and fat  

PubMed Central

The imaging appearance of neurofibromas is well described; however, macroscopic fat in a neurofibroma has been sparsely reported and intralesional ossification has only been documented twice in the literature. We describe a diffuse neurofibroma presenting as a hemifacial mass, atypical for the presence of extensive intralesional ossification and fat; the diagnosis was suggested on identification of other associated radiological features of neurofibromatosis.

Dua, S G; Kulkarni, A V; Kulkarni, S S; Shetty, N S; Shet, T

2012-01-01

42

Aspirin Decreases Heterotopic Ossification After Hip Resurfacing  

Microsoft Academic Search

Background  Heterotopic ossification (HO) is a concern for patients undergoing hip surgery, especially surface replacement arthroplasty\\u000a (SRA) who tend to be younger, more active, and anticipate good motion. It is unclear, however, whether HO occurs more frequently\\u000a after SRA than traditional total hip arthroplasty (THA) and whether aspirin influences the risk.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore determined the incidence of HO after hip resurfacing

Ryan M. Nunley; Jinjun Zhu; John C. Clohisy; Robert L. Barrack

2011-01-01

43

Animal Models of Typical Heterotopic Ossification  

PubMed Central

Heterotopic ossification (HO) is the formation of marrow-containing bone outside of the normal skeleton. Acquired HO following traumatic events is a common and costly clinical complication. In contrast, hereditary HO is rarer, progressive, and life-threatening. Substantial effort has been directed towards understanding the mechanisms underlying HO and finding efficient treatments. However, one crucial limiting factor has been the lack of relevant animal models. This article reviews the major currently available animal models, summarizes some of the insights gained from these studies, and discusses the potential future challenges and directions in HO research.

Kan, Lixin; Kessler, John A.

2011-01-01

44

Determinants of heterotopic ossification after total hip replacement surgery.  

PubMed

The ability of various pre- or peri-operative variables to determine the risk of developing moderate to severe heterotopic ossification (HO) six to twelve months after surgery was investigated among 407 patients undergoing elective total hip replacement (THR) surgery and allocated to placebo in a randomised controlled trial evaluating NSA IDs-based prophylaxis for HO. Overall, 11 (30%) of the 37 patients undergoing revision surgery developed moderate to severe HO compared with 58 (16%) of the 370 patients undergoing primary THR; odds ratio (OR) 2.3, 95% confidence interval (CI) 1.1 to 4.9. Among patients undergoing primary THR , mutually adjusted analysis of collected independent risk factors demonstrated that receiving a transfusion of red cells or having general as well as epidural or spinal anaesthesia present as indicators of increased risk for developing moderate to severe HO. Patients who have undergone revision surgery have a significantly increased risk of clinically relevant ectopic bone, while among patients who have undergone primary THR surgery, those with indicators of excessive surgical bleeding are also at increased risk of clinically relevant HO. PMID:19455501

Fransen, Marlene; Neal, Bruce; Cameron, Ian D; Crawford, Ross; Tregonning, Garnet; Winstanley, Julie; Norton, Robyn

45

The Role of Matrix Gla Protein in Ossification and Recovery of the Avian Growth Plate  

PubMed Central

Extracellular matrix mineralization is an essential physiologic process in bone, teeth, and hypertrophic cartilage. Matrix Gla protein (MGP), an inhibitor of mineralization, is expressed by chondrocytes and vascular smooth muscle cells to inhibit calcification of those soft tissues. Tibial dyschondroplasia (TD), a skeletal abnormality apparent as a plug of non-vascularized, non-mineralized, white opaque cartilage in the tibial growth plate of avian species can serve as a good model for studying process and genes involved in matrix mineralization and calcification. In this work, we studied the involvement of MGP in the development of TD, as well as in the processes of spontaneous and induced recovery from this syndrome. First, we found that during normal bone development, MGP is expressed in specific time and locations, starting from wide-spread expression in the yet un-ossified diaphysis during embryonic development, to specific expression in hypertrophic chondrocytes adjacent to the chondro-osseous junction and the secondary ossification center just prior to calcification. In addition, we show that MGP is not expressed in the impaired TD lesion, however when the lesion begins to heal, it strongly express MGP prior to its calcification. Moreover, we show that when calcification is inhibited, a gap is formed between the expression zones of MGP and BMP2 and that this gap is closed during the healing process. To conclude, we suggest that MGP, directly or through interaction with BMP2, plays a role as ossification regulator that acts prior to ossification, rather then simple inhibitor.

Dan, Harel; Simsa-Maziel, Stav; Reich, Adi; Sela-Donenfeld, Dalit; Monsonego-Ornan, Efrat

2012-01-01

46

ADAM17 controls endochondral ossification by regulating terminal differentiation of chondrocytes.  

PubMed

Endochondral ossification is a highly regulated process that relies on properly orchestrated cell-cell interactions in the developing growth plate. This study is focused on understanding the role of a crucial regulator of cell-cell interactions, the membrane-anchored metalloproteinase ADAM17, in endochondral ossification. ADAM17 releases growth factors, cytokines, and other membrane proteins from cells and is essential for epidermal growth factor receptor (EGFR) signaling and for processing tumor necrosis factor alpha. Here, we report that mice lacking ADAM17 in chondrocytes (A17?Ch) have a significantly expanded zone of hypertrophic chondrocytes in the growth plate and retarded growth of long bones. This abnormality is caused by an accumulation of the most terminally differentiated type of chondrocytes that produces a calcified matrix. Inactivation of ADAM17 in osteoclasts or endothelial cells does not affect the zone of hypertrophic chondrocytes, suggesting that the main role of ADAM17 in the growth plate is in chondrocytes. This notion is further supported by in vitro experiments showing enhanced hypertrophic differentiation of primary chondrocytes lacking Adam17. The enlarged zone of hypertrophic chondrocytes in A17?Ch mice resembles that described in mice with mutant EGFR signaling or lack of its ligand transforming growth factor ? (TGF?), suggesting that ADAM17 regulates terminal differentiation of chondrocytes during endochondral ossification by activating the TGF?/EGFR signaling axis. PMID:23732913

Hall, Katherine C; Hill, Daniel; Otero, Miguel; Plumb, Darren A; Froemel, Dara; Dragomir, Cecilia L; Maretzky, Thorsten; Boskey, Adele; Crawford, Howard C; Selleri, Licia; Goldring, Mary B; Blobel, Carl P

2013-06-03

47

Improving patient experience by transforming primary care: evidence from Geisinger's patient-centered medical homes.  

PubMed

Patient-centered medical homes (PCMHs) have the potential to improve patient experience of care. Since 2006, Geisinger Health System has implemented its own version of an advanced PCMH model, referred to as ProvenHealth Navigator (PHN). To evaluate the impact of PHN on patient experience of care, the authors conducted a survey of patients whose primary care clinics had been transformed to "PHN sites" and were under case management at the time of the survey. A comparable survey of patients from non-PHN sites also was conducted for comparison. The results suggest that patients in PHN sites were significantly more likely to report positive changes in their care experience and quality; moreover, they were more likely to cite the physician's office as their usual source of care rather than the emergency room (83% vs. 68% for physician's office; 11% vs. 23% for emergency room). However, the results also suggest that there was no significant difference between PHN and non-PHN patients in their perceptions of access to care or primary care physician performance in terms of patient-centered care (eg, listening, explaining, involving patients in decision making). These findings are consistent with the expectation that transformation of primary care into PCMH can lead to improved patient experience of care. PMID:23405878

Maeng, Daniel D; Davis, Duane E; Tomcavage, Janet; Graf, Thomas R; Procopio, Kristen M

2013-02-13

48

Health Hazard Evaluation Report HETA 87-130-1790, Primary Childrens Medical Center, Salt Lake City, Utah.  

National Technical Information Service (NTIS)

An evaluation of exposures to halothane (151677) and isoflurane (26675467) in the operating rooms at Primary Childrens Medical Center (SIC-8070), Salt Lake City, Utah, was conducted in response to a request from management. Operating rooms and the recover...

B. J. Gunter W. J. Daniels

1987-01-01

49

[Periarticular heterotopic ossification secondary to central neurogenic dysfunction].  

PubMed

A case of a 48 year old woman with a medical background of tetraparesis related to a right lobectomy and periarticular ossification development (that included both knee joints) is presented. Bone scintigraphy was performed to evaluate the metabolism of the bone lesions. The scintigraphic pattern showed an important involvement of the medial and lateral left knee and medial right knee compartments, initially attributed to degenerative osteoarthritis. We believe that the presentation of this case report is interesting for two reasons: 1) the rareness of knee involvement in periarticular heterotopic ossification related to cerebral dysfunction, and 2) the possibility of a false positive diagnosis: osteoarthritic involvement versus juxta-articular ossification. This paper reviews the role of diagnostic imaging methods in the assessment of periarticular heterotopic ossification and the differential scintigraphic diagnosis regarding to osteoarticular disorders (more frequent among the general population). PMID:11171507

Ruiz Hernández, G; Mínguez Rey, M F; Gomar Sancho, F; Balaguer Martínez, J V; Castillo Pallarés, F J

2000-12-01

50

Isolation of novel mouse genes associated with ectopic ossification by differential display method using ttw, a mouse model for ectopic ossification  

Microsoft Academic Search

Mouse mutant ttw (tiptoe walking) is an excellent model for ectopic ossification. This mutant exhibits ossification in various soft tissues, which is histologically similar to human OPLL (ossification of posterior longitudinal ligament of the spine). We previously reported that ttw is caused by a nonsense mutation of the nucleotide pyrophosphatase (ENPP1) gene, and that a polymorphism of the human ENPP1

Y. Koshizuka; S. Ikegawa; M. Sano; K. Nakamura; Y. Nakamura

2001-01-01

51

Arginine methyltransferase CARM1\\/PRMT4 regulates endochondral ossification  

Microsoft Academic Search

BACKGROUND: Chondrogenesis and subsequent endochondral ossification are processes tightly regulated by the transcription factor Sox9 (SRY-related high mobility group-Box gene 9), but molecular mechanisms underlying this activity remain unclear. Here we report that coactivator-associated arginine methyltransferase 1 (CARM1) regulates chondrocyte proliferation via arginine methylation of Sox9. RESULTS: CARM1-null mice display delayed endochondral ossification and decreased chondrocyte proliferation. Conversely, cartilage development

Tatsuo Ito; Neelu Yadav; Jaeho Lee; Takayuki Furumatsu; Satoshi Yamashita; Kenji Yoshida; Noboru Taniguchi; Megumi Hashimoto; Megumi Tsuchiya; Toshifumi Ozaki; Martin Lotz; Mark T Bedford; Hiroshi Asahara

2009-01-01

52

Primary light-energy conversion in tetrameric chlorophyll structure of photosystem II and bacterial reaction centers: I. A review  

Microsoft Academic Search

The purpose of the review is to show that the tetrameric (bacterio)chlorophyll ((B)Chl) structures in reaction centers of\\u000a photosystem II (PSII) of green plants and in bacterial reaction centers (BRCs) are similar and play a key role in the primary\\u000a charge separation. The Stark effect measurements on PSII reaction centers have revealed an increased dipole moment for the\\u000a transition at

Ravil A. Khatypov; Anton Yu. Khmelnitskiy; Maria M. Leonova; Lyudmila G. Vasilieva; Vladimir A. Shuvalov

2008-01-01

53

Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine  

Microsoft Academic Search

Direct removal of the ossified mass via anterior approach carries good decompression to ossification of the posterior longitudinal\\u000a ligament (OPLL) in the cervical spine. Ossification occasionally involves not only the posterior longitudinal ligament but\\u000a also the underlying dura mater, which increased the opportunity of the cerebrospinal fluid (CSF) leakage or neurological damage.\\u000a The surgeon was required to recognize the dural

Yu Chen; Yongfei Guo; Deyu Chen; Xuhua Lu; Xinwei Wang; Haijun Tian; Wen Yuan

2009-01-01

54

Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum  

Microsoft Academic Search

Study design:Case report.Objectives:To report a case with thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF), in which postoperative paralysis occurred after laminectomy and was reversed after an additional posterior instrumented fusion.Setting:A University Hospital in Japan.Case report:A 71-year-old woman, with a spastic palsy of both lower extremities, had OPLL and OLF

M Yamazaki; M Koda; A Okawa; A Aiba

2006-01-01

55

The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.  

PubMed Central

The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increase the knowledge base necessary for developing and evaluating effective preventive interventions. During 1989, CDC, in consultation with the National Council on Disabilities and members of the disability community, has elected to focus its effort in three areas: developmental disabilities, injuries to the head and spinal cord, and secondary complications among persons with physical disabilities.

Houk, V N; Thacker, S B

1989-01-01

56

Carcinoid tumor of the lung with massive ossification: report of a case showing the evidence of osteomimicry and review of the literature  

PubMed Central

Carcinoid tumor is one of the commonly encountered primary pulmonary neoplasms. Although it has been known to be accompanied by calcification and/or ossification, presentation with a large ossified mass is rare. We describe here the case of a 29-year-old female with the radiological finding of a single bony nodular lesion. Pathological examination of the surgically resected specimen led to the diagnosis of carcinoid tumor of the lung with massive ossification. Although histological features showed the tumor of low grade malignancy, subcarinal and right hilar lymph nodes were found to be positive for metastasis. Further immunohistochemical analysis revealed that the tumor cells expressed the osteogenic inducer protein, bone morphogenic protrein-2 [BMP-2] and osteoblastic marker protein, osteocalcin. We interpreted this to mean that the carcinoid tumor cells had acquired an osteoblastic phenotype and had subsequently developed marked intratumoral ossification. The relevant literature is reviewed and possible mechanisms of tumor-related osteogenesis are discussed.

Tsubochi, Hiroyoshi; Endo, Shunsuke; Oda, Yoshinao; Dobashi, Yoh

2013-01-01

57

Carcinoid tumor of the lung with massive ossification: report of a case showing the evidence of osteomimicry and review of the literature.  

PubMed

Carcinoid tumor is one of the commonly encountered primary pulmonary neoplasms. Although it has been known to be accompanied by calcification and/or ossification, presentation with a large ossified mass is rare. We describe here the case of a 29-year-old female with the radiological finding of a single bony nodular lesion. Pathological examination of the surgically resected specimen led to the diagnosis of carcinoid tumor of the lung with massive ossification. Although histological features showed the tumor of low grade malignancy, subcarinal and right hilar lymph nodes were found to be positive for metastasis. Further immunohistochemical analysis revealed that the tumor cells expressed the osteogenic inducer protein, bone morphogenic protrein-2 [BMP-2] and osteoblastic marker protein, osteocalcin. We interpreted this to mean that the carcinoid tumor cells had acquired an osteoblastic phenotype and had subsequently developed marked intratumoral ossification. The relevant literature is reviewed and possible mechanisms of tumor-related osteogenesis are discussed. PMID:23638230

Tsubochi, Hiroyoshi; Endo, Shunsuke; Oda, Yoshinao; Dobashi, Yoh

2013-04-15

58

"Dot COM", a Nuclear Transit Center for the Primary piRNA Pathway in Drosophila.  

PubMed

The piRNA pathway protects genomes by silencing mobile elements. Despite advances in understanding the processing events that generate piRNAs for silencing, little is known about how primary transcripts are transported from their genomic clusters to their processing centers. Using a model of the Drosophila COM/flamenco locus in ovarian somatic cells, we identified a prominent nuclear structure called Dot COM, which is enriched in long transcripts from piRNA clusters but located far from their transcription sites. Remarkably, transcripts from multiple clusters accumulate at Dot COM, which is often juxtaposed with Yb-bodies, the cytoplasmic processing centers for cluster transcripts. Genetic evidence suggests that the accumulation of precursor transcripts at Dot COM represents one of the most upstream events in the piRNA pathway. Our results provide new insights into the initial steps of the piRNA pathway, and open up a new research area important for a complete understanding of this conserved pathway. PMID:24039799

Dennis, Cynthia; Zanni, Vanessa; Brasset, Emilie; Eymery, Angeline; Zhang, Liang; Mteirek, Rana; Jensen, Silke; Rong, Yikang S; Vaury, Chantal

2013-09-09

59

PREVALENCE OF OBESITY AMONG TYPE 2 DIABETIC PATIENTS IN AL-KHOBAR PRIMARY HEALTH CARE CENTERS  

PubMed Central

Objectives: This study estimates the prevalence of obesity among Type 2 diabetic patients who are followed in mini clinics (hypertension, diabetes) in Primary Health Care Centers (PHCC) in Al-Khobar. Methods: Retrospective study reviewing all diabetic patient files registered in PHC centers in the Al- Khobar area from May 2000 to October 2001. Results: Of the 382 diabetic patients followed in PHC, 88.7% were type 2 diabetics, and according to WHO classification of obesity 0.7% were underweight. Only 21.8% of type 2 diabetic patients were in their ideal range of body weight. While 31.2% were overweight (BMI in the range of 25.0-29.9 kg/m2), 39.9% of the type 2 diabetic patients were found to be obese (BMI= 30 - 39.9 kg / m2), and 6.3% had morbid obesity (BMI ? 40 kg / m2). Conclusion: High prevalence of overweight and obesity in type 2 diabetics is associated with other serious complications. This study emphasizes the importance of training health care providers for the proper follow-up of patients.

Mugharbel, Kholood M.; Al-Mansouri, Mowaffaq A.

2003-01-01

60

Caste-specific postembryonic development of primary and secondary olfactory centers in the female honeybee brain.  

PubMed

Eusocial insects are characterized by division of labor among a sterile worker caste and a reproductive queen. In the honeybee both female castes are determined postembryonically by environmental factors, and queens develop substantially faster than workers. Since olfaction plays a crucial role in organizing honeybee behavior and social interactions, we compared the development of primary and secondary olfactory centers in the brain. Age-synchronized queen and worker pupae were raised in incubators at 34.5 degrees C, and their external morphology was characterized for all pupal stages. The development of olfactory synaptic neuropil was analyzed using anti-synapsin immunocytochemistry, f-actin-phalloidin labeling and confocal microscopy. In the antennal lobes of queens olfactory glomeruli formed approximately 4 days earlier than in workers. The adult number of olfactory glomeruli was in a similar range, but the total glomerular volume was slightly smaller in queens. Olfactory and visual subdivisions (lip, collar) of the mushroom-body calyx formed early, whereas the basal ring separated late. Synaptic microglomeruli in the olfactory lip were established approximately 3-4 days earlier in queens compared to workers. We propose that developmental heterochrony results in fewer synapses in olfactory centers (smaller glomeruli, fewer microglomeruli) in queens, which may result in poorer performance on olfactory learning tasks compared to workers. PMID:18621587

Groh, Claudia; Rössler, Wolfgang

2008-05-07

61

A practice-centered intervention to increase screening for domestic violence in primary care practices  

PubMed Central

Background Interventions to change practice patterns among health care professionals have had mixed success. We tested the effectiveness of a practice centered intervention to increase screening for domestic violence in primary care practices. Methods A multifaceted intervention was conducted among primary care practice in North Carolina. All practices designated two individuals to serve as domestic violence resources persons, underwent initial training on screening for domestic violence, and participated in 3 lunch and learn sessions. Within this framework, practices selected the screening instrument, patient educational material, and content best suited for their environment. Effectiveness was evaluated using a pre/post cross-sectional telephone survey of a random selection of female patients from each practice. Results Seventeen practices were recruited and fifteen completed the study. Baseline screening for domestic violence was 16% with a range of 2% to 49%. An absolute increase in screening of 10% was achieved (range of increase 0 to 22%). After controlling for clustering by practice and other patient characteristics, female patients were 79% more likely to have been screened after the intervention (OR 1.79, 95% CI 1.43–2.23). Conclusion An intervention that allowed practices to tailor certain aspects to fit their needs increased screening for domestic violence. Further studies testing this technique using other outcomes are needed.

Bonds, Denise E; Ellis, Shellie D; Weeks, Erin; Palla, Shana L; Lichstein, Peter

2006-01-01

62

Carminerin contributes to chondrocyte calcification during endochondral ossification.  

PubMed

Endochondral ossification is an essential process not only for physiological skeletal development and growth, but also for pathological disorders. We recently identified a novel cartilage-specific molecule, carminerin (also known as cystatin 10 and encoded by Cst10), which is upregulated in synchrony with cartilage maturation and stimulates the later differentiation of cultured chondrocytes. Although carminerin-deficient (Cst10-/-) mice developed and grew normally, they had a microscopic decrease in the calcification of hypertrophic chondrocytes at the growth plate. When we created experimental models of pathological endochondral ossification, we observed suppression of chondrocyte calcification during formation of osteoarthritic osteophytes, age-related ectopic ossification and healing of bone fractures in Cst10-/- mice. Cultured Cst10-/- chondrocytes showed a reduction in calcification with activation of an SRY site in the promoter of the gene encoding nucleotide pyrophosphatase phosphodiesterase 1 (NPP1, encoded by Enpp1). Functional NPP1 is required for carminerin deficiency to suppress the pathological endochondral ossifications listed above. Carminerin is the first cartilage-specific protein that contributes to chondrocyte calcification during endochondral ossification under physiological and pathological conditions through the transcriptional inhibition of NPP1. PMID:16680148

Yamada, Takashi; Kawano, Hirotaka; Koshizuka, Yu; Fukuda, Toru; Yoshimura, Kimihiro; Kamekura, Satoru; Saito, Taku; Ikeda, Toshiyuki; Kawasaki, Yosuke; Azuma, Yoshiaki; Ikegawa, Shiro; Hoshi, Kazuto; Chung, Ung-il; Nakamura, Kozo; Kato, Shigeaki; Kawaguchi, Hiroshi

2006-05-07

63

Primary charge separation and energy transfer in the photosystem I reaction center of higher plants  

SciTech Connect

Using low intensity femtosecond duration laser pulses at 708 nm, we have observed absorption transients associated with electron transfer through the primary electron acceptor A{sub 0} in the photosystem I (PSI) reaction center from spinach under nonreducing conditions. At this wavelength the electron donor P{sub 700} is excited directly, although some antenna chlorophylls are also excited. Using a nanosecond duration preflash of 690 nm to oxidize P{sub 700}, and then measuring the absorption transients from the antenna alone, it is possible by subtraction to isolate the absorption transients arising from electron transfer. We discuss this method critically. Th spectrum of A{sub 0}{sup -}-A{sub 0} does not appear promptly but takes nearly 3 ps to reach maximum intensity and resembles those spectra previously obtained from higher plants, with a maximum bleaching at 685{+-}2 nm and a shoulder in the region 670-675 nm. The decay time of the primary radical pair P{sub 700}{sup +}A{sub 0}{sup -} is calculated as 20 ps. Analysis of absorption transients indicates that the intrinsic rate constant forming the primary radical pair P{sub 700}{sup +}A{sub 0}{sup -} cannot be measured directly because energy migration in the antenna is fast and quenching is approaching `trap limited` behavior. With use of a detailed model of the antenna energy migration based on the X-ray structure, the intrinsic rate constant for electron transfer is estimated as k{sub 1} nearly equals 0.7 ps{sup -1}. 81 refs., 15 figs., 1 tab.

White, N.T.H.; Beddard, G.S.; Thorne J.R.G.; Feehan, T.M.; Keyes, T.E. [Univ. of Manchester (United Kingdom); Heathcote, P. [Queen Mary and Westfield College, London (United Kingdom)

1996-07-18

64

Proton Displacements Coupled to Primary Electron Transfer in the Rhodobacter sphaeroides Reaction Center.  

PubMed

Using first-principles molecular dynamics (AIMD) and constrained density functional theory (CDFT) we identify the pathway of primary electron transfer in the R. Sphaeroides reaction center from the special pair excited state (P*) to the accessory bacteriochlorophyll (BA). Previous AIMD simulations on the special pair (PLPM) predicted a charge-transfer intermediate formation through the excited-state relaxation along a reaction coordinate characterized by the rotation of an axial histidine (HisM202). To account for the full electron transfer we extend the model to include the primary acceptor BA. In this extended model, the LUMO is primarily localized on the acceptor BA and extends over an interstitial water (water A) that is known to influence the rate of electron transfer (Potter et al. Biochemistry 2005 280, 27155-27164). A vibrational analysis of the dynamical trajectories gives a frequency of 30-35 cm(-1) for a molecular motion involving the hydrogen-bond network around water A, in good agreement with experimental findings (Yakovlev et al. Biochemistry, 2003, 68, 603-610). In its binding pocket water A can act as a switch by breaking and forming hydrogen bonds. With CDFT we calculate the energy required to the formation of the charge-separated state and find it to decrease along the predicted anisotropic reaction coordinate. Furthermore, we observe an increased coupling between the ground and charge-separated state. Water A adapts its hydrogen-bonding network along this reaction coordinate and weakens the hydrogen bond with HisM202. We also present AIMD simulations on the radical cation (P(•+)) showing a weakening of the hydrogen bond between HisL168 and the 3(1)-acetyl of PL. This work demonstrates how proton displacements are crucially coupled to the primary electron transfer and characterizes the reaction coordinate of the initial photoproduct formation. PMID:23627338

Eisenmayer, Thomas J; Lasave, Jorge A; Monti, Adriano; de Groot, Huub J M; Buda, Francesco

2013-05-17

65

Could Ossification of the Achilles Tendon Have a Hereditary Component?  

PubMed Central

Ossification of the Achilles tendon (OTA) is an unusual clinical condition. It is characterized by the presence of an ossified mass within the fibrocartilaginous substance of the Achilles tendon. The etiology of the ossification of the Achilles tendon is unknown. Review of the literature suggests that its etiology is multifactorial. The major contributing factors are trauma and surgery with other minor causes such as systemic diseases, metabolic conditions, and infections. To our knowledge, no previous reports suggest any genetic/hereditary predisposition in OAT. We report 3 siblings who have OAT with no history of any of the aforementioned predisposing factors. Could OAT have a hereditary component as one of its etiologies?

Cortbaoui, Chawki

2013-01-01

66

Ossification of the posterior longitudinal ligament: a case report  

PubMed Central

Ossification of the posterior longitudinal ligament (OPLL) has recently been recognized as a clinical entity. It is a rare condition, having a higher incidence in the Japanese population. It is characterized by hyperplasia of cartilage cells with eventual endochondral ossification of the posterior longitudinal ligament. The radiographic signs are characteristic and consist of a linear band of ossified tissue along the posterior margin of the vertebral body. OPLL can be associated with mild to serious neurological complications due to spinal cord or nerve root compression, or it may be asymptomatic. This paper reviews the radiological, clinical and therapeutic aspects of this rare condition. ImagesFigures 1 and 2Figures 3 and 4

Aker, PD; O'Connor, SM; Mior, SA; Beauchemin, D

1989-01-01

67

Journey toward a Patient-Centered Medical Home: Readiness for Change in Primary Care Practices  

PubMed Central

Context: Information is limited regarding the readiness of primary care practices to make the transformational changes necessary to implement the patient-centered medical home (PCMH) model. Using comparative, qualitative data, we provide practical guidelines for assessing and increasing readiness for PCMH implementation. Methods: We used a comparative case study design to assess primary care practices' readiness for PCMH implementation in sixteen practices from twelve different physician organizations in Michigan. Two major components of organizational readiness, motivation and capability, were assessed. We interviewed eight practice teams with higher PCMH scores and eight with lower PCMH scores, along with the leaders of the physician organizations of these practices, yielding sixty-six semistructured interviews. Findings: The respondents from the higher and lower PCMH scoring practices reported different motivations and capabilities for pursuing PCMH. Their motivations pertained to the perceived value of PCMH, financial incentives, understanding of specific PCMH requirements, and overall commitment to change. Capabilities that were discussed included the time demands of implementation, the difficulty of changing patients' behavior, and the challenges of adopting health information technology. Enhancing the implementation of PCMH within practices included taking an incremental approach, using data, building a team and defining roles of its members, and meeting regularly to discuss the implementation. The respondents valued external organizational support, regardless of its source. Conclusions: The respondents from the higher and lower PCMH scoring practices commented on similar aspects of readiness—motivation and capability—but offered very different views of them. Our findings suggest the importance of understanding practice perceptions of the motivations for PCMH and the capability to undertake change. While this study identified some initial approaches that physician organizations and practices have used to prepare for practice redesign, we need much more information about their effectiveness.

Wise, Christopher G; Alexander, Jeffrey A; Green, Lee A; Cohen, Genna R; Koster, Christina R

2011-01-01

68

Electron spin polarization of the oxidized primary electron donor in reaction centers of photosynthetic purple bacteria  

SciTech Connect

Fast time-resolved EPR spectroscopy is used to study electron spin polarization (ESP) in perdeuterated native, Fe{sup 2+}-containing reaction centers (RCs) of photosynthetic purple bacteria. The spin-correlated radical pair-(SCRP) model previously used to simulate ESP observed in Fe-depleted RCs is extended to include the large anisotropy arising from the magnetic interactions between Fe{sup 2+} and the reduced primary electron-acceptor quinone (Q{sub A}{sup .-}), which results in different quantization axes from the P{sup .+} and the (Q{sub A}{sup .-}Fe{sup 2+}) spins. Using spectral simulations, it is shown that the ESP spectrum is solely due to the P{sup .+} part of the spin-correlated radical pair [P{sup .+}(Q{sub A}{sup .-}Fe{sup 2+})], whereas the rapid decay of the spin-polarized signal is due to spin-lattice relaxation of the (Q{sub A}{sup .-}Fe{sup 2+}) complex. The simulations are very sensitive to the relative orientation of the g matrices of P{sup .+} and (Q{sub A}{sup .-}Fe{sup 2+}). Using orientation II of the g matrix of the oxidized primary donor P{sup .+}, the orientation of the g matrix of (Q{sub A}{sup .-}Fe{sup 2+}) is assessed. Finally, it is shown that the ESP spectrum of perdeuterated native, Fe{sup 2+}-containing RCs of Rhodopseudomonas (Rps) viridis is virtually identical to the spectrum obtained for perdeuterated native Rhodobacter (Rb.) sphaeroides. 55 refs., 5 figs., 4 tabs.

Brink, J.S. van den; Gast, P.; Hoff, A.J. [Leiden Univ. (Netherlands); Hermolle, T.E.P.; Hore, P.J. [Physical and Theoretical Chemistry Lab., Oxford (United Kingdom)

1996-02-08

69

Outcomes after ischemic stroke for hospitals with and without Joint Commission-certified primary stroke centers  

PubMed Central

Background: The Joint Commission (JC) began certifying primary stroke centers (PSCs) in the United States in 2003. We assessed whether 30-day risk-standardized mortality (RSMR) and readmission (RSRR) rates differed between hospitals with and without JC-certified PSCs in 2006. Methods: The study cohort included all fee-for-service Medicare beneficiaries ?65 years old discharged with a primary diagnosis of ischemic stroke (International Classification of Diseases, ninth revision, Clinical Modification 433, 434, 436) in 2006. Hierarchical linear regression models calculated hospital-level RSMRs and RSRRs, adjusting for patient demographics, comorbid conditions, and hospital referral region. Hospitals were categorized as being higher than, no different from, or lower than the national average. Results: There were 310,381 ischemic stroke discharges from 315 JC-certified PSC and 4,231 noncertified hospitals. Mean overall 30-day RSMR and RSRR were 10.9% ± 1.7% and 12.5% ± 1.4%, respectively. The RSMRs of hospitals with JC-certified PSCs were lower than in noncertified hospitals (10.7% ± 1.7% vs 11.0% ± 1.7%), but the RSRRs were comparable (12.5% ± 1.3% vs 12.4% ± 1.7%). Almost half of JC-certified PSC hospitals had RSMRs lower than the national average compared with 19% of noncertified hospitals, but 13% of JC-certified PSC hospitals had lower RSRRs vs 15% of noncertified hospitals. Conclusions: Hospitals with JC-certified PSCs had lower RSMRs compared with noncertified hospitals in 2006; however, differences were small. Readmission rates were similar between the 2 groups. PSC certification generally identified better-performing hospitals for mortality outcomes, but some hospitals with certified PSCs may have high RSMRs and RSRRs whereas some hospitals without PSCs have low rates. Unmeasured factors may contribute to this heterogeneity.

Jones, S.B.; Wang, Y.; Watanabe, E.; Leifheit-Limson, E.; Goldstein, L.B.

2011-01-01

70

Primary central nervous system lymphoma in immunocompetent individuals: a single center experience  

PubMed Central

Primary central nervous system lymphoma (PCNSL) is defined as the involvement of brain, leptomeninges, eyes or spinal cord by non-Hodgkin lymphoma. The role of various prognostic markers in predicting adverse outcome is debated. Objectives: To investigate the clinical and immunohistochemical findings of immunocompetent PCNSL cases (39 cases) diagnosed at the study center, and evaluate the influence of potential prognostic factors on overall survival (OS) of patients. Methods: Data regarding patient characteristics, neuroimaging, pathological and immunohistochemical features and follow-up were obtained from patient records. The influence of potential prognostic parameters on OS was investigated by log-rank test and Cox regression analysis. Results: Patients who received combined chemotherapy and radiotherapy had a significantly better OS when compared to chemotherapy alone. Other variables included in this study were not associated with a significant survival advantage. Conclusion: In this study, we failed to demonstrate a relationship between different clinicopathological variables and OS of patients. Prospective studies with large patient series are needed to investigate other potential prognostic factors.

Aki, Hilal; Uzunaslan, Didem; Saygin, Caner; Batur, Sebnem; Tuzuner, Nukhet; Kafadar, Ali; Ongoren, Seniz; Oz, Buge

2013-01-01

71

Water access and attendance for diarrhea in primary health care centers, Gaza strip.  

PubMed

Water access and sanitation has worsened in Gaza strip since the conflict between Israel and Palestine in January 2009. This study aimed to investigate the relationship between attendance for diarrhea to a Primary Health Care Center (PHCC) in Gaza strip and several potential risk factors including water access. A matched case control study with prospective data record was performed. Cases were patients attending a PHCC for diarrhea, and controls were patients attending for any other cause with no diarrhea within the previous three months or since birth. We matched 133 cases and 133 controls, for date of inclusion, age, gender. All patients attended PHCC and were included in January/February 2010. A stool analysis for bacteria and parasites was performed for cases. Of the 266 patients, 62% (166) have to buy water from a private provider. In multivariate analysis, four variables were independently predictive of diarrhea: public water access (OR: 0.046; 95% CI: 0.005-0.454; P=0.0083), poultry or rabbits at home, and presence of cooker at home. A bacterial cause was found in 5.5% (7) and Giardia duodenalis in 20% (26). Treatments did not comply with WHO recommendations. Efforts should be made to improve water access and to implement guidelines for a better management of diarrhea in Gaza strip. PMID:21803391

Abouteir, A; El Yaagoubi, F; Bioh-Johnson, I; Kamel, A; Godard, N; Cormerais, L; Robin, F; Lesens, O

2011-07-30

72

Primary electron transfer kinetics in bacterial reaction centers with modified bacteriochlorophylls at the monomeric sites BA,B.  

PubMed Central

The primary electron transfer has been investigated by femtosecond time-resolved absorption spectroscopy in two chemically modified reaction centers (RC) of Rhodobacter sphaeroides, in which the monomeric bacteriochlorophylls BA and BB have both been exchanged by 13(2)-hydroxybacteriochlorophyll a or [3-vinyl]-13(2)-hydroxybacteriochlorophyll a. The kinetics of the primary electron transfer are not influenced by the 13(2)-hydroxy modification. In RCs containing [3-vinyl]-13(2)-hydroxybacteriochlorophyll a the primary rate is reduced by a factor of 10.

Finkele, U; Lauterwasser, C; Struck, A; Scheer, H; Zinth, W

1992-01-01

73

Skeletal ossification and sequence heterochrony in xenarthran evolution.  

PubMed

Previous analyses of how mammals vary in their ossification sequences have focused on monotremes, marsupials, and boreoeutherian placentals. Here, we focus on the sequence of cranial and postcranial ossification events during growth in the xenarthran skull and skeleton, including armadillos, anteaters, and sloths. We use two different methods to quantify sequence heterochrony: sequence analysis of variance (ANOVA) and event-paring/Parsimov. Our results indicate that Parsimov is conservative and does not detect clear heterochronic shifts between xenarthran and boreoeutherian placentals. Sequence-ANOVA performs better, but both methods exhibit sensitivity to the artifactual accumulation of ties. By controlling for ties and taking into account results that the methods have in common, our analysis suggests that xenarthrans significantly differ from other placentals by a late ossification of the sternum and an early ossification of the phalanges and pubis. We interpret these differences as showing that heterochrony plays a role in the skeletal development of xenarthrans, a change from previous studies that have emphasized the developmental homogeneity of the skeleton across placental mammals. PMID:23016907

Hautier, Lionel; Weisbecker, Vera; Goswami, Anjali; Knight, Frank; Kardjilov, Nikolay; Asher, Robert J

74

Compression médullaire thoracique secondaire à une ossification des ligaments jaunes  

Microsoft Academic Search

Ossification of the ligamentum flavum is common in Japan but rare in Western countries. Myelopathy of variable severity is a possible complication. Extension of the lesions over several levels at the thoracic spine is exceedingly rare. We report a new case in a 50-year-old man who had slowly progressive spinal cord compression with a sensory level at the navel. Computed

Ali Akhaddar; Abdelaziz Mansouri; Ibtissame Zrara; Miloudi Gazzaz; Mohamed Maftah; Brahim Mostarchid; Saïd Benomar; Mohamed Boucetta

2002-01-01

75

Spinal dural ossification causing neurological signs in a cat.  

PubMed

A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat's locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats. PMID:23777582

Antila, Johanna M; Jeserevics, Janis; Rakauskas, Mindaugas; Anttila, Marjukka; Cizinauskas, Sigitas

2013-06-19

76

Ossification of the posterior longitudinal ligament in a Nigerian woman  

PubMed Central

Ossification of the posterior longitudinal ligament (OPLL), though commonly reported among the Japanese population, has however been infrequently reported among other racial groups. It has not been reported among black Africans. A case of OPLL of the cervical spine seen in a 62-year-old Nigerian woman is hereby reported.

Adelowo, Olufemi; Olatunji, Ayodeji

2011-01-01

77

Monotreme ossification sequences and the riddle of mammalian skeletal development.  

PubMed

The developmental differences between marsupials, placentals, and monotremes are thought to be reflected in differing patterns of postcranial development and diversity. However, developmental polarities remain obscured by the rarity of monotreme data. Here, I present the first postcranial ossification sequences of the monotreme echidna and platypus, and compare these with published data from other mammals and amniotes. Strikingly, monotreme stylopodia (humerus, femur) ossify after the more distal zeugopodia (radius/ulna, tibia/fibula), resembling only the European mole among all amniotes assessed. European moles also share extreme humeral adaptations to rotation digging and/or swimming with monotremes, suggesting a causal relationship between adaptation and ossification heterochrony. Late femoral ossification with respect to tibia/fibula in monotremes and moles points toward developmental integration of the serially homologous fore- and hindlimb bones. Monotreme cervical ribs and coracoids ossify later than in most amniotes but are similarly timed as homologous ossifications in therians, where they are lost as independent bones. This loss may have been facilitated by a developmental delay of coracoids and cervical ribs at the base of mammals. The monotreme sequence, although highly derived, resembles placentals more than marsupials. Thus, marsupial postcranial development, and potentially related diversity constraints, may not represent the ancestral mammalian condition. PMID:21521190

Weisbecker, Vera

2011-02-18

78

Patterns of ossification in southern versus northern placental mammals.  

PubMed

Consensus on placental mammal phylogeny is fairly recent compared to that for vertebrates as a whole. A stable phylogenetic hypothesis enables investigation into the possibility that placental clades differ from one another in terms of their development. Here, we focus on the sequence of skeletal ossification as a possible source of developmental distinctiveness in "northern" (Laurasiatheria and Euarchontoglires) versus "southern" (Afrotheria and Xenarthra) placental clades. We contribute data on cranial and postcranial ossification events during growth in Afrotheria, including elephants, hyraxes, golden moles, tenrecs, sengis, and aardvarks. We use three different techniques to quantify sequence heterochrony: continuous method, sequence-ANOVA (analysis of variance) and event-paring/Parsimov. We show that afrotherians significantly differ from other placentals by an early ossification of the orbitosphenoid and caudal vertebrae. Our analysis also suggests that both southern placental groups show a greater degree of developmental variability; however, they rarely seem to vary in the same direction, especially regarding the shifts that differ statistically. The latter observation is inconsistent with the Atlantogenata hypothesis in which afrotherians are considered as the sister clade of xenarthrans. Interestingly, ancestral nodes for Laurasiatheria and Euarchontoglires show very similar trends and our results suggest that developmental homogeneity in some ossification sequences may be restricted to northern placental mammals (Boreoeutheria). PMID:23815655

Hautier, Lionel; Bennett, Nigel C; Viljoen, Hermien; Howard, Lauren; Milinkovitch, Michel C; Tzika, Athanasia C; Goswami, Anjali; Asher, Robert J

2013-02-28

79

Notch signaling in chondrocytes modulates endochondral ossification and osteoarthritis development  

PubMed Central

Here we examined the involvement of Notch signaling in the endochondral ossification process, which is crucial for osteoarthritis (OA) development. Intracellular domains of Notch1 and -2 were translocated into the nucleus of chondrocytes with their differentiation in mouse limb cartilage and in mouse and human OA articular cartilage. A tissue-specific inactivation of the Notch transcriptional effector recombination signal binding protein for Ig kappa J (RBPj?) in chondroprogenitor cells of SRY-box containing gene 9 (Sox9)-Cre;Rbpjfl/fl mouse embryos caused an impaired terminal stage of endochondral ossification in the limb cartilage. The RBPj? inactivation in adult articular cartilage after normal skeletal growth using type II collagen (Col2a1)-CreERT;Rbpjfl/fl mice by tamoxifen injection caused resistance to OA development in the knee joint. Notch intracellular domain with the effector RBPj? stimulated endochondral ossification through induction of the target gene Hes1 in chondrocytes. Among the Notch ligands, Jagged1 was strongly induced during OA development. Finally, intraarticular injection of N-[N-(3,5-diflurophenylacetate)-l-alanyl]-(S)-phenylglycine t-butyl ester (DAPT), a small compound Notch inhibitor, to the mouse knee joint prevented OA development. The RBPj?-dependent Notch signaling in chondrocytes modulates the terminal stage of endochondral ossification and OA development, representing an extracellular therapeutic target of OA.

Hosaka, Yoko; Saito, Taku; Sugita, Shurei; Hikata, Tomohiro; Kobayashi, Hiroshi; Fukai, Atsushi; Taniguchi, Yuki; Hirata, Makoto; Akiyama, Haruhiko; Chung, Ung-il; Kawaguchi, Hiroshi

2013-01-01

80

Ontogeny of cranial epi-ossifications in Triceratops  

Microsoft Academic Search

Historically, the scarcity of non-adult Triceratops fossils collected from Upper Cretaceous sediments of North America limited our understanding and promoted controversy with regard to the morphology, and presence or absence of cranial epi-ossifications in this widely known horned dinosaur. The recent discovery of several exceptionally well preserved juvenile and subadult Triceratops skulls and numerous juvenile, subadult, and adult cranial elements,

John R. Horner; Mark B. Goodwin

2008-01-01

81

The retention of health human resources in primary healthcare centers in Lebanon: a national survey  

PubMed Central

Background Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. Methods A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Results Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. Conclusions The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should be dedicated to enhancing providers’ role satisfaction and sense of job security. Such initiatives are of pivotal importance to stabilize the workforce and ensure its longevity.

2012-01-01

82

Primary Electron Donor(s) in Isolated Reaction Center of Photosystem II from Chlamydomonas reinhardtii.  

PubMed

Isolated reaction centers (RCs) from wild-type Chlamydomonas (C.) reinhardtii of Photosystem II (PSII), at different levels of intactness, were studied to provide more insight into the nature of the charge-separation (CS) pathway(s). We argue that previously studied D1/D2/Cyt(b559) complexes (referred to as RC680), with Chl(D1) serving as the primary electron donor, contain destabilized D1 and D2 polypeptides and, as a result, do not provide a representative model system for the intact RC within the PSII core. The shapes of nonresonant transient hole-burned (HB) spectra obtained for more intact RCs (referred to as RC684) are very similar to P(+)Q(A)(-) - PQ(A) absorbance difference and triplet minus singlet spectra measured in PSII core complexes from Synechocystis PCC 6803 [Schlodder et al. Philos. Trans. R. Soc. London, Ser. B2008, 363, 1197]. We show that in the RC684 complexes, both P(D1) and Chl(D1) may serve as primary electron donors, leading to two different charge separation pathways. Resonant HB spectra cannot distinguish the CS times corresponding to different paths, but it is likely that the zero-phonon holes (ZPHs) observed in the 680-685 nm region (corresponding to CS times of ?1.4-4.4 ps) reveal the Chl(D1) pathway; conversely, the observation of charge-transfer (CT) state(s) in RC684 (in the 686-695 nm range) and the absence of ZPHs at ?(B) > 685 nm likely stem from the P(D1) pathway, for which CS could be faster than 1 ps. This is consistent with the finding of Krausz et al. [Photochem. Photobiol. Sci.2005, 4, 744] that CS in intact PSII core complexes can be initiated at low temperatures with fairly long-wavelength excitation. The lack of a clear shift of HB spectra as a function of excitation wavelength within the red-tail of the absorption (i.e., 686-695 nm) and the absence of ZPHs suggest that the lowest-energy CT state is largely homogeneously broadened. On the other hand, in usually studied destabilized RCs, that is, RC680, for which CT states have never been experimentally observed, Chl(D1) is the most likely electron donor. PMID:22462595

Acharya, Khem; Zazubovich, Valter; Reppert, Mike; Jankowiak, Ryszard

2012-04-11

83

The Critical Role of the Epidermal Growth Factor Receptor in Endochondral Ossification  

PubMed Central

Loss of epidermal growth factor receptor (EGFR) activity in mice alters growth plate development, impairs endochondral ossification, and retards growth. However, the detailed mechanism by which EGFR regulates endochondral bone formation is unknown. Here, we show that administration of an EGFR-specific small molecule inhibitor, gefitinib, into 1-month-old rats for 7 days produced profound defects in long bone growth plate cartilage characterized by epiphyseal growth plate thickening and massive accumulation of hypertrophic chondrocytes. Immunostaining demonstrated that growth plate chondrocytes express EGFR but endothelial cells and osteoclasts show little to no expression. Gefitinib did not alter chondrocyte proliferation or differentiation and vascular invasion into the hypertrophic cartilage. However, osteoclast recruitment and differentiation at the chondro-osseous junction was attenuated due to decreased RANKL expression in the growth plate. Moreover, gefitinib treatment inhibited the expression of matrix metalloproteinases (MMP9, 13, and 14), increased the amount of collagen fibrils, and decreased degraded extracellular matrix products in the growth plate. In vitro, the EGFR ligand TGF? strongly stimulated RANKL, MMP9 and MMP13 expression and suppressed OPG expression in primary chondrocytes. In addition, a mouse model of cartilage-specific EGFR inactivation exhibited a similar phenotype of hypertrophic cartilage enlargement. Together, our data demonstrate that EGFR signaling supports osteoclastogenesis at the chondro-osseous junction and promotes chondrogenic expression of MMPs in the growth plate. Therefore, we conclude that EGFR signaling plays an essential role in the remodeling of growth plate cartilage extracellular matrix into bone during endochondral ossification.

Zhang, Xianrong; Siclari, Valerie A.; Lan, Shenghui; Zhu, Ji; Koyama, Eiki; Dupuis, Holly L.; Enomoto-Iwamoto, Motomi; Beier, Frank; Qin, Ling

2011-01-01

84

Leptin promotes ossification through multiple ways of bone metabolism in osteoblast: a pilot study.  

PubMed

Leptin may be a potential option in preventing osteoporosis for menopausal women. The objective of this study is to explore the molecular mechanism of leptin on bone metabolism in osteoblast. Primary osteoblasts were isolated from parietal bone of adult female rats. mRNA level of OB-Rb in osteoblasts was inhibited by siRNA to block leptin signal transmission. The whole genome expression was tested by using gene chip to preliminarily explore the molecular mechanism of leptin in regulating osteoblast activity. The optimal concentration of siRNA was 25 nM, resulting in a maximal inhibition of OB-Rb mRNA. Ossification (p < 0.05) and bone mineralization (p = 0.0001) were downregulated by inhibiting leptin signal transmission, while bone resorption (p = 0.007), osteoblast differentiation (p = 0.026) and negative regulation of bone remodeling (p = 0.004) were upregulated. The expressions of some genes were regulated by OB-Rb siRNA. The expressions of alkaline phosphatase (p = 0.014) and osteocalcin (p = 0.002) were reduced, while that of vascular endothelial growth factor A (p = 0.0076) and IL-6 (p = 0.021) were increased. In a model of osteoblast, leptin positively promotes ossification through multiple ways including bone mineralization, remodeling, resorption and osteoblast differentiation, but which way plays the most critical role is not discussed in this study and needs to be clarified in future. PMID:23706140

Zhang, Jing; Li, Tingting; Xu, Liangzhi; Li, Wenjuan; Cheng, Meng; Zhuang, Jing; Chen, Yan; Xu, Wenming

2013-05-24

85

Metabolic syndrome among obese Qataris attending primary health care centers in Doha, 2010  

PubMed Central

Objectives: To determine the prevalence of metabolic syndrome among obese patients using the IDF definition and to identify factors that are associated with it. Materials and Methods: A cross-sectional randomized study was conducted at four primary care centers inside Doha, Qatar. One hundred and thirty-six Adults, ? 18 Qatari obese patients, were chosen by systematic random sampling. They were interviewed and screened for the presence of metabolic syndrome, which was diagnosed according to the International Diabetes Federation criteria: An abdominal circumference ? 94 cm in males or ? 80 cm in females, plus any two of the following: HDL cholesterol < 1.03 mmol / mL (< 40 mg / dL) [males] or < 1.3 mmol / mL (< 50 mg / dL) [females], Triglycerides ? 1.7 mmol / mL (?150 mg / dL), Blood pressure ? 130 / 85 mmHg or the patient receiving antihypertensive treatment and baseline glycemia > 5.6 mmol / mL (> 100 mg / dL), or previously-diagnosed type 2 diabetes mellitus. Results: The overall prevalence of the metabolic syndrome among obese patients was 46.3%. The prevalence was higher in females (50%) than in males (42.4%). It was seen to increase with increasing body mass index class, from class 1 to class 2. The prevalence of metabolic comorbidities of abnormal waist circumference, raised blood pressure, raised fasting blood glucose, high triglycerides, and reduced high density lipoprotein was 88.2, 42.6, 32.4, 31.6, and 27.9%, respectively. Based on the logistic regression multivariable analysis, increasing age and being diabetic were the only significant associated factors that influenced the risk of having the metabolic syndrome. Conclusion: The prevalence of the metabolic syndrome was high, and the highest comorbidities were abnormal waist circumference and high blood pressure. Diabetes and increasing age were the only significant risk factors of having this syndrome.

Ismail, Mansoura F. S.

2012-01-01

86

Survey of 5 European countries suggests that more elements of patient-centered medical homes could improve primary care.  

PubMed

The patient-centered medical home is a US model for comprehensive care. This model features a personal physician or registered nurse who is augmented by a proactive team and information technology. Such a model could prove useful for advanced European systems as they strive to improve primary care, particularly for chronically ill patients. We surveyed 6,428 chronically ill patients and 152 primary care providers in five European countries to assess aspects of the patient-centered medical home. Although most patients reported that they had a personal physician and no problems in contacting the practice after hours, for example, other aspects of the patient-centered medical home, such as provision of written self-management support to patients, were not as widespread. We conclude that despite strong organizational structures, European primary care systems need additional efforts to recognize chronically ill patients as partners in care and can embrace patient-centered medical homes to improve care for European patients. PMID:23514777

Faber, Marjan; Voerman, Gerlienke; Erler, Antje; Eriksson, Tina; Baker, Richard; De Lepeleire, Jan; Grol, Richard; Burgers, Jako

2013-03-20

87

A survey of the attitude and practice of research among doctors in Riyadh Military Hospital primary care centers, Saudi Arabia  

PubMed Central

Objectives: To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH) toward research and to identify the main barriers to conduct research. Materials and Methods: A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs) working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection. Results: The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5%) for participating in research, followed by the lack of support (58.8%). Conclusions: Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.

Al-Abdullateef, Saad H.

2012-01-01

88

Advancing survivorship care through the National Cancer Survivorship Resource Center: developing American Cancer Society guidelines for primary care providers.  

PubMed

The National Cancer Survivorship Resource Center (The Survivorship Center) began in 2010 as a collaboration between the American Cancer Society and the George Washington University Cancer Institute and was funded by the Centers for Disease Control and Prevention. The Survivorship Center aims to improve the overall health and quality of life of posttreatment cancer survivors. One key to addressing the needs of this ever-growing population is to develop clinical follow-up care guidelines that emphasize not only the importance of surveillance for cancer recurrence, but also address the assessment and management of the physical and psychosocial long-term and late effects that may result from having cancer and undergoing cancer treatment as well as highlight the importance of healthy behaviors that can reduce the risk of cancer recurrence, second primary cancers, and other chronic diseases. Currently, The Survivorship Center is coordinating the work of experts in oncology, primary care, and other health care professions to develop follow-up care guidelines for 10 priority cancer sites. PMID:23512728

Cowens-Alvarado, Rebecca; Sharpe, Katherine; Pratt-Chapman, Mandi; Willis, Anne; Gansler, Ted; Ganz, Patricia A; Edge, Stephen B; McCabe, Mary S; Stein, Kevin

2013-03-19

89

Lincoln County Primary Care Center Is a Model for Good Health.  

ERIC Educational Resources Information Center

Describes a rural West Virginia health-care center as a successful model program for integration between the clinic and community. Describes center facilities, funding sources, community cooperation, and cooperative residency program with regional medical school. Discusses implications for other medical-education programs. Describes differences…

Casto, James E.

1992-01-01

90

Lincoln County Primary Care Center Is a Model for Good Health.  

ERIC Educational Resources Information Center

|Describes a rural West Virginia health-care center as a successful model program for integration between the clinic and community. Describes center facilities, funding sources, community cooperation, and cooperative residency program with regional medical school. Discusses implications for other medical-education programs. Describes differences…

Casto, James E.

1992-01-01

91

Primary centers and secondary concentrations of tectonic activity through time in the western hemisphere of Mars  

Microsoft Academic Search

Five main stages of radial and concentric structures formed around Tharsis from the Noachian through the Amazonian as determined by geologic mapping of 24,452 structures within the stratigraphic framework of Mars and by testing their radial and concentric orientations. Tectonic activity peaked in the Noachian (stage 1) around the largest center. Claritas, an elongate center extending more than 20° in

Robert C. Anderson; James M. Dohm; Matthew P. Golombek; Albert F. C. Haldemann; Brenda J. Franklin; Kenneth L. Tanaka; Juan Lias; Brian Peer

2001-01-01

92

Evidence-Based Practice in the Use of Antibiotics for Respiratory Tract Infections in Primary Health Centers in Kuwait  

Microsoft Academic Search

Objectives: The objective of this study was to evaluate the use of antibiotics in treating upper respiratory tract infections (URTIs) in primary health centers in Kuwait and investigate the extent to which antibiotic use follows international guidelines. SubjectsandMethods: A nationwide cross-sectional study was conducted with a sample size of 615 patients selected by using a multi-stage cluster sampling method. Of

Salem Ayyad; Abdullah Al-Owaisheer; Faisal Al-Banwan; Abdullah Al-Mejalli; Mumtaz Shukkur; Lukman Thalib

2010-01-01

93

Primary Mediastinal La0rge B-Cell Lymphoma: A Single-Center Study of Clinicopathologic Characteristics  

Microsoft Academic Search

Primary mediastinal large B-cell lymphoma (PMLBCL) is a subset of LBCL with unique clinicopathologic features. Some studies\\u000a have raised the question of differences in biological features and clinical course among patients from different parts of\\u000a the world. We conducted a retrospective clinicopathologic analysis of 24 patients with PMLBCL from a single center in Croatia.\\u000a We also conducted the first investigation

Slobodanka Ostoji? Koloni?; Sonja Džebro; Rajko Kušec; Ana Planinc-Peraica; Mara Dominis; Branimir Jakši?

2006-01-01

94

Primary centers and secondary concentrations of tectonic activity through time in the western hemisphere of Mars  

NASA Astrophysics Data System (ADS)

Five main stages of radial and concentric structures formed around Tharsis from the Noachian through the Amazonian as determined by geologic mapping of 24,452 structures within the stratigraphic framework of Mars and by testing their radial and concentric orientations. Tectonic activity peaked in the Noachian (stage 1) around the largest center. Claritas, an elongate center extending more than 20° in latitude and defined by about half of the total grabens which are concentrated in the Syria Planum, Thaumasia, and Tempe Terra regions. During the Late Noachian and Early Hesperian (stage 2), extensional structures formed along the length of present-day Valles Marineris and in Thaumasia (with a secondary concentration near Warrego Vallis) radial to a region just to the south of the central margin of Valles Marineris. Early Hesperian (stage 3) radial grabens in Pavonis, Syria, Ulysses, and Tempe Terra and somewhat concentric wrinkle ridges in Lunae and Solis Plana and in Thaumasia, Sirenum, Memnonia, and Amazonis are centered northwest of Syria with secondary centers at Thaumasia, Tempe Terra, Ulysses Fossae, and western Valles Marineris. Late Hesperian/Early Amazonian (stage 4) structures around Alba Patera, the northeast trending alignment of Tharsis Montes, and Olympus Mons appears centered on Alba Patera. Stage 5 structures (Middle-Late Amazonian) represent the last pulse of Tharsis-related activity and are found around the large shield volcanoes and are centered near Pavonis Mons. Tectonic activity around Tharsis began in the Noachian and generally decreased through geologic time to the Amazonian. Statistically significant radial distributions of structures formed during each stage, centered at different locations within the higher elevations of Tharsis. Secondary centers of radial structures during many of the stages appear related to previously identified local magmatic centers that formed at different times and locations throughout Tharsis.

Anderson, Robert C.; Dohm, James M.; Golombek, Matthew P.; Haldemann, Albert F. C.; Franklin, Brenda J.; Tanaka, Kenneth L.; Lias, Juan; Peer, Brian

2001-09-01

95

[Multi-channel cochlear implant in cochlear ossification].  

PubMed

Cochlear ossification, considered until only a few years ago as a contraindication for cochlear implants (C.I.), may now be managed by means of a wide variety of surgical techniques. In cases with massive ossification, the drill-out circummodiolar technique described by Gantz et al. in 1988 and successively modified by Balkany et al. in 1997 may be adopted. The technique of electrode insertion in the scala vestibuli, perfected by Steenerson et al. in 1990, may be used when cochlear ossification has spread no further than the scala tympani. Other methods call for a groove to be drilled along the proximal tip of the basal turn of the cochlea (Cohen and Waltzman, 1993), the insertion of electrodes through the middle cranial fossa (Colletti et al., 2000), or the utilization of a double electrode array (Bredberg et al., 1997, Lenarz et al., 2001). This study reports the experience conducted at the Cochlear Implants Centre of the Otorhinolaryngoiatrics, Otological and Otoneurological Microsurgery Section of the University of Parma in a group of 15 patients who underwent C.I. in the presence of varying degrees of ossification. In 3 cases the ossification was limited to the region of the round window and a few millimetres of the scala tympani; cochleostomy was performed anteriorly and inferiorly to the anterior niche of the round window. In 11 cases (of which 3 of pediatric age), the ossification had spread to the horizontal portion of the scala tympani; in these cases, the electrodes were inserted in the scala vestibuli. The scala vestibuli was opened by drilling anteriorly to the round window and superiorly to the spiral ligament. In the only case of massively ossified cochlea, it was possible to partially insert the electrodes in a circum-modiolar tunnel. In the 12-month follow-up hearing test, the 3 patients with ossification of the round window region and the first millimetres of the scala tympani respectively averaged 61.6% in recognizing 2-syllable words and 59% in recognizing words embedded in phrases. The averages on the 12-month follow-up hearing test in the 8 adult patients who received the implant in the scala vestibuli were 80.6% in recognizing 2-syllable words and 89.1% in recognizing words in phrases. The 3 pediatric patients were classified on the Geers and Moog scale, which situated 2 of them in the 6th category of perception and 1 of them in the 4th category of perception. As regards the only case of massive cochlear ossification, the patient underwent surgery recently, and the sole follow-up available is the one conducted after only 3 months; the vowel identification average was 55%; the average on the VCV test was 31%; and the 2-syllable word recognition average was 20%. PMID:12173282

Pasanisi, E; Bacciu, A; Vincenti, V; Guida, M; Barbot, A; Berghenti, M T; Bacciu, S

2002-06-01

96

Integrating Education into Primary Care Quality and Cost Improvement at an Academic Medical Center  

ERIC Educational Resources Information Center

|Introduction: In 1996 the University of Michigan Health System created the Guidelines Utilization, Implementation, Development, and Evaluation Studies (GUIDES) unit to improve the quality and cost-effectiveness of primary care for common medical problems. GUIDES's primary functions are to oversee the development of evidence-based, practical…

Harrison, R. Van; Standiford, Connie J.; Green, Lee A.; Bernstein, Steven J.

2006-01-01

97

Slipped capital femoral epiphysis caused by neurogenic heterotopic ossification.  

PubMed

Slipped capital femoral epiphysis (SCFE) is rare in nonambulatory patients, as mechanical factors play important roles in the development of the disease. We report a case of SCFE, which occurred in a 12-year-old girl with a nonambulatory status after cerebral infarction. SCFE occurred after she received passive range of motion exercise and extracorporeal shock wave treatment for neurogenic heterotopic ossification around the hip joint. The patient was successfully managed by a stepwise approach, with radiological and clinical improvements. PMID:23969564

Chang, Sam Yeol; Yoo, Won Joon; Park, Moon Seok; Chung, Chin Youb; Choi, In Ho; Cho, Tae-Joon

2013-11-01

98

Is ossification of posterior longitudinal ligament an enthesopathy?  

Microsoft Academic Search

The purpose of this study was to investigate the relationship of ossification of posterior longitudinal ligament (OPLL) with\\u000a enthesis, the site where the posterior longitudinal ligament (PLL) attaches to the vertebral body, by multi-detector CT reconstruction\\u000a images. Twenty-nine patients with OPLL were studied. According to the plaques’ continuity to the vertebral body, OPLL plaques\\u000a were classified into two categories: “free”

Jian Chen; Dianwen Song; Xinwei Wang; Xiaolong Shen; Yang Li; Wen Yuan

99

Heterotopic ossification after hip replacement in Addison’s disease  

Microsoft Academic Search

We report a unique case of a 60-year-old man suffering from Addison’s disease who underwent a hybrid total hip replacement\\u000a subsequently developing heterotopic ossification. Radiotherapy failed to arrest the progression of disease and isotope bone\\u000a scan at 15 months suggested ongoing disease process. Addison’s disease has been shown to be associated with calcification\\u000a of auricular cartilage and abdominal viscera but never

Harish Kurup; David Chapple; Peter Ward

2011-01-01

100

Endochondral ossification is required for hematopoietic stem cell niche formation  

PubMed Central

Little is known about the formation of niches, local micro-environments required for stem cell maintenance. Here we develop an in vivo assay for adult hematopoietic stem cell (HSC) niche formation 1-2. With this assay, we identified a population of progenitor cells with surface markers CD45-Tie2-?V+CD105+Thy1.1- (CD105+Thy1-) that when sorted from 15.5 dpc fetal bones (fb) and transplanted under the adult mouse kidney capsule could recruit host-derived blood vessels, produce donor-derived ectopic bones through a cartilage intermediate, and generate a marrow cavity populated by host-derived long term reconstituting HSC (LT-HSC). In contrast, CD45-Tie2-?V+CD105+Thy1+ (CD105+Thy1+) fb progenitors form bone that does not contain a marrow cavity. Suppressing expression of factors involved in endochondral ossification, such as osterix and VEGF, inhibited niche generation 22-24. CD105+Thy1-progenitor populations derived from regions of the fetal mandible or calvaria that do not undergo endochondral ossification formed only bone without marrow in our assay27. Collectively, our data implicates endochondral ossification, bone formation that proceeds through a cartilage intermediate, as a requirement for adult HSC niche formation.

Chan, Charles K. F.; Chen, Ching-Cheng; Luppen, Cynthia A.; Kraft, Daniel L.; Kim, Jae-Beom; DeBoer, Anthony; Wei, Kevin; Weissman, Irving L.

2008-01-01

101

Surgical Treatment for Primary Mitral Valve Tumor: A 25Year Single-Center Experience  

Microsoft Academic Search

Objective: Primary mitral valve (MV) tumor is a rare lesion, and to date, there have been few larger surgical series of MV tumors. We retrospectively analyzed 11 cases of primary MV tumors regarding clinical and pathological features, surgical procedure and long-term outcomes. Methods: From November 1983 to December 2008, we operated on 11 patients (age 36.3 ± 17.7 years, weight

Guo-Hua Luo; Wei-Guo Ma; Han-Song Sun; Shi-Wei Pan; Zhi-Xiong Huang; Hong-Yue Wang; Xiao-Dong Zhu

2011-01-01

102

DRUG CONTROL OF HYPERTENSION IN PRIMARY HEALTH CARE CENTERS-REGISTERED PATIENTS, AL-KHOBAR, SAUDI ARABIA  

PubMed Central

Objective: To assess the quality of the pharmacological control of hypertension. Design: A cross-sectional study. Subjects: Primary health care centers-registered hypertensive patients. Setting: Primary health care centers in Al-Khobar, Saudi Arabia. Methods: Data was recorded, using a structured questionnaire, through direct interviewing of patients, and from their medical records. It included demographic characteristics, hypertension related, and doctors’-related variables; and patients’ utilization of other health facilities and whether they had other chronic diseases. Results: The proportion of patients with controlled hypertension was 37%. It was significantly increased with age below 55 years, with non-Saudis, duration of treatment shorter than 5 years; and with the use of monotherapy. Doctors’ care-related variables did not show significant variation with the number of controlled patients which may imply that the quality of follow-up might not be adequate. Conclusions: The proportion of controlled patients cared for in the PHC centers is low. The factors associated with control were age, and the use of a single antihypertensive drug. The study questions the quality of follow-up of patients by the PHC physicians.

Elzubier, Ahmed G.; Al-Shahri, Mohammed A.

1997-01-01

103

SPECIFIC ANTIBODY WITHIN LYMPHOID GERMINAL CENTER CELLS OF MICE AFTER PRIMARY IMMUNIZATION WITH HORSERADISH PEROXIDASE: A LIGHT AND ELECTRON MICROSCOPIC STUDY  

PubMed Central

The appearance in mice of specific antibody within newly formed germinal centers in lymph nodes was demonstrated by light and electron microscopy after regional primary antigenic stimulation with horseradish peroxidase (HRP). Lymphoid germinal center cells containing anti-HRP antibody in the perinuclear space and in the cytoplasm were detected from 17 to 26 days after antigenic stimulation. Extracellular anti-HRP antibody within germinal centers, localized between dendritic reticular cells and lymphoid elements, could not be found before the appearance of intracellular antibody. These findings strongly suggest antibody formation by lymphoid germinal center cells. Both antigen and corresponding antibody persisted in intercellular spaces up to 35 days after primary stimulation. The concomitant presence in a given lymph node of germinal centers which are positive or negative with regard to specific antibody provide evidence in favor of monospecificity of individual centers. The mechanisms of antigen-trapping within germinal centers are discussed in the light of the present observations.

Sordat, Bernard; Sordat, Martine; Hess, Max W.; Stoner, Richard D.; Cottier, Hans

1970-01-01

104

Evaluation of Primary Care Futures: A Faculty Development Program for Community Health Center Preceptors.  

ERIC Educational Resources Information Center

|A study of 203 community health center preceptors who attended workshops on educational planning, teaching styles, evaluation, and feedback found that participants showed significant increases in use of five of seven teaching concepts while analyzing a role-play interaction; increased familiarity with, and retained for three months, nine of 11…

Quirk, Mark E.; DeWitt, Thomas; Lasser, Daniel; Huppert, Michael; Hunniwell, Elliot

1998-01-01

105

Eleven Years of Primary Health Care Delivery in an Academic Nursing Center.  

ERIC Educational Resources Information Center

Client visits to an academic community nursing center (n=25,495) were coded and analyzed. Results show expansion of nursing practice and services, strong case management, and management of illness care. The usefulness of computerized clinical documentation system and of the Lundeen conceptional model of community nursing care was demonstrated.…

Hildebrandt, Eugenie; Baisch, Mary Jo; Lundeen, Sally P.; Bell-Calvin, Jean; Kelber, Sheryl

2003-01-01

106

Contemporary issues in primary amenorrhea: An experience from a Tertiary Care Center  

PubMed Central

Introduction: Amenorrhea is classified as primary if menstrual bleeding has never occurred in the absence of hormonal treatment. The clinical significance of a lack of regular menstrual cycles extends beyond reproductive concerns. Episodes of amenorrhea as short as 90 day may have implications for bone and cardiovascular health. Aims and Objective: To evaluate all patients presenting with primary amenorrhea in the Endocrinology OPD of Gauhati Medical College and Hospital. Materials and Methods: A total of 14 patients presenting to the Endocrinology OPD from March 2010 to May 2012 with a history of primary amenorrhea were included in the study. All patients were subjected to a detailed history, a thorough clinical examination, and relevant biochemical, hormonal, and radiological investigations. Result: In our study, the average age of presentation was 17.23 ± 4.2 years. Out of the 14 patients presenting with primary amenorrhea, 5 patients (35.71%) were found to have Turner?s syndrome, 2 (14.28%) had XX (pure) gonadal dysgenesis, 2 (14.28%) patients had XY gonadal dysgenesis (Swyer syndrome), 2 (14.28%) patients had Müllerian agenesis, 2 (14.28%) patients had hypothalamic amenorrhea, and 1 (7.14%) patient was found to have multiple pituitary hormone deficiency. Conclusion: In concordance with other studies, Turner?s syndrome, Müllerian agenesis, and gonadal dysgenesis are the commonest causes of primary amenorrhea in our study. However, in contrast to certain Western reports, primary amenorrhea rather than short stature remains the commonest cause for seeking medical evaluation in patients with Turner?s syndrome.

Bhuyan, Ashok Krishna; Sarma, Dipti; Saikia, Uma Kaimal

2012-01-01

107

[Feedback on prescribing profiles at a primary health center. Important element in quality assurance of drug prescription].  

PubMed

DU90%--the number of drugs that account for 90% of DDDs--and adherence to guidelines in this segment were proposed by the Swedish Medical Quality Council (MKR) as indicators for assessing the quality of drug prescribing. We tested these indicators at a primary health care (PHC) center in Stockholm. Bar-coded prescriptions purchased at pharmacies were compared with the guidelines issued by the regional drug committee. The data were presented and discussed at the PHC center. Although the DU90% method neither examines the appropriateness of use nor provides outcome data, it was shown to be an inexpensive, flexible and simple method for assessing the general quality of drug prescribing. PMID:11271576

Nyman, K; Bergens, A; Björin, A S; Guterstam, P; Nyrén, O; Jansson, U; Wettermark, B; Bergman, U

2001-01-17

108

Figure Facts: Encouraging Undergraduates to Take a Data-Centered Approach to Reading Primary Literature  

ERIC Educational Resources Information Center

The ability to interpret experimental data is essential to understanding and participating in the process of scientific discovery. Reading primary research articles can be a frustrating experience for undergraduate biology students because they have very little experience interpreting data. To enhance their data interpretation skills, students…

Round, Jennifer E.; Campbell, A. Malcolm

2013-01-01

109

Figure Facts: Encouraging Undergraduates to Take a Data-Centered Approach to Reading Primary Literature  

PubMed Central

The ability to interpret experimental data is essential to understanding and participating in the process of scientific discovery. Reading primary research articles can be a frustrating experience for undergraduate biology students because they have very little experience interpreting data. To enhance their data interpretation skills, students used a template called “Figure Facts” to assist them with primary literature–based reading assignments in an advanced cellular neuroscience course. The Figure Facts template encourages students to adopt a data-centric approach, rather than a text-based approach, to understand research articles. Specifically, Figure Facts requires students to focus on the experimental data presented in each figure and identify specific conclusions that may be drawn from those results. Students who used Figure Facts for one semester increased the amount of time they spent examining figures in a primary research article, and regular exposure to primary literature was associated with improved student performance on a data interpretation skills test. Students reported decreased frustration associated with interpreting data figures, and their opinions of the Figure Facts template were overwhelmingly positive. In this paper, we present Figure Facts for others to adopt and adapt, with reflection on its implementation and effectiveness in improving undergraduate science education.

Round, Jennifer E.; Campbell, A. Malcolm

2013-01-01

110

Figure Facts: Encouraging Undergraduates to Take a Data-Centered Approach to Reading Primary Literature  

ERIC Educational Resources Information Center

|The ability to interpret experimental data is essential to understanding and participating in the process of scientific discovery. Reading primary research articles can be a frustrating experience for undergraduate biology students because they have very little experience interpreting data. To enhance their data interpretation skills, students…

Round, Jennifer E.; Campbell, A. Malcolm

2013-01-01

111

Tailored care management with patient-centered web-based portal in primary health care: sustaining a relational context.  

PubMed

While many innovative information and communication technologies have been offered as solutions to primary care management challenges, few have been shown to be effective and or sustainable over time. Information technology approaches have been narrow in focus, relying on designs that enhance usability, interoperability and adaptability by delimiting the traits, attributes, and characteristics of individual communication processes. It is increasingly understood in primary health care settings that relational communication continuity between the patient and the health care team is essential for optimizing co-determined treatments, interventions, and self-management strategies. Successful utilization of a patient-centered web-based portal must account for essential proximity of the relational aspect of care between the patient and the immediate health care team. PMID:23388306

Ronan, James P

2013-01-01

112

Flight tests of a hybrid-centered integrated 3D perspective-view primary flight display  

NASA Astrophysics Data System (ADS)

This paper describes flight tests of a Honeywell Synthetic Vision System (SVS) prototype operating in a hybrid-centered mode on a Primus EpicTM large format display. This novel hybrid mode effectively resolves some cognitive and perceptual human factors issues associated with traditional heading-up or track-up display modes. By integrating synthetic 3D perspective view with advanced Head-Up Display (HUD) symbology in this mode, the test results demonstrate that the hybrid display mode provides clear indications of current track and crab conditions, and is effective in overcoming flight guidance symbology collision and resultant ambiguity. The hybrid-centering SVS display concept is shown to be effective in all phases of flight and is particularly valuable during landing operations with a strong cross-wind. The recorded flight test data from Honeywell's prototype SVS concept at Reno, Nevada on board Honeywell Citation V aircraft will be discussed.

He, Gang; Feyereisen, Thea; Wilson, Blake; Wyatt, Sandy; Engels, Jary

2006-06-01

113

Solid Waste Processing Center Primary Opening Cells Systems, Equipment and Tools  

SciTech Connect

This document addresses the remote systems and design integration aspects of the development of the Solid Waste Processing Center (SWPC), a facility to remotely open, sort, size reduce, and repackage mixed low-level waste (MLLW) and transuranic (TRU)/TRU mixed waste that is either contact-handled (CH) waste in large containers or remote-handled (RH) waste in various-sized packages.

Bailey, Sharon A.; Baker, Carl P.; Mullen, O Dennis; Valdez, Patrick LJ

2006-04-17

114

Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress. Rural Policy Brief No. 2011-6.  

National Technical Information Service (NTIS)

The patient-centered medical home (PCMH) is an increasingly endorsed primary care delivery model. Multiple definitions of PCMH exist. Most describe a PCMH as the infrastructure (providers, staff, health information technology, care processes, etc.) that s...

A. C. MacKinney F. Ullrich K. J. Mueller

2011-01-01

115

Utilization and expenditures of veterans obtaining primary care in community clinics and VA medical centers: an observational cohort study  

PubMed Central

Background To compare VA inpatient and outpatient utilization and expenditures of veterans seeking primary care in community-based outpatient clinics (CBOCs) and VA medical centers (VAMCs) in fiscal years 2000 (FY00) and 2001. Methods The sample included 25,092 patients who obtained primary care exclusively from 108 CBOCs in FY00, 26,936 patients who obtained primary care exclusively from 72 affiliated VAMCs in FY00, and 11,450 "crossover" patients who obtained primary care in CBOCs and VAMCs in FY00. VA utilization and expenditure data were drawn from the VA's system-wide cost accounting system. Veteran demographic characteristics and a 1999 Diagnostic Cost Group risk score were obtained from VA administrative files. Outpatient utilization (primary care, specialty care, mental health, pharmacy, radiology and laboratory) and inpatient utilization were estimated using count data models and expenditures were estimated using one-part or two-part models. The second part of two-part models was estimated using generalized linear regressions. Results CBOC patients had a slightly more primary care visits per year than VAMC patients (p < 0.0001), but lower primary care costs (-$71, p < 0.0001). CBOC patients had lower odds of one or more specialty, mental health, ancillary visits and hospital stays per year, and fewer numbers of visits and stays if they had any and lower specialty, mental health, ancillary and inpatient expenditures (all, p < 0.0001). As a result, CBOC patients had lower total outpatient and overall expenditures than VAMC patients (p < 0.0001). Conclusion CBOCs provided veterans improved access to primary care and other services, but expenditures were contained because CBOC patients who sought health care had fewer visits and hospital stays than comparable VAMC patients. These results suggest a more complex pattern of health care utilization and expenditures by CBOC patients than has been found in prior studies. This study also illustrates that CBOCs continue to be a critical primary care and mental health access point for veterans.

Maciejewski, Matthew L; Perkins, Mark; Li, Yu-Fang; Chapko, Michael; Fortney, John C; Liu, Chuan-Fen

2007-01-01

116

Posterior Ossification of the Shoulder: The Bennett LesionEtiology, Diagnosis, and Treatment  

Microsoft Academic Search

We report a series of ossific lesions of the posterior inferior glenoid in a group of elite baseball players. We hope to clarify the etiology, diagnosis, and treatment of the Bennett lesion. From August 1985 to August 1991, we identified six professional baseball pitchers and one college pitcher with evidence of ossification of the shoul der on plain radiographs, computed

James D. Ferrari; Dudley A. Ferrari; James Coumas; Arthur M. Pappas

1994-01-01

117

Ossification of the thoracic posterior longitudinal ligament in a fixed population: radiological and neurological manifestations  

Microsoft Academic Search

Reportedly, ossification of the posterior longitudinal ligament (OPLL) usually involves the cervical spine and often accompanies other ligamentous ossification such as diffuse idiopathic skeletal hyperostosis (DISH). It is considered serious because it sometimes causes severe radiculomyelopathy; however, the present study, based on a fixed population sample, revealed that OPLL of the thoracic spine is nearly always asymptomatic. The prevalence of

M. Ono; W. J. Russell; S. Kudo; Y. Kuroiwa; M. Takamori; S. Motomura; J. Murakami

1982-01-01

118

Ossification of the thoracic posterior longitudinal ligament in a fixed population. Radiological and neurological manifestations  

Microsoft Academic Search

Reportedly, ossification of the posterior longitudinal ligament (OPLL) usually involves the cervical spine and often accompanies other ligamentous ossification such as diffuse idiopathic skeletal hyperostosis (DISH). It is considered serious because it sometimes causes severe radiculomyelopathy; however, the present study, based on a fixed population sample, revealed that OPLL of the thoracic spine is nearly always asymptomatic. The prevalence of

M. Ono; W. J. Russell; S. Kudo; Y. Kuroiwa; M. Takamori; S. Motomura; J. Murakami

1982-01-01

119

Ossification heterochrony in the therian postcranial skeleton and the marsupial-placental dichotomy.  

PubMed

Postcranial ossification sequences in 24 therian mammals and three outgroup taxa were obtained using clear staining and computed tomography to test the hypothesis that the marsupial forelimb is developmentally accelerated, and to assess patterns of therian postcranial ossification. Sequence rank variation of individual bones, phylogenetic analysis, and algorithm-based heterochrony optimization using event pairs were employed. Phylogenetic analysis only recovers Marsupialia, Australidelphia, and Eulipotyphla. Little heterochrony is found within marsupials and placentals. However, heterochrony was observed between marsupials and placentals, relating to late ossification in hind limb long bones and early ossification of the anterior axial skeleton. Also, ossification rank position of marsupial forelimb and shoulder girdle elements is more conservative than that of placentals; in placentals the hind limb area is more conservative. The differing ossification patterns in marsupials can be explained with a combination of muscular strain and energy allocation constraints, both resulting from the requirement of active movement of the altricial marsupial neonates toward the teat. Peramelemorphs, which are comparatively passive at birth and include species with relatively derived forelimbs, differ little from other marsupials in ossification sequence. This suggests that ossification heterochrony in marsupials is not directly related to diversity constraints on the marsupial forelimb and shoulder girdle. PMID:18489720

Weisbecker, Vera; Goswami, Anjali; Wroe, Stephen; Sánchez-Villagra, Marcelo R

2008-05-16

120

Primary percutaneous coronary intervention in nonagenarians: six-month outcomes from a single-center registry.  

PubMed

Little is known about the efficacy and medium-term outcomes of primary percutaneous coronary intervention (PCI) in very old patients. We evaluated in-hospital and 6-month outcomes in a retrospective cohort of nonagenarian patients presenting at our hospital with ST-segment elevation myocardial infarction (STEMI) and treated by primary PCI from January 2003 to May 2012. During this period, primary PCI was performed in 1598 consecutive patients; twenty-seven patients (age, 92.5 ± 2.5 years) were enrolled in the study. Four patients (15%) were in advanced Killip class at presentation. STEMI location was anterior in 44%. Patients received aspirin, 300 mg clopidogrel loading dose, and heparin. Abciximab was given to 41% of patients. Coronary angiography showed multivessel disease in 52% of patients. Pain-to-balloon and door-to-balloon times were 375.0 ± 410.2 minutes and 107.3 ± 47.6 minutes, respectively. Intra-aortic balloon pump was implanted in 1 patient. An average of 1.3 ± 0.7 stents (95% bare-metal stents) were implanted per patient. Procedural success rate, defined as Thrombolysis in Myocardial Infarction (TIMI) flow grade ? 2 and residual stenosis <20%, was 89%. Hospital mortality was 18.5%. TIMI major bleeding and acute renal failure, defined as an absolute increase of 0.5 mg/dL serum creatinine, occurred in 7% and 22% of patients, respectively. Overall 6-month survival rate was 67%. Our data suggest that primary PCI can be performed in nonagenarian patients with high success rate and with an acceptable bleeding risk, even when aggressive antithrombotic drugs, such as glycoprotein IIb/IIIa inhibitors, are given. PMID:23645049

Rigattieri, Stefano; Cera, Maria; Sciahbasi, Alessandro; Di Russo, Cristian; Fedele, Silvio; Ferraiuolo, Giuseppe; Altamura, Giuliano; Pugliese, Francesco Rocco; Loschiavo, Paolo

2013-05-01

121

Low Primary Cesarean Rate and High VBAC Rate With Good Outcomes in an Amish Birthing Center  

PubMed Central

PURPOSE Recent national guidelines encourage a trial of labor after cesarean (TOLAC) as a means of increasing vaginal births after cesarean (VBACs) and decreasing the high US cesarean birth rate and its consequences (2010 National Institute of Health Consensus Statement and American College of Obstetricians and Gynecologists revised guideline). A birthing center serving Amish women in Southwestern Wisconsin offered an opportunity to look at the effects of local culture and practices that support vaginal birth and TOLAC. This study describes childbirth and perinatal outcomes during a 17-year period in LaFarge, Wisconsin. METHODS We undertook a retrospective analysis of the records of all women admitted to the birth center in labor. Main outcome measures include rates of cesarean deliveries, TOLAC and VBAC deliveries, and perinatal outcomes for 927 deliveries between 1993 and 2010. RESULT S The cesarean rate was 4% (35 of 927), the TOLAC rate was 100%, and the VBAC rate was 95% (88 of 92). There were no cases of uterine rupture and no maternal deaths. The neonatal death rate of 5.4 of 1,000 was comparable to that of Wisconsin (4.6 of 1,000) and the United States (4.5 of 1,000). CONCLUSIONS Both the culture of the population served and a number of factors relating to the management of labor at the birthing center have affected the rates of cesarean delivery and TOLAC. The results of the LaFarge Amish study support a low-technology approach to delivery where good outcomes are achieved with low cesarean and high VBAC rates.

Deline, James; Varnes-Epstein, Lisa; Dresang, Lee T.; Gideonsen, Mark; Lynch, Laura; Frey, John J.

2012-01-01

122

Methodological challenges of measuring primary care delivery to pediatric medicaid beneficiaries who use community health centers.  

PubMed

Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R(2) = 4.3%) compared with the variation explained by patient demographic variables (mean R(2) = 29.9%). The results reinforce the need for caution when one is attributing quality differences to provider performance. PMID:23237184

Tyo, Karen R; Gurewich, Deborah; Shepard, Donald S

2012-12-13

123

Follicular dendritic cell networks of primary follicles and germinal centers: phenotype and function  

PubMed Central

Follicular dendritic cells (FDCs) were identified decades ago by their ability to retain immune complexes and more recent findings indicate that they are a source of B cell attractants and trophic factors. New imaging studies have shown that B cells closely associate with their dendritic processes during migration. Here we will review the properties of these specialized follicular stromal cells and provide an update on the requirements for their maturation into phenotypically distinct cells within germinal center light and dark zones. We will then discuss current understanding of how they help support the B cell immune response.

Allen, Christopher D C; Cyster, Jason G

2008-01-01

124

The Residency Program in Social Medicine of Montefiore Medical Center: 37 Years of Mission-Driven, Interdisciplinary Training in Primary Care, Population Health, and Social Medicine  

Microsoft Academic Search

Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received

A. H. Strelnick; Debbie Swiderski; Alice Fornari; Victoria Gorski; Eliana Korin; Philip Ozuah; Janet M. Townsend; Peter A. Selwyn

2008-01-01

125

Prophylaxis of Heterotopic Ossification in Patients Sedated after Polytrauma  

Microsoft Academic Search

\\u000a Background and Purpose:  Heterotopic ossification (HO) often follows acetabular fractures after multitrauma. Irradiation is a mean for prophylaxis.\\u000a We established a standard procedure in our hospital for patients under sedation, when obtaining informed consent for HO prophylaxis\\u000a is impossible.\\u000a \\u000a \\u000a \\u000a Patients and Methods:  We reviewed current scientific evidence, calculated the risks of radiation and presented the ethical and legal framework.\\u000a The subject was

Susanne Oertel; Uwe Schneider; Marius Keel; Urs Martin Lütolf; Georg Bosshard

2008-01-01

126

Patient-centered primary health care: synergy potential for health systems strengthening.  

PubMed

The ultimate goal of government health systems is to provide highly effective equitable services that save lives and reduce morbidity and mortality. The pressure to conform to duplicative global and donor initiatives compounds existing challenges to health systems strengthening such as shortages of human resources for health, weak supply chains, inadequate laboratory services and parallel data management systems. This article illustrates how primary health care, as the point of entry into the health care system for the majority of individuals in sub-Saharan Africa, should be strengthened to ensure that individuals and their communities receive essential, holistic care. PMID:24020596

Stender, S C; Christensen, A

2013-10-01

127

Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device  

Microsoft Academic Search

Background  This study aimed to assess the feasibility and short-term results for percutaneous radiofrequency ablation in the treatment\\u000a of primary and secondary lung tumors.\\u000a \\u000a \\u000a \\u000a Methods  Between May 2003 and July 2004, 15 patients (mean age, 64.9 years; range, 51–80 years) with 18 pulmonary lesions (9 primitive\\u000a non–small cell lung cancers and 9 metastases) underwent the ablation procedure. All the patients had absolute

D. Laganà; G. Carrafiello; M. Mangini; L. Boni; G. Dionigi; M. C. Fusi; L. Cinquepalmi; F. Rovera; S. Cuffari; C. Fugazzola

2006-01-01

128

Evidence for Highly Dispersive Primary Charge Separation Kinetics and Gross Heterogeneity in the Isolated PS II Reaction Center of Green Plants †  

Microsoft Academic Search

Despite the availability of an X-ray structure and many spectroscopic studies, important issues related to structural heterogeneity, excitonic structure, primary charge separation (CS), and excitation energy transfer dynamics of the isolated reaction center (RC) of photosystem II (PS II) remain unresolved. The issues addressed here include (1) whether the primary CS kinetics at low temperatures are highly dispersive (due to

K. Riley; R. Jankowiak; M. Rätsep; G. J. Small; V. Zazubovich

2004-01-01

129

A germinal center-independent pathway generates unswitched memory B cells early in the primary response  

PubMed Central

Memory B cells can be produced from the classical germinal center (GC) pathway or a less understood GC-independent route. We used antigen-based cell enrichment to assess the relative contributions of these pathways to the polyclonal memory B cell pool. We identified a CD38+ GL7+ B cell precursor population that differentiated directly into IgM+ or isotype-switched (sw) Ig+ memory B cells in a GC-independent fashion in response to strong CD40 stimulation. Alternatively, CD38+ GL7+ B cell precursors had the potential to become Bcl-6+ GC cells that then generated primarily swIg+ memory B cells. These results demonstrate that early IgM+ and swIg+ memory B cells are products of a GC-independent pathway, whereas later switched Ig+ memory B cells are products of GC cells.

Pape, Kathryn A.; Jenkins, Marc K.

2012-01-01

130

Excitation and electron transfer from selectively excited primary donor chlorophyll (P700) in a photosystem I reaction center  

SciTech Connect

The primary processes in a photosystem I reaction center were studied by fluorescence up-conversion with a subpicosecond time resolution at room temperature. The samples were P700(primary donor chlorophyll)-enriched particles which retained {approx}14 chlorophylls per P700. Upon selective excitation of P700 at 701 nm at {approx}5{degree}C, anisotropy of the fluorescence at 749 nm decayed from {approx}0.3 to {approx}0.15 with a time constant of 1 ps. The dynamic depolarization is attributed to electronic excitation equilibration between P700 and the surrounding chlorophylls. In the isotropic fluorescence kinetics, at least two decaying components of 2.2 ps ({approx}35%) and 15 ps ({approx}55%) were found. The fast and slow components indicate the charge separation before and after full equilibration of excitation energy, respectively. A kinetic model calculation based on the above results suggests that the intrinsic rate constant of the primary electron transfer from P700{sup *} is > 0.25 ps{sup -1}. 51 refs., 4 figs., 1 tab.

Kumazaki, Shigeichi; Yoshihara, Keitaro [Inst. for Molecular Science, Okazaki (Japan); Ikegami, Isamu [Teikyo Univ., Kanagawa (Japan)

1997-01-23

131

Gender Differences in Posttraumatic Stress Disorder Among Primary Care Patients After the World Trade Center Attack of September 11, 2001  

PubMed Central

Background Debate surrounds the nature of gender differences in rates of posttraumatic stress disorder (PTSD). Objective The goal of this study was to quantify and explore the reasons for gender differences in rates of PTSD in low income, primary care patients after the World Trade Center (WTC) attack of September 11, 2001. Methods A survey was conducted at a large primary care practice in New York City 7 to 16 months after the WTC attack. The study involved a systematic sample of primary care patients aged 18 to 70 years. The main outcome measures were the Life Events Checklist, the Posttraumatic Stress Disorder Checklist–Civilian Version, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, all administered by a bilingual research staff. Results A total of 3807 patients were approached at the primary care clinic. Of the 1347 who met eligibility criteria, 1157 (85.9%) consented to participate. After the addition of the WTC/PTSD supplement to the study, the total number of patients was 992, of whom 982 (99.0%) completed the survey. Both sexes had high rates of direct exposure to the WTC attack and high rates of lifetime exposure to stressful life events. Overall, females had lower rates of exposure to the attack compared with males (P < 0.05). Hispanic females had the highest rate of PTSD in the full sample. Gender differences in rates of PTSD were largely accounted for by differences in marital status and education. The rate of current major depressive disorder (MDD) was higher in females than in males (P < 0.001), and the reverse was true for substance abuse (P < 0.001). Gender differences for MDD and substance abuse persisted even after adjustments for demographic differences between the sexes. Conclusions The increased rate of PTSD in women attending a primary care clinic was mediated by their social and economic circumstances, such as living alone without a permanent relationship and with little education or income. The increased rate of MDD in women appeared to be less dependent on these circumstances. These findings have implications for the treatment of women with PTSD in primary care and for research on gender differences in rates of psychiatric disorders.

Weissman, Myrna M.; Neria, Yuval; Das, Amar; Feder, Adriana; Blanco, Carlos; Lantigua, Rafael; Shea, Steven; Gross, Raz; Gameroff, Marc J.; Pilowsky, Daniel; Olfson, Mark

2013-01-01

132

Early Presentation of Heterotopic Ossification Mimicking Pyomyositis - Two Case Reports -  

PubMed Central

Early diagnosis and treatment of heterotopic ossification (HO) is essential to the prevention of complications. It is difficult to diagnose HO in its initial phase because non-specific clinical manifestations, laboratory findings and imaging findings of immature HO may mimic other diseases such as cellulitis, osteomyelitis, thrombophlebitis, deep vein thrombosis and local infection with abscess. We experienced two cases of HO, which were misdiagnosed as pyomyositis at first by clinical signs and MRI findings indicating the deep infection; the extensive intramuscular ossification appeared later on. We observed an increase of C-reactive protein and creatine kinase followed by the elevation of alkaline phosphatase with abnormal triphasic bone scan. The trajectory of these biomarkers was analyzed to get more insight into the early stages of HO along with the imaging findings. Although our cases cannot be generalized as typical of immature HO, they clearly demonstrate that the change of specific biomarkers with a careful history taking and physical examination should be noted to detect HO as early as possible while avoiding confusion with other mimicking conditions.

Choi, Yoon-Hee; Kim, Kyoung-Eun; Lim, Sung-Hoon

2012-01-01

133

Primary Stenting of Subclavian and Innominate Artery Occlusive Disease: A Single Center's Experience  

SciTech Connect

Purpose: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. Methods: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. Results: Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. Conclusion: Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions.

Brountzos, E. N., E-mail: platanos@hol.qr; Petersen, B.; Binkert, C.; Panagiotou, I.; Kaufman, J. A. [Oregon Health Sciences University, Dotter Interventional Institute (United States)

2004-11-15

134

Patient-Centered Care: The Influence of Patient and Resident Physician Gender and Gender Concordance in Primary Care  

PubMed Central

Abstract Background Patient-centered care (PCC) is thought to significantly influence the process of care and its outcomes and has been identified as part of a comprehensive strategy for improving our nation's healthcare delivery system. Patient and physician gender, as well as gender concordance, may influence the provision of PCC. Methods Patients (315 women, 194 men) were randomized to care by primary care resident physicians (48 women, 57 men). Sociodemographic information, history of health risk behaviors (tobacco use, alcoholism, and obesity), and self-reported global pain and health status were collected before the first visit. That visit and subsequent patient visits to the primary care physician (PCP) were videotaped during the year-long study period. PCC was measured by coding all videotapes using a modified version of the Davis Observation Code. Results No significant gender differences in PCC were found between the male and female patients; however, female physicians provided increased PCC to their patients. The greatest amount of PCC was seen in the female patient-female physician gender dyad. Regression analyses, controlling for other patient variables, confirmed that female concordant dyads were associated with a greater amount of PCC. There was no significant relationship for the male patient-male physician concordance (vs. disconcordance). Conclusions These findings highlight the influence of gender in the process of care and provision of PCC. Gender concordance in female patient-female physician dyads demonstrated significantly more PCC. Further research in other clinical settings using other measures of PCC is needed. A public mandate to provide care that is patient-centered has implications for medical education.

Azari, Rahman

2012-01-01

135

Primary care nursing role and care coordination: an observational study of nursing work in a community health center.  

PubMed

Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination. PMID:22686111

Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

2012-05-31

136

Use of 3-dimensional stereolithographic polymer models for heterotopic ossification surgical excision.  

PubMed

Heterotopic ossification is a known complication of traumatic injuries. To minimize iatrogenic complications during excision, an understanding of anatomic relationships is essential. Current imaging modalities, such as computed tomography and plain radiographs, are limited to providing a 2-dimensional representation of a 3-dimensional problem. This study describes the benefits of 3-dimensional stereolithography in the perioperative management of symptomatic heterotopic ossification using models were that were fabricated based on high-resolution computed tomography scans. The models facilitated heterotopic ossification excision through frequent intraoperative reference, allowing the authors to avoid iatrogenic neurovascular injuries. PMID:23590770

Fleming, Mark E; Waterman, Scott S; Lewandowski, Louis R; Chi, Benjamin B

2013-04-01

137

Does a Plastic Drape Reduce Incidence of Heterotopic Ossification After Hip Resurfacing?  

Microsoft Academic Search

Background  High rates of heterotopic ossification have been associated with hip resurfacing as compared to THA. Bone debris from femoral\\u000a head reamings is cited as one of the risk factors linked to increased rates of heterotopic ossification.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore asked whether (1) the incidence of heterotopic ossification differed with and without the use of a plastic drape\\u000a used to collect bone

John S. Shields; Ali Mofidi; William G. Ward; Riyaz H. Jinnah

2011-01-01

138

Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers  

PubMed Central

Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs) in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP). Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP) measurements, and CVRF were extracted from medical records of patients followed for a 12-month period. Results. 59.7% of patients reached target BP <140/90?mmHg. More women were captured in the sampling (2.1?:?1), achieving better BP control than men. Diabetic patients (26.4%) had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90?mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics.

Sandoval, Daniela; Bravo, Miguel; Koch, Elard; Gatica, Sebastian; Ahlers, Ivonne; Henriquez, Oscar; Romero, Tomas

2012-01-01

139

Influence of electronic asymmetry on the spectroscopic and photodynamic properties of the primary electron donor in the photosynthetic reaction center  

SciTech Connect

Resonance Raman and subpicosecond resolution transient absorption data are presented on the reaction center (RC) from the Rb. sphaeroides (M)H202L/(L)L131H double mutant. This RC contains a bacteriochlorophyll/bacteriopheophytin heterodimer primary electron donor (D), as a result of introducing a Leu at M subunit residue 202, as well as a hydrogen bond to the ring-V keto group of he BChl component, as a result of introducing a His at L subunit residue 131. The double mutant shows a longer lifetime (40ps) for the lowest excited singlet state and a lower quantum yield of change separation (25%) than observed perviously for the heterodimer single mutants (M)H202L and (L)H173L. These changes are ascribed in large measure to a decrease in the contribution of the accessory pigment BChl{sub L} to the initial stage of charge separation. Both the rate of internal conversion of the excited primary donor and the characteristics of the near-infrared ground state absoption of the dimer appear to be intermediate between those found for the (M)H202L single mutant and wild type RCs. Resonance Raman profiles obtained via excitation at several wavelengths across the heterodimer absorption band suggest that there is a change in the nature and perhaps ordering of the two lowest excited states of the heterodimer in the double mutant compared with the single mutant. 44 refs., 13 figs., 1 tab.

Laporte, L.L.; Kirmaier, C.; Holten, D. [Washington Univ., St. Louis, MO (United States); Palaniappan, V.; Bocian, D.F. [Univ. of California, Riverside, CA (United States); Davis, D.G.; Schenck, C.C. [Colorado State Univ., Fort Collins, CO (United States)

1996-10-31

140

[Updates on ossification of posterior longitudinal ligament. Effect of insulin/IGF-1 signals and leptin signals on ossification of the spinal ligament in Zucker fatty rats].  

PubMed

The involvement of insulin/IGF-1 signals and leptin signals in spinal ligament cells was investigated using Zucker fatty rats (fa/fa) that carry mutation of the leptin receptor gene (fa) and monosodium glutamate-treated (MSG) rats that present obesity due to destruction of the hypothalamic ventromedial nucleus. Zucker fatty rats (ZFR) , that have a with functional abnormality of leptin receptors are a spontaneous model of ossification of the posterior longitudinal ligament that develops sympathetic nerve hypoactivity. (insulin/IGF-1 signals) IRS-1-positive cells, IRS-1 protein were eminent by detected in the cartilage endplate and the enthesis region in ZFR group. On the other hand, IRS-2-positive cells were slightly less in the ZFR group than in the MSG and control groups. The results suggest that IRS-1-mediated signaling for cell proliferation was enhanced in ZFR, which may explain the ossification of the posterior longitudinal ligament. (Leptin signals) We investigated the effects of leptin on the spinal ligament in ZFR histopathologically and immunohistochemically. Since Ob-R does not play any role due to functional abnormality in ZFR, the direct involvement of leptin in ligament ossification may be slight in ZFR. beta(2)AR expression in the stage preceding ligament ossification was confirmed, suggesting that ossification of the spinal ligament may be inhibited by sympathetic nerve stimulation in ZFR. PMID:19794255

Yamamoto, Kengo; Kosaka, Taiichi

2009-10-01

141

Heterotopic ossification of the elbows in a major petrol burn.  

PubMed

A case of a young man who developed heterotopic ossification (HO) in his elbows following an accident where he sustained petrol burns to over 60% of his body. His injuries necessitated intubation, escharotomies and a protracted intensive care unit stay that was complicated by septicaemia. Several weeks after the injury, he was diagnosed with HO in his right elbow, followed by the left elbow a week later. He was commenced on an non-steroidal anti-inflammatory drug, a long-term course of a bisphosphonate and regular physiotherapy. He is now waiting for the HO bone to mature before having definitive excision of his lesions in 12-18 months time. PMID:22927269

Zaman, Shahriar Raj

2012-08-27

142

Intracranial plasma cell-granuloma with extensive ossification.  

PubMed

Intracranial plasma-cell granuloma is non-neoplastic proliferation of plasma cells which occurs rarely. We present an unusual case of an 18-year-old female patient with extensively ossified intracranial plasma-cell granuloma. Computed Tomography (CT) and Magnetic Resonance Image (MRI) demonstrated a left frontoparietal mass with extensive calcification. The lesion was removed subtotally. Histopathological findings revealed diffuse inflammatory cells consisting mostly of reactive plasma cells, histiocytes and neutrophils, several lymphocytes, lymphoplasmacytic cells, a few eosinophils throughout the dura and adjacent brain. Widespread psammomatous and dystrophic calcifications, and very extensive ossification with trabecular bone formation were present within the lesion. In the case of an intracranial mass lesion with calcification, plasma-cell granuloma, although rare, should be included in the differential diagnosis. PMID:16801048

Ozüm, Unal; Ozer, Hatice; Karada?, Ozen; Polat, Nurettin

2006-06-01

143

Chondrogenesis and ossification of the lissamphibian pectoral girdle.  

PubMed

Knowledge of amphibian shoulder development is requisite for further understanding of gnathostome pectoral girdle evolution. Fish and amniotes share few pectoral girdle elements, but modern amphibians exhibit a unique combination of traits that bridge the morphological gap between these two groups. I analyzed patterns of chondrogenesis, ossification, and bone histology of the pectoral girdles of two anuran species (Xenopus laevis and Bombina orientalis) and two urodele species (Ambystoma mexicanum and Desmognathus aeneus) to provide new insight into the evolution of the tetrapod pectoral girdle. Comparisons reveal the following: 1) variation in the pattern of chondrogenesis among the anuran species analyzed correlates to variation in adult pectoral girdle morphology; 2) morphologically similar pectoral skeletons do not necessarily have similar patterns of bone histology; and 3) the urodele and anuran pectoral girdles included herein share a common morphology despite differences in patterns of chondrogenesis. PMID:17999401

Shearman, Rebecca M

2008-04-01

144

Ossification of the yellow ligament causing thoracic cord compression.  

PubMed

Ossification of the yellow ligament (OYL) is not infrequent in the cervical and lumbar regions but is very rare in the thoracic spine, with no more than 40 cases reported in the literature. We describe a 50-year-old male with progressive paraparesis and sensory dysfunction, secondary to OYL at T10-T11, studied by computed tomography (CT) and magnetic resonance imaging (MRI). Decompressive laminectomy and removal of the ligament resulted in marked clinical improvement. Patients with OYL may initially develop sensory dysfunction associated with leg weakness. This pathological entity can be well defined by CT and MRI, and surgery by decompressive laminectomy is advised for all cases. The OYL should be removed both posteriorly and laterally to the dural sac to obtain sufficient decompression of the spinal canal. PMID:10853911

Maiuri, F; Iaconetta, G; Gambardella, A

2000-01-01

145

Engineering of a functional bone organ through endochondral ossification.  

PubMed

Embryonic development, lengthening, and repair of most bones proceed by endochondral ossification, namely through formation of a cartilage intermediate. It was previously demonstrated that adult human bone marrow-derived mesenchymal stem/stromal cells (hMSCs) can execute an endochondral program and ectopically generate mature bone. Here we hypothesized that hMSCs pushed through endochondral ossification can engineer a scaled-up ossicle with features of a "bone organ," including physiologically remodeled bone, mature vasculature, and a fully functional hematopoietic compartment. Engineered hypertrophic cartilage required IL-1? to be efficiently remodeled into bone and bone marrow upon subcutaneous implantation. This model allowed distinguishing, by analogy with bone development and repair, an outer, cortical-like perichondral bone, generated mainly by host cells and laid over a premineralized area, and an inner, trabecular-like, endochondral bone, generated mainly by the human cells and formed over the cartilaginous template. Hypertrophic cartilage remodeling was paralleled by ingrowth of blood vessels, displaying sinusoid-like structures and stabilized by pericytic cells. Marrow cavities of the ossicles contained phenotypically defined hematopoietic stem cells and progenitor cells at similar frequencies as native bones, and marrow from ossicles reconstituted multilineage long-term hematopoiesis in lethally irradiated mice. This study, by invoking a "developmental engineering" paradigm, reports the generation by appropriately instructed hMSC of an ectopic "bone organ" with a size, structure, and functionality comparable to native bones. The work thus provides a model useful for fundamental and translational studies of bone morphogenesis and regeneration, as well as for the controlled manipulation of hematopoietic stem cell niches in physiology and pathology. PMID:23401508

Scotti, Celeste; Piccinini, Elia; Takizawa, Hitoshi; Todorov, Atanas; Bourgine, Paul; Papadimitropoulos, Adam; Barbero, Andrea; Manz, Markus G; Martin, Ivan

2013-02-11

146

Engineering of a functional bone organ through endochondral ossification  

PubMed Central

Embryonic development, lengthening, and repair of most bones proceed by endochondral ossification, namely through formation of a cartilage intermediate. It was previously demonstrated that adult human bone marrow-derived mesenchymal stem/stromal cells (hMSCs) can execute an endochondral program and ectopically generate mature bone. Here we hypothesized that hMSCs pushed through endochondral ossification can engineer a scaled-up ossicle with features of a “bone organ,” including physiologically remodeled bone, mature vasculature, and a fully functional hematopoietic compartment. Engineered hypertrophic cartilage required IL-1? to be efficiently remodeled into bone and bone marrow upon subcutaneous implantation. This model allowed distinguishing, by analogy with bone development and repair, an outer, cortical-like perichondral bone, generated mainly by host cells and laid over a premineralized area, and an inner, trabecular-like, endochondral bone, generated mainly by the human cells and formed over the cartilaginous template. Hypertrophic cartilage remodeling was paralleled by ingrowth of blood vessels, displaying sinusoid-like structures and stabilized by pericytic cells. Marrow cavities of the ossicles contained phenotypically defined hematopoietic stem cells and progenitor cells at similar frequencies as native bones, and marrow from ossicles reconstituted multilineage long-term hematopoiesis in lethally irradiated mice. This study, by invoking a “developmental engineering” paradigm, reports the generation by appropriately instructed hMSC of an ectopic “bone organ” with a size, structure, and functionality comparable to native bones. The work thus provides a model useful for fundamental and translational studies of bone morphogenesis and regeneration, as well as for the controlled manipulation of hematopoietic stem cell niches in physiology and pathology.

Scotti, Celeste; Piccinini, Elia; Takizawa, Hitoshi; Todorov, Atanas; Bourgine, Paul; Papadimitropoulos, Adam; Barbero, Andrea; Manz, Markus G.; Martin, Ivan

2013-01-01

147

[Development of ossification in children with chronic digestive insufficiency (author's transl)].  

PubMed

In 84 children suffering from chronic insufficiency of digestion, ossification of both hands was observed by means of fluoroscopic controls for several years. In 48 of 71 patients there was a retarded ossification; in 23 it was normal, or respectively more advanced. 18 boys and girls succeeded in making up for there retardation by means of consequent diet so that it might be regarded as a "spurt of growth". But in 10 of them retardation was constant, and in 14 children it increased. The causes of insufficient improvement were: late diagnosis and therapy, failures of diet, but also additional diseases--different from digestive insufficiency--, and long-term use of corticosteroides. In 30 of 84 children ossification was always normal or advanced. They had received early and consequent diet for years. Only in few cases, slight or moderate diseases were diagnosed. Development of ossification was parallel to body height, but not to weight gain. PMID:110578

Glaser, H; Genssler, W; Fiehring, C

1979-01-01

148

Vessel formation is induced prior to the appearance of cartilage in BMP-2-mediated heterotopic ossification  

Technology Transfer Automated Retrieval System (TEKTRAN)

Heterotopic ossification (HO), or endochondral bone formation at nonskeletal sites, often results from traumatic injury and can lead to devastating consequences. Alternatively, the ability to harness this phenomenon would greatly enhance current orthopedic tools for treating segmental bone defects. ...

149

Pathophysiological Role of Endothelin in Ectopic Ossification of Human Spinal Ligaments Induced by Mechanical Stress  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) of the spine is characterized by progressive ectopic bone formation\\u000a in the spinal ligament. To identify the genes related to ossification affected by mechanical stress during OPLL, analyses\\u000a using cDNA microarray were carried out using cultured human spinal ligament cells that had been subjected to uniaxial cyclic\\u000a stretching. Samples were obtained from a

T. Iwasawa; K. Iwasaki; T. Sawada; A. Okada; K. Ueyama; S. Motomura; S. Harata; I. Inoue; S. Toh; K.-I. Furukawa

2006-01-01

150

Conserved relative timing of cranial ossification patterns in early mammalian evolution.  

PubMed

We analyzed a comprehensive data set of ossification sequences including seven marsupial, 13 placental and seven sauropsid species. Data are provided for the first time for two major mammalian clades, Chiroptera and Soricidae, and for two rodent species; the published sequences of three species were improved with additional sampling. The relative timing of the onset of ossification in 17 cranial elements was recorded, resulting in 136 event pairs, which were treated as characters for each species. Half of these characters are constant across all taxa, 30% are variable but phylogenetically uninformative, and 19% potentially deliver diagnostic features for clades of two or more taxa. Using the conservative estimate of heterochronic changes provided by the program Parsimov, only a few heterochronies were found to diagnose mammals, marsupials, or placentals. A later onset of ossification of the pterygoid with respect to six other cranial bones characterizes therian mammals. This result may relate to the relatively small size of this bone in this clade. One change in relative onset of ossification is hypothesized as a potential human autapomorphy in the context of the sampling made: the earlier onset of the ossification of the periotic with respect to the lacrimal and to three basicranial bones. Using the standard error of scaled ranks across all species as a measure of each element's lability in developmental timing, we found that ossification of early, middle, and late events are similarly labile, with basicranial traits the most labile in timing of onset of ossification. Despite marsupials and placental mammals diverging at least 130 Ma, few heterochronic shifts in cranial ossification diagnose these clades. PMID:18803770

Sánchez-Villagra, Marcelo R; Goswami, Anjali; Weisbecker, Vera; Mock, Orin; Kuratani, Shigeru

151

Effect of Hydro-alcoholic Extract of Soybean on Embryonic Growth and Ossification Indices in Mouse  

Microsoft Academic Search

Vojdani, Z., Khozani, T.T., Dehghani, F., Panjehshahin, M.R., Habibi, A. and Mehrabani, D. 2007. Effect of hydro-alcoholic extract of soybean on embryonic growth and ossification indices in mouse. J. Appl. Anim. Res., 31: 117–120.To evaluate the effects of soybean hydro-alchoholic extraction on growth and ossification indices, fifty female mice were randomly selected and caged with males overnight. The day when

Zahra Vojdani; Tahereh Talaei Khozani; Farzaneh Dehghani; Mohammad Reza Panjehshahin; Afrooz Habibi; Davood Mehrabani

2007-01-01

152

Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam  

PubMed Central

Background Fever is a common reason for attending primary health facilities in Vietnam. Response of health care providers to patients with fever commonly consists of making a presumptive diagnosis and proposing corresponding treatment. In Vietnam, where malaria was brought under control, viral infections, notably dengue, are the main causes of undifferentiated fever but they are often misdiagnosed and inappropriately treated with antibiotics. This study investigate if educating primary health center (PHC) staff or introducing rapid diagnostic tests (RDTs) improve diagnostic resolution and accuracy for acute undifferentiated fever (AUF) and reduce prescription of antibiotics and costs for patients. Methods In a PHC randomized intervention study in southern Vietnam, the presumptive diagnoses for AUF patients were recorded and confirmed by serology on paired (acute and convalescence) sera. After one year, PHCs were randomized to four intervention arms: training on infectious diseases (A), the provision of RDTs (B), the combination (AB) and control (C). The intervention lasted from 2002 until 2006. Results The frequency of the non-etiologic diagnosis "undifferentiated fever" decreased in group AB, and - with some delay- also in group B. The diagnosis "dengue" increased in group AB, but only temporarily, although dengue was the most common cause of fever. A correct diagnosis for dengue initially increased in groups AB and B but only for AB this was sustained. Antibiotics prescriptions increased in group C. During intervention it initially declined in AB with a tendency to increase afterwards; in B it gradually declined. There was a substantial increase of patients' costs in B. Conclusions The introduction of RDTs for infectious diseases such as dengue, through free market principles, does improve the quality of the diagnosis and decreases the prescription of antibiotics at the PHC level. However, the effect is more sustainable in combination with training; without it RDTs lead to an excess of costs.

2010-01-01

153

Veteran family reintegration, primary care needs, and the benefit of the patient-centered medical home model.  

PubMed

Men and women returning from the wars in Afghanistan and Iraq face a multitude of difficulties while integrating back into civilian life, but the importance of their veteran status is often overlooked in primary care settings. Family physicians have the potential to be the first line of defense to ensure the well-being of veterans and their families because many will turn to nonmilitary and non-Veterans Affairs providers for health care needs. An awareness of the unique challenges faced by this population is critical to providing care. A patient-centered medical home orientation can help the family physician provide veterans and their families the care they need. Specific recommendations for family physicians include screening their patient population; providing timely care; treating the whole family; and integrating care from multiple disciplines and specialties, providing veterans and families with "one-stop shopping" care. An awareness of the unique challenges faced by veterans and their families translates into better overall outcomes for this population. PMID:21057073

Hinojosa, Ramon; Hinojosa, Melanie Sberna; Nelson, Karen; Nelson, David

154

Barriers and Facilitators to Implementing Primary Stroke Center Policy in the United States: Results From 4 Case Study States  

PubMed Central

Objectives. We identified barriers and facilitators to the state-level implementation of primary stroke center (PSC) policies, which encourage the certification or designation of specialized stroke treatment facilities and may address concerns such as transportation bypass, telemedicine, and treatment protocols. Methods. We studied the experiences of 4 states (Florida, Massachusetts, New Mexico, and New York) selected from the 18 states that had enacted PSC policies or were actively considering doing so. We conducted semistructured interviews during fieldwork in each case study state. Results. Our results showed that system fragmentation, gaps in human and financial resources, and complexity at the interorganizational and operational levels are common barriers and that policy champions, stakeholder support and communication, and operational adaptation are essential facilitators in the adoption and implementation of PSC policies. Conclusions. The identification of barriers and facilitators reveals the contextual elements that can help or hinder policy implementation and may be useful in informing policy formulation and implementation in other jurisdictions. Proactively identifying jurisdictional challenges and opportunities may help facilitate the policy process for PSC designation and allow jurisdictions to develop more effective stroke systems of care.

Slade, Catherine P.; Brewer, Gene A.; Gase, Lauren N.

2011-01-01

155

Spongiosa primary development: a biochemical hypothesis by Turing patterns formations.  

PubMed

We propose a biochemical model describing the formation of primary spongiosa architecture through a bioregulatory model by metalloproteinase 13 (MMP13) and vascular endothelial growth factor (VEGF). It is assumed that MMP13 regulates cartilage degradation and the VEGF allows vascularization and advances in the ossification front through the presence of osteoblasts. The coupling of this set of molecules is represented by reaction-diffusion equations with parameters in the Turing space, creating a stable spatiotemporal pattern that leads to the formation of the trabeculae present in the spongy tissue. Experimental evidence has shown that the MMP13 regulates VEGF formation, and it is assumed that VEGF negatively regulates MMP13 formation. Thus, the patterns obtained by ossification may represent the primary spongiosa formation during endochondral ossification. Moreover, for the numerical solution, we used the finite element method with the Newton-Raphson method to approximate partial differential nonlinear equations. Ossification patterns obtained may represent the primary spongiosa formation during endochondral ossification. PMID:23193429

López-Vaca, Oscar Rodrigo; Garzón-Alvarado, Diego Alexander

2012-09-12

156

Primary homologies of the circumorbital bones of snakes.  

PubMed

Some snakes have two circumorbital ossifications that in the current literature are usually referred to as the postorbital and supraorbital. We review the arguments that have been proposed to justify this interpretation and provide counter-arguments that reject those conjectures of primary homology based on the observation of 32 species of lizards and 81 species of snakes (both extant and fossil). We present similarity arguments, both topological and structural, for reinterpretation of the primary homologies of the dorsal and posterior orbital ossifications of snakes. Applying the test of similarity, we conclude that the posterior orbital ossification of snakes is topologically consistent as the homolog of the lacertilian jugal, and that the dorsal orbital ossification present in some snakes (e.g., pythons, Loxocemus, and Calabaria) is the homolog of the lacertilian postfrontal. We therefore propose that the terms postorbital and supraorbital should be abandoned as reference language for the circumorbital bones of snakes, and be replaced with the terms jugal and postfrontal, respectively. The primary homology claim for the snake "postorbital" fails the test of similarity, while the term "supraorbital" is an unnecessary and inaccurate application of the concept of a neomorphic ossification, for an element that passes the test of similarity as a postfrontal. This reinterpretation of the circumorbital bones of snakes is bound to have important repercussions for future phylogenetic analyses and consequently for our understanding of the origin and evolution of snakes. J. Morphol. 274:973-986, 2013. © 2013 Wiley Periodicals, Inc. PMID:23630161

Palci, Alessandro; Caldwell, Michael W

2013-04-30

157

Theory of Optical Spectra of Photosystem II Reaction Centers: Location of the Triplet State and the Identity of the Primary Electron Donor  

PubMed Central

Based on the structural analysis of photosystem II of Thermosynechococcus elongatus, a detailed calculation of optical properties of reaction-center (D1–D2) complexes is presented applying a theory developed previously. The calculations of absorption, linear dichroism, circular dichroism, fluorescence spectra, all at 6 K, and the temperature-dependence of the absorption spectrum are used to extract the local optical transition energies of the reaction-center pigments, the so-called site energies, from experimental data. The site energies are verified by calculations and comparison with seven additional independent experiments. Exciton relaxation and primary electron transfer in the reaction center are studied using the site energies. The calculations are used to interpret transient optical data. Evidence is provided for the accessory chlorophyll of the D1-branch as being the primary electron donor and the location of the triplet state at low temperatures.

Raszewski, Grzegorz; Saenger, Wolfram; Renger, Thomas

2005-01-01

158

Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers  

Microsoft Academic Search

Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary

Rajesh Bhat; Kieran McBride; Sam Chakraverty; Raghunandan Vikram; Alison Severn

2007-01-01

159

Burn Injury Enhances Bone Formation in Heterotopic Ossification Model.  

PubMed

OBJECTIVE:: To demonstrate the pro-osteogenic effect of burn injury on heterotopic bone formation using a novel burn ossicle in vivo model. BACKGROUND:: Heterotopic ossification (HO), or the abnormal formation of bone in soft tissue, is a troubling sequela of burn and trauma injuries. The exact mechanism by which burn injury influences bone formation is unknown. The aim of this study was to develop a mouse model to study the effect of burn injury on heterotopic bone formation. We hypothesized that burn injury would enhance early vascularization and subsequent bone formation of subcutaneously implanted mesenchymal stem cells. METHODS:: Mouse adipose-derived stem cells were harvested from C57/BL6 mice, transfected with a BMP-2 adenovirus, seeded on collagen scaffolds (ossicles), and implanted subcutaneously in the flank region of 8 adult mice. Burn and sham groups were created with exposure of 30% surface area on the dorsum to 60°C water or 30°C water for 18 seconds, respectively (n = 4/group). Heterotopic bone volume was analyzed in vivo by micro-computed tomography for 3 months. Histological analysis of vasculogenesis was performed with platelet endothelial cell adhesion molecule staining. Osteogenic histological analysis was performed by Safranin O, Picrosirius red, and aniline blue staining. Qualitative analysis of heterotopic bone composition was completed with ex vivo Raman spectroscopy. RESULTS:: Subcutaneously implanted ossicles formed heterotopic bone. Ossicles from mice with burn injuries developed significantly more bone than sham control mice, analyzed by micro-computed tomography at 1, 2, and 3 months (P < 0.05), and had enhanced early and late endochondral ossification as demonstrated by Safranin O, Picrosirius red, and aniline blue staining. In addition, burn injury enhanced vascularization of the ossicles (P < 0.05). All ossicles demonstrated chemical composition characteristic of bone as demonstrated by Raman spectroscopy. CONCLUSIONS:: Burn injury increases the predilection to osteogenic differentiation of ectopically implanted ossicles. Early differences in vascularity correlated with later bone development. Understanding the role of burn injury on heterotopic bone formation is an important first step toward the development of treatment strategies aimed to prevent unwanted and detrimental heterotopic bone formation. PMID:23673767

Peterson, Jonathan R; De La Rosa, Sara; Sun, Hongli; Eboda, Oluwatobi; Cilwa, Katherine E; Donneys, Alexis; Morris, Michael; Buchman, Steven R; Cederna, Paul S; Krebsbach, Paul H; Wang, Stewart C; Levi, Benjamin

2013-05-12

160

Primary Cutaneous Follicle Center Cell Lymphomas and Large B Cell Lymphomas of the Leg Descend from Germinal Center Cells. A Single Cell Polymerase Chain Reaction Analysis  

Microsoft Academic Search

Primary cutaneous B cell lymphomas are defined as non-Hodgkin lymphomas that occur in the skin without extracutaneous involvement for 6 mo after diagnosis. They are characterized by a less aggressive course and better prognosis than their nodal counterparts. According to the European Organization for Research and Treatment of Cancer classification, the major subentities of primary cutaneous B cell lymphoma are

Sylke Gellrich; Sascha Rutz; Sven Golembowski; Claudia Jacobs; Malgorzata von Zimmermann; Pamela Lorenz; Heike Audring; Marcus Muche; Wolfram Sterry; Sigbert Jahn

2001-01-01

161

Significance of proteinuria in type 2 diabetic patients treated at a primary health care center in Abha City, Saudi Arabia.  

PubMed

The aim of the present study is to describe the prevalence of proteinuria in a series of type 2 diabetic patients registered and followed up in the diabetes clinic of a primary health care center (PHCC) in Abha city, southern Saudi Arabia and to relate the proteinuria to some clinical manifestations. The study involved the files of 208 diabetic patients (118 females and 90 males). They were chosen from 475 files of diabetic patients receiving care in the PHC center of Shamasan in Abha City. The selection for this study was based on the fulfillment of certain criteria: type 2 diabetic patients, registered for at least 12 months and visited the clinic for at least once during that period. For each patient the age, sex, family history, diabetes duration, body mass index, the last readings of fasting blood sugar, total cholesterol level, systolic and diastolic blood pressure were used. Proteinuria was considered whenever the last and any of the preceding 3 urine analysis revealed it by the dipstick test provided the patient was not suffering on the day of the test from fever, urinary tract infections, other renal diseases or congestive heart failure. Further, the last recorded subjective evaluation of the treating physician concerning diet, drug and appointment compliance as poor or good was used. The mean age is 56.2+/-8.8 years. The mean duration of diabetes was 9.6+/-4.7 years, while the fasting blood sugar shows a considerably high mean of 218.0+/-72.0 mg/dl. The total cholesterol level on the other hand showed a slight high average of 233.7+/-55.2 mg/dl. The mean systolic and diastolic blood pressure were within normal ranges (136.4+/-18.9mmHg and 87.5+/-10.8mmHg) respectively. The results of the three different types of compliance as scored by the treating physician. The poor scores dominate with 74%, 82.7% and 78.4% of patients' diet, drug and appointment compliances. Proteinuria is present in more than half of the patients (54.3%). The outcome of the logistic regression model for proteinuria showed that the significant factors were the poor glycemic control with an odds ratio (OR) of 3.13, diabetes duration (OR= 1.08 for every year) and diastolic blood pressure (OR= 6.11). The overall model prediction was 72.12%. Diabetic patients treated in the PHC level should be regularly monitored for microalbuminuria and not gross proteinuria to prevent progression to overt nephropathy which will eventually lead to ESRD. The risk increases with poorly controlled and hypertensive patients. PMID:15587831

Al-Homrany, Mohammed A; Abdelmoneim, Ismail

162

To Study the Incidence of Heterotopic Ossification After Anterior Cruciate Ligament Reconstruction  

PubMed Central

Introduction: Previous studies have enumerated the advantages of an arthroscopic Anterior Cruciate Ligament (ACL) reconstruction with the use of a Bone Patellar Tendon Bone (BPTB) graft. Complications are extremely rare in such surgeries and one such known complication, which is an extra-articular heterotophic ossification at the femoral tunnel site, is rarely seen only in few patients. Aim: To evaluate the incidence of heterotrophic ossifications at the femoral tunnel site and the efficacy of the preventive measures which were undertaken, in patients who had undergone ACL reconstructions with the use of bone patellar tendon bone grafts. Material and Methods: A total of 285 patients who had ACL tears within a duration of six years, were evaluated prospectively for the incidence of heterotrophic ossifications after they underwent arthroscopic reconstructions with the use of bone patellar tendon bone grafts by the double incision technique. The effect of the efficacy of various preventive measures on the incidence of the heterotophic ossifications post surgery was also studied. Results: The observed incidence of the heterotophic ossifications was 2.58% in patients whom preventive measures were not used. In contrast, an incidence of 1.54% of similar complications was recorded, after preventive measures were undertaken. Our results showed that heterotophic ossifications after arthroscopic reconstructions with the use of bone patellar tendon bone grafts were a rare complication and that their incidence could be further reduced if preventive measures were taken. Conclusion: The heterotophic ossification is a rare complication after an ACL reconstruction is done with the use of a bone patellar tendon bone graft by the double incision technique. Its incidence reduces significantly after preventive measures are undertaken.

Bhandary, Bhaskara; Shetty, Sudeep; Bangera, Vinay V.; R., Yogaprakash; Kassim, Mohammed Shabir; Alva, Karan; Bhandary, Sudarshan

2013-01-01

163

To study the incidence of heterotopic ossification after anterior cruciate ligament reconstruction.  

PubMed

Introduction: Previous studies have enumerated the advantages of an arthroscopic Anterior Cruciate Ligament (ACL) reconstruction with the use of a Bone Patellar Tendon Bone (BPTB) graft. Complications are extremely rare in such surgeries and one such known complication, which is an extra-articular heterotophic ossification at the femoral tunnel site, is rarely seen only in few patients. Aim: To evaluate the incidence of heterotrophic ossifications at the femoral tunnel site and the efficacy of the preventive measures which were undertaken, in patients who had undergone ACL reconstructions with the use of bone patellar tendon bone grafts. Material and Methods: A total of 285 patients who had ACL tears within a duration of six years, were evaluated prospectively for the incidence of heterotrophic ossifications after they underwent arthroscopic reconstructions with the use of bone patellar tendon bone grafts by the double incision technique. The effect of the efficacy of various preventive measures on the incidence of the heterotophic ossifications post surgery was also studied. Results: The observed incidence of the heterotophic ossifications was 2.58% in patients whom preventive measures were not used. In contrast, an incidence of 1.54% of similar complications was recorded, after preventive measures were undertaken. Our results showed that heterotophic ossifications after arthroscopic reconstructions with the use of bone patellar tendon bone grafts were a rare complication and that their incidence could be further reduced if preventive measures were taken. Conclusion: The heterotophic ossification is a rare complication after an ACL reconstruction is done with the use of a bone patellar tendon bone graft by the double incision technique. Its incidence reduces significantly after preventive measures are undertaken. PMID:23814735

Bhandary, Bhaskara; Shetty, Sudeep; Bangera, Vinay V; R, Yogaprakash; Kassim, Mohammed Shabir; Alva, Karan; Bhandary, Sudarshan

2013-03-28

164

Two Programs for Primary Care Practitioners: Family Medicine Training in an Affiliated University Hospital Program and Primary Care Graduate Training in an Urban Private Medical Center  

ERIC Educational Resources Information Center

|Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…

Farley, Eugene S.; Piemme, Thomas E.

1975-01-01

165

Substance P Signaling Mediates BMP Dependent Heterotopic Ossification  

PubMed Central

Heterotopic ossification (HO) is a disabling condition associated with neurologic injury, inflammation, and overactive BMP signaling. The inductive factors involved in lesion formation are unknown. We found that the expression of the neuro-inflammatory factor Substance P (SP) is dramatically increased in early lesional tissue in patients who have either fibrodysplasia ossificans progressiva (FOP) or acquired HO, and in three independent mouse models of HO. In Nse-BMP4, a mouse model of HO, robust HO forms in response to tissue injury; however null mutations of the preprotachykinin gene encoding SP prevent HO. Importantly, ablation of SP+ sensory neurons, treatment with an antagonist of SP receptor NK1r, deletion of NK1r gene, or genetic down-regulation of NK1r-expressing mast cells also profoundly inhibits injury-induced HO. These observations establish a potent neuro-inflammatory induction and amplification circuit for BMP-dependent HO lesion formation, and identify novel molecular targets for prevention of HO.

Kan, Lixin; Lounev, Vitali Y; Pignolo, Robert J; Duan, Lishu; Liu, Yijie; Stock, Stuart R; McGuire, Tammy L; Lu, Bao; Gerard, Norma P; Shore, Eileen M; Kaplan, Frederick S; Kessler, John A

2012-01-01

166

Osteosarcoma following single fraction radiation prophylaxis for heterotopic ossification  

PubMed Central

Radiotherapy for prophylaxis of heterotopic ossification (HO) is commonly used in high risk patients following orthopedic surgery. While treatment is effective and can prevent morbidity associated with HO, with any dose of radiation there is a concern of a radiation induced malignancy. Here we a report a case of radiation induced osteosarcoma which developed 11?years after a single fraction of 700?cGy. We performed dosimetric analysis by superimposing the patient’s original treatment field on a CT scan performed after the diagnosis. The radiotherapy dose for this patient is lower than classically reported for radiation induced sarcomas. We identified greatest bony destruction that was thought to be the epicenter of the tumor, and this was specially contoured on the diagnostic CT scan. This volume appears to be located at the edge of the radiotherapy field. Fifty percent of the treated volume received 240?cGy, the mean dose was 333?cGy. There was a variation across the treatment volume, between 21.8?cGy and 717?cGy. While a rare complication, we stress the importance of informing regarding the risk of a radiation induced malignancy following HO prophylaxis.

2012-01-01

167

Is ossification of posterior longitudinal ligament an enthesopathy?  

PubMed

The purpose of this study was to investigate the relationship of ossification of posterior longitudinal ligament (OPLL) with enthesis, the site where the posterior longitudinal ligament (PLL) attaches to the vertebral body, by multi-detector CT reconstruction images. Twenty-nine patients with OPLL were studied. According to the plaques' continuity to the vertebral body, OPLL plaques were classified into two categories: "free" and "contiguous". A "broken sign" was defined as a crack between two plaques. The sites where each "contiguous" plaque attached to the vertebral body were then analysed. There were 78 ossified plaques in total, and six were "free". There were eight cases with a "broken sign", including six "free" ones. The site where all 72 "contiguous" plaques attached to the vertebral body included the zone where the PLL enthesis was situated, while other zones were included in only part of the plaques. Our conclusion was that there might be no real "free type" ossified plaques, and OPLL could start from enthesis, which indicated OPLL could be a kind of enthesopathy. PMID:21104248

Chen, Jian; Song, Dianwen; Wang, Xinwei; Shen, Xiaolong; Li, Yang; Yuan, Wen

2010-11-23

168

Ossification of the posterior longitudinal ligament: a review of literature.  

PubMed

Ossification of the posterior longitudinal ligament (OPLL) is most commonly found in men, in the elderly, and in Asian patients. The disease can start with mild or no symptoms, but some patients progress slowly to develop symptoms of myelopathy. An accurate diagnosis through the use plain radiograph, computed tomography, and magnetic resonance imaging findings is very important to monitor the development of symptoms and to make decisions regarding a treatment plan. When symptoms are mild and non-progressive, conservative treatments and periodic observations are good enough, but once symptoms of myelopathy are present and neurologic symptoms are progressive, the treatment of choice is surgery to relieve spinal cord compression. Surgical management of OPLL continues to be controversial. Each surgical technique has some advantages and disadvantages, and the choice of operation should be decided carefully with various considerations. The patient's neurological condition, location and extent of pathology, cervical kyphosis, presence or absence of accompanied instability, and the individual surgeon's experience must be an important factors that should be considered before surgery. PMID:22164324

Choi, Byung-Wan; Song, Kyung-Jin; Chang, Han

2011-11-28

169

Substance P signaling mediates BMP-dependent heterotopic ossification.  

PubMed

Heterotopic ossification (HO) is a disabling condition associated with neurologic injury, inflammation, and overactive bone morphogenetic protein (BMP) signaling. The inductive factors involved in lesion formation are unknown. We found that the expression of the neuro-inflammatory factor Substance P (SP) is dramatically increased in early lesional tissue in patients who have either fibrodysplasia ossificans progressiva (FOP) or acquired HO, and in three independent mouse models of HO. In Nse-BMP4, a mouse model of HO, robust HO forms in response to tissue injury; however, null mutations of the preprotachykinin (PPT) gene encoding SP prevent HO. Importantly, ablation of SP(+) sensory neurons, treatment with an antagonist of SP receptor NK1r, deletion of NK1r gene, or genetic down-regulation of NK1r-expressing mast cells also profoundly inhibit injury-induced HO. These observations establish a potent neuro-inflammatory induction and amplification circuit for BMP-dependent HO lesion formation, and identify novel molecular targets for prevention of HO. PMID:21748788

Kan, Lixin; Lounev, Vitali Y; Pignolo, Robert J; Duan, Lishu; Liu, Yijie; Stock, Stuart R; McGuire, Tammy L; Lu, Bao; Gerard, Norma P; Shore, Eileen M; Kaplan, Frederick S; Kessler, John A

2011-10-01

170

Patellar tendon ossification after anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft  

PubMed Central

Background Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone – patellar tendon – bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature. Case presentation We present a case of a 42-year-old Caucasian man affected by symptomatic extended heterotopic ossification of patellar tendon after 20 months from ACL reconstruction using BPTB. The clinical diagnosis was confirmed by Ultrasound, X-Ray and Computed Tomography studies, blood tests were performed to exclude metabolic diseases then the surgical removal of the lesion was performed. After three years from surgery, the patient did not report femoro-patellar pain, there was not range of motion limitation and the clinical-radiological examinations resulted negative. Conclusion The surgical removal of the ossifications followed by anti-inflammatory therapy, seems to be useful in order to relieve pain and to prevent relapses. Moreover, a thorough cleaning of the patellar tendon may reveal useful, in order to prevent bone fragments remain inside it and to reduce patellar tendon heterotopic ossification risk.

2013-01-01

171

Pathological Calcification and Ossification in Relation to Leriche and Policard's Theory  

PubMed Central

(1) Pathology of calcification and ossification.—The Leriche-Policard theories. Hyperæmia of bone causes decalcification. Reduced blood supply causes sclerosis. Diminution of vascularity of fibrous tissue causes calcification. Excess of calcium, adequate blood supply and fibroblasts give rise to bone anywhere. Subperiosteal ossification. “Myositis ossificans.” (2) Radiological significance of density of bone shadows.—Decalcification of disuse, of infections, of neoplasms. Traumatic and infective scquestra. Evidence that a fragment of bone is avascular. (3) Hyperæmic decalcification of bone.—Delayed and non-union of fractures. Kummel's disease. Spontaneous hyperæmic dislocation of the atlas. Hyperæmic decalcification and nephrolithiasis. (4) Anæmic sclerosis of bone.—Syphilitic bone disease. Malignant bone disease. Fragility of sclerosed bone—Paget's, Kienboch's, Kohler's and Panner's, Albers-Schönberg's diseases. (5) Pathological calcification.—Calcification of supraspinatus tendon. Calcification of tumours—angioma, hæmatoma, and thrombosed vessels, lipoma, cysts, etc. Calcification of semilunar cartilages and intervertebral discs. (6) Pathological ossification.—Ossification of tendons. Ossification of semilunar cartilages.

Jones, Watson; Roberts, R. E.

1933-01-01

172

Heterotopic ossification as a complication of acetabular fracture. Prophylaxis with low-dose irradiation.  

PubMed

In a retrospective review of thirty-seven patients who had operative treatment for thirty-eight complex acetabular fractures, postoperative low-dose irradiation was administered to seventeen patients (eighteen fractures) to suppress heterotopic ossification. All of the patients had been operated on through either an extended iliofemoral incision or a modified extended iliofemoral incision. The prophylactic radiation was administered using a low-dose protocol; most of the patients received 1,000 rads in 200-rad increments, starting on the third post-operative day. The incidence of heterotopic ossification in the eighteen irradiated limbs was much lower than in the twenty patients who comprised the control group (50 per cent compared with 90 per cent). Only two of the irradiated limbs had Class-3 heterotopic ossification as described by Brooker et al., and no patient had Class-4 (ankylosis of the hip). Of the twenty control-group patients, ten had severe heterotopic ossification: Class 3 in seven and Class 4 in three. The difference in the incidence of severe (Class-3 or 4) heterotopic ossification between the two groups of patients was significant (p less than 0.01). PMID:3138241

Bosse, M J; Poka, A; Reinert, C M; Ellwanger, F; Slawson, R; McDevitt, E R

1988-09-01

173

Effects of sex and age on the ossification of the collateral cartilages of the distal phalanx of the Finnhorse and the relationships between ossification and body size and type of horse  

Microsoft Academic Search

The ossification of the collateral cartilages of the distal phalanx was evaluated in dorsopalmar radiographs of the front feet of 202 Finnhorses (101 females and 101 males, aged six months to 20 years) with reference to the sex, age, body measurements and type of horse. Ossification was more common and more extensive in females than in males from about two

R.-M Tulamo

1997-01-01

174

Molecular events caused by cyclic stretch in spinal ligament cells from patients with ossification of the posterior longitudinal ligament  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the spinal ligaments. Although mechanical stress is thought to be an important factor in the progression of OPLL, the mechanism by which mechanical stress promotes the ossification of ligaments in OPLL is still unknown. Therefore, we investigated osteogenic responses induced by mechanical stress

Ken-Ichi Furukawa; Masahiko Tanno; Kazumasa Ueyama; Seiko Harata; Shigeru Motomura

2002-01-01

175

Association of the human NPPS gene with ossification of the posterior longitudinal ligament of the spine (OPLL)  

Microsoft Academic Search

OPLL (ossification of the posterior longitudinal ligament of the spine) is a common form of human myelopathy with a prevalence\\u000a of as much as 4% in a variety of ethnic groups. To clarify the genetic factors that predispose to OPLL, we have studied ttw (tiptoe walking), a mouse model that presents ectopic ossification of the spinal ligaments similar to OPLL

Isao Nakamura; Shiro Ikegawa; Akihiko Okawa; Shin’ya Okuda; Y. Koshizuka; Hiroshi Kawaguchi; Kozo Nakamura; Tsunemaro Koyama; Sumio Goto; Junya Toguchida; Mutsumi Matsushita; Takahiro Ochi; Kunio Takaoka; Y. Nakamura

1999-01-01

176

Total decompression of the spinal cord for combined ossification of posterior longitudinal ligament and yellow ligament in the thoracic spine  

Microsoft Academic Search

One of the causes of hyperostosis in the spinal canal, ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine, can result in serious myelopathy, leading to sandwich-type compression of the spinal cord from anterior and posterior. For such cases we devised a treatment of total decompression of the spinal cord

K. Tomita

1990-01-01

177

The Impact of Body Mass Index on Heterotopic Ossification  

SciTech Connect

Purpose: To analyze the impact of different body mass index (BMI) as a surrogate marker for heterotopic ossification (HO) in patients who underwent surgical repair (SR) for displaced acetabular fractures (DAF) followed by radiation therapy (RT). Methods and Materials: This is a single-institution retrospective study of 395 patients. All patients underwent SR for DAF followed by RT {+-} indomethacin. All patients received postoperative RT, 7 Gy, within 72 h. The patients were separated into four groups based on their BMI: <18.5, 18.5-24.9, 25-29.9, and >30. The end point of this study was to evaluate the efficacy of RT {+-} indomethacin in preventing HO in patients with different BMI. Results: Analysis of BMI showed an increasing incidence of HO with increasing BMI: <18.5, (0%) 0/6 patients; 18.5-24.9 (6%), 6 of 105 patients developed HO; 25-29.9 (19%), 22 of 117; >30 (31%), 51 of 167. Chi-square and multivariate logistic regression analysis showed that the correlation between odds of HO and BMI is significant, p < 0.0001. As the BMI increased, the risk of HO and Brooker Classes 3, 4 HO increased. The risk of developing HO is 1.0 Multiplication-Sign (10%) more likely among those with higher BMI compared with those with lower BMI. For a one-unit increase in BMI the log odds of HO increases by 1.0, 95% CI (1.06-1.14). Chi-square test shows no significant difference among all other factors and HO (e.g., indomethacin, race, gender). Conclusions: Despite similar surgical treatment and prophylactic measures (RT {+-} indomethacin), the risk of HO appears to significantly increase in patients with higher BMI after DAF. Higher single-fraction doses or multiple fractions and/or combination therapy with nonsteroidal inflammatory drugs may be of greater benefit to these patients.

Mourad, Waleed Fouad, E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel); Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (United States); Packianathan, Satya [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Shourbaji, Rania A. [Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States); Zhang Zhen; Graves, Mathew [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Khan, Majid A. [Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States); Baird, Michael C. [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Russell, George [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)

2012-04-01

178

[Sonographic examination on the time frame of ossification of the distal fibula epiphysis].  

PubMed

In order to increase the reliability of forensic age estimations in living adolescents and young adults without justification for X-ray examinations, the establishment of radiation-free imaging procedures is desirable. In this study, the ossification stage of the right-hand distal fibula epiphysis was sonographically determined prospectively in 309 male and 307 female healthy volunteers. For this purpose a four-stage classification system was used. A sonographically determined ossification stage 3 permits the proof of completion of age 13 in boys and the proof of completion of age 12 in girls. In case of an ossification stage 4 the completion of age 14 in boys and the completion of age 13 in girls can be certified. In order to increase the level of reliability of age estimates, findings should be collected by at least two independent examiners who are experienced in the sonography of skeletons, followed by consensus-building. PMID:23878894

Schulz, Ronald; Schiborr, Manfred; Pfeiffer, Heidi; Schmidt, Sven; Schmeling, Andreas

179

Ossification of the ligamentum flavum: a unique report of a Hispanic woman.  

PubMed

Ossification of the ligamentum flavum (OLF) is a disease of ectopic bone formation within the ligamentum flavum, which may result in mass effect and neurological compromise. The low thoracic region is the most common region of occurrence, and this is followed by the cervical, then lumbar, spine. The prevalence of OLF is significantly higher in the Japanese population compared with other nationalities and has a male preponderance. Ossification of the ligamentum flavum has been reported in association with the more common ligamentous pathological entities--ossification of the posterior longitudinal ligament and diffuse idiopathic skeletal hyperostosis. These latter two conditions have been linked to several metabolic processes, and a possible genetic basis has been hypothesized. Here, the authors present a unique case of OLF of the cervical spine in a patient with idiopathic hypercalcemia. PMID:21361753

Christiano, Lana D; Assina, Rachid; Goldstein, Ira M

2011-03-01

180

Lower extremities paresis due to ossification of the Posterior Longitudinal Ligament  

PubMed Central

Abstract: Ossification of the Posterior Longitudinal Ligament (OPLL) is a condition caused by new bone developing in the posterior longitudinal ligament within the spinal canal. OPLL is a common cause of myelopathy in East Asian countries. Here, we report a case with OPLL in thoracic and lumbar spine in Kermanshah, West of Iran. Case: A 40 years old man gradually developed lower extremities paresis with defecation or voiding difficulties. Radiographic evaluation by computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the mass of ossification at the posterior aspect of the T2-T4 and T12-L1 of vertebral body with spinal cord compression. Although OPLL is a common cause of myelopathy in the East Asian countries, it should be included in differential diagnosis of myelopathy in other regions. Keywords: Ossification of the posterior longitudinal ligament (OPLL), Spinal canal, Myelopathy

Sepehri, Parandoush; Shobeiri, Elham

2012-01-01

181

Study of triplet state of the primary electron donor on preparations of reaction centers of photosynthetic bacteria using magnetooptical absorbance difference spectroscopy  

SciTech Connect

The authors use magneto-optical absorbance difference spectroscopy based on fluorescence determination to investigate the photosynthetic membrane reaction centers of two photosynthetic bacteria, the blue-green mutant of Rps. sphaeroides R-26 and the cytoplasmatic membrane from C. aurantiacus, and their primary electron donors. The mechanism of triplet state excitation under the action of continuous irradiation and a modulating magnetic field is described in detail. Data are also given on hyperfine structure determined by computer processing of the spectral image.

Elfimov, E.I.; Voznyak, V.M.; Shkuropatov, A.Ya.; Shuvalov, V.A.

1987-11-01

182

The mandibular condylar growth center: Separation and characterization of the cellular elements  

Microsoft Academic Search

The developing mandibular condylar growth center consists of a number of histologically distinct cell types. There is an increase in cell volume that takes place from the condylar surface layer through the center of ossification, resulting in a disorganized, irregular cellular pattern. Consequently, the isolation and separation of the different cells from this tissue is difficult using standard methodologies. Countercurrent

R. Landesberg; R. L. Proctor; R. N. Rosier; J. E. Puzas

1995-01-01

183

Radiology of postnatal skeletal development  

Microsoft Academic Search

Thirty-six manubriosternal composites from skeletally immature cadavers were examined morphologically and radiographically. Sternebral ossification followed certain patterns. The manubrium (first sternebra) usually had one primary ossification center and one or two smaller centers. These usually were caudad to the major center (longitudinally bifid). The second sternebra invariably had only one ossification center. The third and fourth sternebrae had latitudinal (right-left)

John A. Ogden; Gerald J. Conlogue; Mary L. Bronson; Pamela S. Jensen

1979-01-01

184

Changes in Basic Metabolic Elements Associated With the Degeneration and Ossification of Ligamenta Flava  

PubMed Central

Objective: To determine the association between levels of basic metabolic elements and degeneration and ossification of the ligamentum flavum (LF). Subjects: Fourteen consecutive patients with degenerative lumbar stenosis, 11 with ossification of the thoracic ligamenta flava, and 11 control subjects. Methods: The basic elements of calcium (Ca), phosphorus (P), magnesium (Mg), zinc (Zn), copper (Cu), manganese (Mn), molybdenum (Mo), and fluoride (F) in the specimens were measured using atomic absorption spectrometry, the phosphomolybdic blue method, and a fluoride-selected electrode. Results: Ca content and the ratio of Ca/Mg in the LF specimens increased significantly in the sequence of control, degeneration, and ossification groups. Compared with values for the control group, the Zn, Mn, and Mo contents in the ossification and degeneration groups were significantly lower (P < 0.01); in contrast, Cu content was significantly higher (P < 0.01). As to F, its content in the specimens of the ossification group was much higher than those in the degeneration and control groups (P < 0.01); the F content in the ligamenta flava and sera from patients with fluorosis was also significantly higher than in those from patients without fluorosis (P < 0.01). Compared with the control group, there were no differences in the F content in serum from patients without fluorosis; however, the F content in ligamenta flava specimens from patients without fluorosis was significantly higher (P < 0.01). Conclusions: There are trends in the contents of basic metabolic elements in the degeneration and ossification of ligamenta flava. These basic metabolic elements may play an important role in this process.

Wang, Zhe; Li, Xiang-Dong; Li, Ming-Quan; Wang, Quan-Ping

2008-01-01

185

Proton ENDOR study of the primary donor P740 +, a special pair of chlorophyll d in photosystem I reaction center of Acaryochloris marina  

NASA Astrophysics Data System (ADS)

Oxidized primary electron donor P740, a special pair of chlorophyll (Chl) d in photosystem (PS) I reaction center of a newly identified cyanobacterium Acaryochloris marina was studied by EPR and proton ENDOR spectroscopy. EPR and ENDOR spectra of P740 + were compared with those of P700 + in PS I reaction center of spinach. The g-factors of the purified Chl a+ and Chl d+ in CH 2Cl 2/THF, P700 + and P740 + in PS I reaction centers were determined to be 2.0025, 2.0032, 2.0027 and 2.0028, respectively. Hyperfine coupling constants of 1.9, 2.8 and 3.8 MHz that were detected in the ENDOR spectrum of P700 + were absent in the ENDOR spectrum of P740 +. These features of P740 + were mainly ascribed to the difference between the chemical structures of Chl a and Chl d.

Mino, Hiroyuki; Kawamori, Asako; Aoyama, Daisuke; Tomo, Tatsuya; Iwaki, Masayo; Itoh, Shigeru

2005-08-01

186

Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers  

Microsoft Academic Search

Aim  To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native\\u000a dialysis fistulas.\\u000a \\u000a \\u000a \\u000a Methods  Forty-one patients (26 men, 15 women; age range 26–82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients)\\u000a primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was\\u000a primary stenosis in

Rajesh Bhat; Kieran McBride; Sam Chakraverty; Raghunandan Vikram; Alison Severn

2007-01-01

187

Postoperative Single-Fraction Radiation for Prevention of Heterotopic Ossification of the Elbow  

SciTech Connect

Purpose: Heterotopic ossification (HO) about the elbow has been described after surgery, trauma, and burns. Even limited deposits can lead to significant functional deficits. Little data exist regarding outcomes of patients treated with radiation therapy (RT) after elbow surgery. We report here the Cleveland Clinic experience with single-fraction radiation following surgery to the elbow. The primary endpoint was the rate of new HO after RT. Secondary endpoints were range of motion, functional compromise, and toxicity. Methods and Materials: From May 1993 to July 2006, 36 patients underwent elbow surgery followed by single-fraction RT. Range of motion data were collected before and during surgery and at last follow-up. Radiographs were reviewed for persistent or new HO. Patient and treatment factors were analyzed for correlation with development of HO or functional compromise. Results: Median follow-up was 8.7 months, median age was 42 years, and 75% of patients were male. Twenty-six (72%) patients had HO prior to surgery. All patients had significant limitations in flexion/extension or pronation/supination at baseline. Thirty-one (86%) patients had prior elbow trauma, and 26 (72%) patients had prior surgery. RT was administered a median of 1 day postoperatively (range, 1-4 days). Thirty-four patients received 700 cGy, and 2 patients received 600 cGy. Three (8%) patients developed new HO after RT. All patients had improvement in range of motion from baseline. No patient or treatment factors were significantly associated with the development of HO or functional compromise. Conclusions: Single-fraction RT after surgery to the elbow is associated with favorable functional and radiographic outcomes.

Robinson, Clifford G. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Polster, Joshua M. [Department of Radiology, Cleveland Clinic, Cleveland, Ohio (United States); Reddy, Chandana A. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Lyons, Janice A. [Department of Radiation Oncology, UH Case Medical Center, Cleveland, Ohio (United States); Evans, Peter J.; Lawton, Jeffrey N. [Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio (United States); Graham, Thomas J. [Curtis National Hand Center, Baltimore, Maryland (United States); Suh, John H., E-mail: suhj@ccf.or [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States)

2010-08-01

188

Heterotopic mineralization (ossification or calcification) in tendinopathy or following surgical tendon trauma  

PubMed Central

Heterotopic tendon mineralization (ossification or calcification), which may be a feature of tendinopathy or which may develop following surgical trauma (repair or graft harvest), has not received much attention. The purpose of this article is to review the prevalence, mechanisms and consequences of heterotopic tendon mineralization and to identify the gaps in our current understanding. We focus on endochondral heterotopic ossification and draw on knowledge of the mechanisms of this process in other tissues and conditions. Finally, we introduce a novel murine Achilles tendon needle injury model, which will enable us to further study the mechanisms and biomechanical consequences of tendon mineralization.

O'Brien, Etienne J O; Frank, Cyril B; Shrive, Nigel G; Hallgrimsson, Benedikt; Hart, David A

2012-01-01

189

High hydrogen permeability in the Nb-Zr-Ni eutectic alloy containing the primary body-centered-cubic (Nb, Zr) phase  

NASA Astrophysics Data System (ADS)

Hydrogen permeability (?), i.e., the product of hydrogen diffusion coefficient (D) and hydrogen solubility (K), of the as-cast Nb40Zr30Ni30 (mol %) alloy has been investigated. This alloy is composed of the primary body-centered-cubic (bcc)-(Nb, Zr) and eutectic {(Nb,Zr)+ZrNi} phase and the chemical composition and the volume fraction of the primary phase are Nb89Zr8Ni3 and 40%, respectively. ? of this alloy increases with increasing temperature and is 4.64×10-8 [mol H2 m-1 s-1 Pa-0.5] at 673 K, which is 2.9 times larger than that of pure Pd. The present work indicates that ? of the Nb-Zr-Ni alloys increases with increasing the volume fraction of the primary bcc-(Nb, Zr) phase.

Ishikawa, K.; Takano, T.; Matsuda, T.; Aoki, K.

2005-08-01

190

Association between serum leptin and bone metabolic markers, and the development of heterotopic ossification of the spinal ligament in female patients with ossification of the posterior longitudinal ligament  

Microsoft Academic Search

Obesity is a risk factor for ossification of the posterior longitudinal ligament (OPLL) of the spine, which is characterized\\u000a by heterotopic bone formation in the posterior longitudinal spinal ligament. Hyperleptinemia is a common feature of obese\\u000a people and leptin is believed to be an important factor in the pathogenesis of OPLL. However, the association between leptin\\u000a and bone metabolism and

Yoshikazu Ikeda; Arata Nakajima; Atsuomi Aiba; Masao Koda; Akihiko Okawa; Kazuhisa Takahashi; Masashi Yamazaki

191

Transforming primary care practices in a Hawai'i Island clinic: obtaining patient perceptions on patient centered medical home.  

PubMed

Health care access is a significant problem for residents of Hawai'i Island who are experiencing a healthcare provider shortage crisis. Many residents must travel far for routine medical care, and in some cases to other islands. Hamakua Health Center, Inc., which operates from two clinical sites (Honokaa and Kapaau), is transitioning towards a Patient-Centered Medical Home care model. Through focus groups, a qualitative study was completed to obtain patient perceptions on Patient-Centered Medical Home. The Hamakua and Kohala Family Health Center staff were asked to recommend a list of patients from their respective health centers for focus group participation. In this sample (N=18), 67% of participants were female of various ethnicities. The participants' mean age was 62.2 (SD =14.3) years. Questions asked by the moderator were based on the American College of Providers' Patient-Centered Medical Home Assessment Tool. The three universal themes generated by the focus groups included quality care, provider and health services accessibility, and communication and coordination. Health information technology was a topic that was explored in the focus groups, and encompasses all three themes. Communication is regarded as a key to receiving quality care. Participants suggested having a rotation of specialists flown-in regularly from O'ahu to improve care quality. Technology is appreciated as it can streamline the information exchange process, and increase the patient's access to health services. There is unanimous concern regarding confidentiality and privacy. It is imperative that the health centers keep patients informed as they make their transition. PMID:23115754

Takane, Alain K; Hunt, Susan B

2012-09-01

192

Rates of primary electron transfer reactions in the photosystem I reaction center reconstituted with different quinones as the secondary acceptor  

SciTech Connect

Rates of sequential electron transfer reactions from the primary electron donor chlorophyll dimer (P700) to the electron acceptor chlorophyll a-686 (A[sub 0]) and to the secondary acceptor quinone (Q[sub [phi

Kumazaki, Shigeichi; Kandori, Hideki; Yoshihara, Keitaro (Inst. for Molecular Science, Okazaki (Japan)); Iwaki, Masayo; Itoh, Shigeru (National Inst. for Basic Biology, Okazaki (Japan)); Ikegamu, Isamu (Teikyo Univ., Kanagawa (Japan))

1994-10-27

193

Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers  

SciTech Connect

Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.

Bhat, Rajesh [Ninewells Hospital, Department of Clinical Radiology (United Kingdom)], E-mail: raj.bhat@nhs.net; McBride, Kieran [Queen Margaret Hospital (United Kingdom); Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison [Ninewells Hospital, Department of Clinical Radiology (United Kingdom)

2007-11-15

194

Early “Simple” Release of Posttraumatic Elbow Contracture Associated With Heterotopic Ossification  

Microsoft Academic Search

“Simple” elbow release in the setting of heterotopic ossification is defined as excision of ectopic bone and removal of restricting soft tissues without associated articular procedures. In the past, such procedures were postponed until bone scans were quiescent, serum alkaline phosphatase was normal, and the ectopic bone was mature. Postoperative management sometimes included radiation therapy, prolonged nonsteroidal anti-inflammatory agents, and

Randall W. Viola; Douglas P. Hanel

1999-01-01

195

Posterior ossification of the shoulder: the Bennett lesion. Etiology, diagnosis, and treatment.  

PubMed

We report a series of ossific lesions of the posterior inferior glenoid in a group of elite baseball players. We hope to clarify the etiology, diagnosis, and treatment of the Bennett lesion. From August 1985 to August 1991, we identified six professional baseball pitchers and one college pitcher with evidence of ossification of the shoulder on plain radiographs, computed tomography, or magnetic resonance imaging. Arthroscopic examination was performed in all cases. All seven players had identifiable posterior labral injury on arthroscopic examination; six of these seven also had varying degrees of undersurface posterior rotator cuff damage. No anterior tissue damage, anterior instability, or subacromial impingement was noted. No ossification was identified arthroscopically. Intraarticular labral and rotator cuff tears were debrided arthroscopically and patients underwent rehabilitation for 4 to 6 months after surgery. Six of the seven athletes returned to preinjury performance levels; however, one pitcher is no longer playing competitive baseball. The Bennett lesion is an extraarticular posterior ossification associated with posterior labral injury and posterior undersurface rotator cuff damage. It is not, however, a result of traction stresses in the region of the triceps insertion. Recognition is important for identification and treatment of the lesion and associated pathologic damage. PMID:8198183

Ferrari, J D; Ferrari, D A; Coumas, J; Pappas, A M

196

Possible involvement of vitamin D receptor gene polymorphism in male patients with ossification of spinal ligaments  

Microsoft Academic Search

Ossification of spinal ligaments (OSL) is a common form of myelopathy characterized by heterotopic bone formation in the spinal ligaments, predominantly in men. Although the etiology of OSL is not fully understood, previous studies have strongly suggested the involvement of genetic factors in this disease. To investigate the possible involvement of vitamin D receptor ( VDR) gene polymorphism in Japanese

Eiichi Shiigi; Toshihiro Sugiyama; Hiroshi Tanaka; Hidenori Murata; Yoshiharu Shirakura; Shinya Kawai

2001-01-01

197

Is Radiation Superior to Indomethacin to Prevent Heterotopic Ossification in Acetabular Fractures?: A Systematic Review  

PubMed Central

Heterotopic ossification is a well-known complication after fixation of an acetabular fracture. Indomethacin and radiation therapy are used as prophylaxis to prevent heterotopic ossification. It is unclear, however, whether either is superior, although this may relate to lack of power in individual studies. To compare the effectiveness of indomethacin with the effectiveness of radiation therapy, we conducted a systematic review in which all published prospective studies were evaluated. We performed a literature search in PubMed®, MEDLINE®, EMBASE™, and the Cochrane Controlled Trial Register. The retrieved studies were analyzed and categorized according to the quality and validity score of Jadad et al. We found five appropriate prospective studies, describing 384 patients. Although the quality of the available studies made a proper meta-analysis inappropriate, the incidence of heterotopic ossification was significantly lower in patients treated with radiation than in patients receiving indomethacin (five of 160 versus 20 of 224, respectively). Until further information is available, we believe the evidence supports radiation therapy as the preferred method for preventing heterotopic ossification after operative treatment of acetabular fractures. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Frolke, Jan Paul M.

2008-01-01

198

Timing of Ossification in Duck, Quail, and Zebra Finch: Intraspecific Variation, Heterochronies, and Life History Evolution  

PubMed Central

Skeletogenic heterochronies have gained much attention in comparative developmental biology. The temporal appearance of mineralized individual bones in a species – the species ossification sequence – is an excellent marker in this kind of study. Several publications describe interspecific variation, but only very few detail intraspecific variation. In this study, we describe and analyze the temporal order of ossification of skeletal elements in the zebra finch, Taeniopygia guttata, the Japanese quail, Coturnix coturnix japonica, and the White Pekin duck, a domestic race of the mallard Anas platyrhynchos, and explore patterns of intraspecific variation in these events. The overall sequences were found to be conserved. In the duck, variability is present in the relative timing of ossification in the occipital, the basisphenoid and the otic regions of the skull and the phalanges in the postcranium. This variation appears generally in close temporal proximity. Comparison with previously published data shows differences in ossification sequence in the skull, the feet, and the pelvis in the duck, and especially the pelvis in the quail. This clearly documents variability among different breeds.

Mitgutsch, Christian; Wimmer, Corinne; Sanchez-Villagra, Marcelo R.; Hahnloser, Richard; Schneider, Richard A.

2011-01-01

199

Ossification of the posterior longitudinal ligament of the cervical spine in Asian Indians — a multiracial comparison  

Microsoft Academic Search

Ossification of the Posterior longitudinal ligament (OPLL) has been thought to be a predominantly Japanese disease with few reports among the non-orientals and Caucasians. A prospective clinicoradiological study of 47 symptomatic Caucasoid Indians is reported. Twenty-seven patients presented with myelopathy, twelve with myeloradiculopathy and six with radiculopathy. ‘Total’ configuration of OPLL was the most frequent (70%). The most frequent location

P. N. Jayakumar; V. R. Shastry Kolluri; M. K. Vasudev; S. G. Srikanth

1996-01-01

200

The efficacy of biochemical markers in patients with ossification of posterior longitudinal ligament of the spine  

Microsoft Academic Search

Study design: Serum levels of carboxyterminal propeptide of type I collagen (PICP), osteocalcin (OC), carboxyterminal telopeptide of type I collagen (ICTP) and urinary levels of pyridinoline (Pyr) and deoxypyridinoline (Dpyr) were measured in patients with ossification of posterior longitudinal ligament of the spine (OPLL) and age-matched control subjects. Objectives: To evaluate the efficacy of these biochemical markers of the patients

C Ishihara; K Kushida; M Takahashi; T Ohishi; H Murata; A Nagano; S Goto

2000-01-01

201

Clients' satisfaction with primary health care in Tehran: A cross-sectional study on Iranian Health Centers  

PubMed Central

BACKGROUND: Primary health care system is the basic core of public service provision in Iran. This study aimed to assess clients’ satisfaction with primary health care in Tehran, the capital of Iran, as a metropolitan. METHODS: Through a cross-sectional study in 2009-10, four urban primary health care clinics were selected through stratified random sampling. Four hundred participants were interviewed in the selected clinics about their satisfaction with the primary health care services and setting. Six domains of satisfaction including accessibility to services, continuity of care, humaneness of staff, comprehensiveness of care, provision of health education and effectiveness of services were calculated from selected variables. The descriptive statistics, chi-square and t-tests were used when appropriate. RESULTS: The mean age of users of health services was 31.3 years (SD=9.6). Thirteen percent of participants were male. The most common reasons for asking health services reported as vaccination, family planning and children care. Overall, primary health care services were suitable for eighty percent of the participants. The mean and standard deviation for Access to services was 2.11 (SD=3.44), continuity of care was -0.35 (SD=3.49), humanness of staff was 3.93 (SD=5.70), comprehensiveness of care was -0.53 (SD=3.66), provision of health educational materials was -1.45 (SD=3.64) and effectiveness of services was 4.30 (SD=7.47). CONCLUSIONS: Primary health care is a comprehensive and suitable strategy to provide health services in public health. Package of services in primary health care may affect clients’ satisfaction. Using family doctors may improve the indices.

Sohrabi, Mohammad-Reza; Albalushi, Rima Mohammad

2011-01-01

202

A study of the morbidity pattern of referred patients and the effectiveness of the referral system in primary health care centers.  

PubMed

Patient referral system is considered to be an important element in achieving the objectives of the Primary Health Care services. Patients attending the Primary Health Care Center (PHCC) expect basic medical care and appropriate follow-up services. Thus, patients requiring further evaluation and treatment are referred to a secondary health care facility. In this study the morbidity pattern as well as the referral system was evaluated in selected PHCC in the city of Jeddah. A systematic random sample of all the patient referrals from selected PHCC's were analyzed. A total of 1,164 referrals were studied, 59.9 per cent were females and 40.1 per cent were males. The contents of referral letters from PHCC to hospitals as well as feed back from hospitals were analyzed. The majority of referrals were for the age group 25-44 years old 458 (39.3%). The results demonstrated that 5 per cent of patients were routinely referred to the secondary health care centers, and the feedback from these secondary health care facilities was (22.7%). It was also noted that the majority of referral letters lack commonly accepted standards of information about the patient. It was concluded that the follow-up and feed-back system needs to be reinforced. The primary health care providers need to review the patient referral system and implement specific criteria for the optimum utilization of this essential service for the benefit of the community. PMID:1294691

Kordy, M N; Ibrahim, M A; al-Gamal, F M; Bahnassy, A; Milaat, W

1992-01-01

203

A higher frequency of lumbar ossification of the posterior longitudinal ligament in elderly in an outpatient clinic in Japan  

PubMed Central

Purpose Little is known about the prevalence and epidemiological characteristics of lumbar ossification of the posterior longitudinal ligament (OPLL). We analyzed the rate of lumbar OPLL in an outpatient unit where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease. Methods We analyzed consecutive, first-time visiting outpatients who received abdominal and pelvic computed tomography (CT) scan at the Department of General Medicine, Asahikawa Medical University Hospital, Japan, between April 2009 and March 2012. Each parameter such as age, sex, and clinical presentation was investigated. Results Out of 393 patients who underwent abdominal and pelvic CT scan, 33 (8.4%) were diagnosed as lumbar OPLL. When compared with patients without lumbar OPLL (n = 360), there was no significant difference in gender, body mass index (BMI), presence of hypertension, diabetes mellitus or hyperlipidemia, and smoking habit, while the age in patients with lumbar OPLL was significantly higher. Conclusion These results suggest for the first time that lumbar OPLL is frequently observed in elderly people in the primary care setting, in Japan.

Okumura, Toshikatsu; Ohhira, Masumi; Kumei, Shima; Nozu, Tsukasa

2013-01-01

204

Terminal phalangeal accessory ossification center of the thumb: an additional radiographic finding in Larsen syndrome.  

PubMed

Larsen syndrome is an autosomal-dominant disorder characterized by multiple joint dislocations, vertebral anomalies and dysmorphic facies. Both autosomal-dominant and autosomal-recessive forms of the disorder have been proposed. Individuals with autosomal-dominant Larsen syndrome have characteristic "cylindrical-shape" thumbs caused by broad, shortened phalanges. Autosomal-dominant Larsen syndrome results from heterozygosity for mutations in filamin B, a cytoskeletal protein involved in multicellular processes. We report here a patient with a duplicated or accessory distal thumb phalanx and multiple large joint dislocations who was shown to be heterozygous for a filamin B mutation predicting the amino acid substitution G1691S. This adds a new radiographic finding, duplicated or accessory distal phalanx, to the radiographic abnormalities seen in this rare dominant disorder. PMID:16715218

Alanay, Yasemin; Utine, Gulen Eda; Lachman, Ralph S; Krakow, Deborah; Tuncbilek, Ergul

2006-05-20

205

Patient-Centered Approach to Building Problem Solving Skills Among Older Primary Care Patients: Problems Identified and Resolved  

Microsoft Academic Search

This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified

Susan Enguidanos; Alexis Coulourides Kogan; Bronwyn Keefe; Scott Miyake Geron; Lynne Katz

2011-01-01

206

Effects of a Psychological Intervention in a Primary Health Care Center for Caregivers of Dependent Relatives: A Randomized Trial  

ERIC Educational Resources Information Center

|Purpose: To assess, in the context of Primary Health Care (PHC), the effect of a psychological intervention in mental health among caregivers (CGs) of dependent relatives. Design and Methods: Randomized multicenter, controlled clinical trial. The 125 CGs included in the trial were receiving health care in PHC. Inclusion criteria: Identifying…

Rodriguez-Sanchez, Emiliano; Patino-Alonso, Maria C.; Mora-Simon, Sara; Gomez-Marcos, Manuel A.; Perez-Penaranda, Anibal; Losada-Baltar, Andres; Garcia-Ortiz, Luis

2013-01-01

207

Primary School, School-Based Decision Making, Family Resource/Youth Services Centers. First Year Reports to the Prichard Committee.  

ERIC Educational Resources Information Center

|These three reports by national consultants assess first year progress in implementing state mandated educational reforms in Kentucky. First, "The Status of Primary School Reform in Kentucky and Its Implications," by James Rath, Lilian Katz, and John Fanning, reports on site visits to 14 public schools to assess progress in implementing the…

Raths, James; And Others

208

Correlation of paramagnetic states and molecular structure in bacterial photosynthetic reaction centers: The symmetry of the primary electron donor in Rhodopseudomonas viridis and Rhodobacter sphaeroides R-26  

SciTech Connect

The orientation of the principal axes of the primary electron donor triplet state measured in single crystals of photosynthetic reaction centers is compared to the x-ray structures of the bacteria Rhodobacter (Rb.) sphaeroides R-26 and Rhodopseudomonas (Rps.) viridis. The primary donor of Rps. viridis is significantly different from that of Rb. sphaeroides. The measured directions of the axes indicate that triplet excitation is almost completely localized on the L-subunit half of the dimer in Rps. viridis but is more symmetrically distributed on the dimeric donor in Rb. sphaeroides R-26. The large reduction of the zero field splitting parameters relative to monomeric bacteriochlorophyll triplet in vitro suggests significant participation of asymmetrical charge transfer electronic configurations in the special pair triplet state of both organisms.

Norris, J.R.; Budil, D.E.; Gast, P.; Chang, C.H.; El-Kabbani, O.; Schiffer, M. (Argonne National Laboratory, IL (USA))

1989-06-01

209

Direct Measurement of the Effective Rate Constant for Primary Charge Separation in Isolated Photosystem II Reaction Centers  

SciTech Connect

Transient absorption measurements of the pheophytin a anion band and Qx band bleach region using preferential excitation of P680 are performed on isolated photosystem II reaction centers to determine the effective rate constant for charge separtion. A novel analysis of the Qx band bleach region explicity takes the changing background into account in order to directly measure the rate of growth of the bleach. Both spectral regions reveal biphasic kinetics, with a ca. (8 ps)-1 rate constant for the faster component, and a ca. (50 ps)-1 rate constant for the slower component. We propose that the fster component corresponds to the effective rate constant for charge separation from within the equilibrated reaction center core and provides a lower limit for the intrinsic rate constant for charge separation. The slower component corresponds to charge separation that is limited by slow energy transfer from a long-wavelength accessory chlorophyll a.

Greenfield, S. R.; Seibert, M.; Govindjee; Wasielewski, M. R.

1997-03-27

210

The Houston parent—child development center and the primary prevention of behavior problems in young children  

Microsoft Academic Search

This study reports the effectiveness of the Houston Parent-Child Development Center (PCDC) program for preventing behavior problems in young children. The PCDC is a 2-year, intensive parent-child education program for children ages 1-3 and their parents. Low-income Mexican American families were randomly assigned to program or control groups. A follow-up of the program 1-4years later, when children averaged 5½ years

Dale L. Johnson; James N. Breckenridge

1982-01-01

211

Determination of the primary charge separation rate in isolated photosystem II reaction centers with 500-fs time resolution  

SciTech Connect

The authors have measured directly the rate of formation of the oxidized chlorophyll a electron donor (P680+) and the reduced electron acceptor pheophytin a{sup {minus}} (Pheoa{sup {minus}}) following excitation of isolated spinach photosystem II reaction centers at 4{degree}C. The reaction-center complex consists of D{sub 1}, D{sub 2}, and cytochrome b-559 proteins and was prepared by a procedure that stabilizes the protein complex. Transient absorption difference spectra were measured from 440 to 850 nm as a function of time with 500-fs resolution following 610-nm laser excitation. The formation of P680+-Pheoa{sup {minus}} is indicated by the appearance of a band due to P680+ at 820 nm and corresponding absorbance changes at 505 and 540 nm due to formation of Pheoa{sup {minus}}. The appearance of the 820-nm band is monoexponential with {tau} = 3.0 {plus minus} 0.6 ps. Treatment of the photosystem II reaction centers with sodium dithionite and methyl viologen followed by exposure to laser excitation, conditions known to result in accumulation of Pheoa{sup {minus}}, results in formation of a transient absorption spectrum due to {sup 1*}P680. They find no evidence for an electron acceptor that precedes the formation of Pheoa{sup {minus}}.

Wasielewski, M.R.; Johnson, D.G. (Argonne National Laboratory, IL (USA)); Seibert, M. (Solar Energy Research Institute, Golden, CO (USA)); Govindjee (Univ. of Illinois, Urbana (USA))

1989-01-01

212

A partnership model for implementing electronic health records in resource-limited primary care settings: experiences from two nurse-managed health centers  

PubMed Central

Objective To present a partnership-based and community-oriented approach designed to ease provider anxiety and facilitate the implementation of electronic health records (EHR) in resource-limited primary care settings. Materials and Methods The approach, referred to as partnership model, was developed and iteratively refined through the research team's previous work on implementing health information technology (HIT) in over 30 safety net practices. This paper uses two case studies to illustrate how the model was applied to help two nurse-managed health centers (NMHC), a particularly vulnerable primary care setting, implement EHR and get prepared to meet the meaningful use criteria. Results The strong focus of the model on continuous quality improvement led to eventual implementation success at both sites, despite difficulties encountered during the initial stages of the project. Discussion There has been a lack of research, particularly in resource-limited primary care settings, on strategies for abating provider anxiety and preparing them to manage complex changes associated with EHR uptake. The partnership model described in this paper may provide useful insights into the work shepherded by HIT regional extension centers dedicated to supporting resource-limited communities disproportionally affected by EHR adoption barriers. Conclusion NMHC, similar to other primary care settings, are often poorly resourced, understaffed, and lack the necessary expertise to deploy EHR and integrate its use into their day-to-day practice. This study demonstrates that implementation of EHR, a prerequisite to meaningful use, can be successfully achieved in this setting, and partnership efforts extending far beyond the initial software deployment stage may be the key.

Dennehy, Patricia; White, Mary P; Hamilton, Andrew; Pohl, Joanne M; Tanner, Clare; Onifade, Tiffiani J

2011-01-01

213

Primary Care DirectConnect: How the Marriage of Call Center Technology and the EMR Brought Dramatic Results--A Service Quality Improvement Study  

PubMed Central

Of the key Health Plan patient satisfaction measures used in Kaiser Permanente Colorado, ease of contacting the physician's office with a medical question was consistently rated as the lowest quarterly patient satisfaction measure. Furthermore, medical office staff had become dissatisfied with their inability to contact patients who had previously left messages. In addition to the shear volume of messages, the return calls were often unanswered, leading to subsequent attempts to reach patients, creating additional work for medical office staff. DirectConnect—the project name for a system and set of processes focused on improving patient satisfaction with the ability to contact Primary Care delivery teams by telephone—focuses on isolating medical advice calls from the other types of calls handled by the centralized Call Center. The system identifies the patient using his/her unique electronic medical record number, then automatically routes medical advice calls directly to the appropriate Primary Care Physician (PCP) or staff. The clinician may then evaluate and respond to the patient's need quickly, thus managing more of their panel's requests in real time. How is DirectConnect different from simply having the patient contact their PCP's office directly? The primary difference is “one-number” convenience that allows all patients to dial one number to access their PCP's team. In addition, calls are routed to various staff as available to reduce long telephone queues and wait times. The DirectConnect system has resulted in statistically significant improvement in key service quality measures. Patient satisfaction improved from a pre-implementation nine quarter mean of 55.9% to a post-implementation 12 quarter mean of 70.2%. Fourteen percent to 17% of all Primary Care calls are now handled by the patient's home medical office team, creating a 54% improvement in the centralized Call Center's speed of answering calls in the first quarter post implementation—making no additions to medical office staffing levels. The efficiencies gained by directly connecting medical advice-seeking patients with their Primary Care team resulted in an estimated savings of 198 and 247 cumulative hours per week in unnecessary telephone work for Call Center and medical office staff regionwide.

Bowman, Brent; Smith, Scott

2010-01-01

214

Kinetics and mechanism of electron transfer in intact photosystem II and in the isolated reaction center: pheophytin is the primary electron acceptor.  

PubMed

The mechanism and kinetics of electron transfer in isolated D1/D2-cyt(b559) photosystem (PS) II reaction centers (RCs) and in intact PSII cores have been studied by femtosecond transient absorption and kinetic compartment modeling. For intact PSII, a component of approximately 1.5 ps reflects the dominant energy-trapping kinetics from the antenna by the RC. A 5.5-ps component reflects the apparent lifetime of primary charge separation, which is faster by a factor of 8-12 than assumed so far. The 35-ps component represents the apparent lifetime of formation of a secondary radical pair, and the approximately 200-ps component represents the electron transfer to the Q(A) acceptor. In isolated RCs, the apparent lifetimes of primary and secondary charge separation are approximately 3 and 11 ps, respectively. It is shown (i) that pheophytin is reduced in the first step, and (ii) that the rate constants of electron transfer in the RC are identical for PSII cores and for isolated RCs. We interpret the first electron transfer step as electron donation from the primary electron donor Chl(acc D1). Thus, this mechanism, suggested earlier for isolated RCs at cryogenic temperatures, is also operative in intact PSII cores and in isolated RCs at ambient temperature. The effective rate constant of primary electron transfer from the equilibrated RC* excited state is 170-180 ns(-1), and the rate constant of secondary electron transfer is 120-130 ns(-1). PMID:16641109

Holzwarth, A R; Müller, M G; Reus, M; Nowaczyk, M; Sander, J; Rögner, M

2006-04-25

215

Association between serum leptin and bone metabolic markers, and the development of heterotopic ossification of the spinal ligament in female patients with ossification of the posterior longitudinal ligament.  

PubMed

Obesity is a risk factor for ossification of the posterior longitudinal ligament (OPLL) of the spine, which is characterized by heterotopic bone formation in the posterior longitudinal spinal ligament. Hyperleptinemia is a common feature of obese people and leptin is believed to be an important factor in the pathogenesis of OPLL. However, the association between leptin and bone metabolism and the development of OPLL is not understood fully. The objective of the present study was to determine the association between serum leptin concentration and bone metabolic markers and the extent of heterotopic ossification of the spinal ligament in patients with OPLL. The serum concentrations of leptin, insulin, fructosamine, bone-specific alkaline phosphatase, and carboxyterminal propeptide of type I procollagen, urine deoxypyridinoline levels, and the number of vertebrae with OPLL involvement were measured in 125 (68 males and 57 females) patients with OPLL. The correlation between leptin and these other factors was then examined. Serum leptin and insulin concentrations were increased significantly in OPLL females compared to non-OPLL female controls. In the females with OPLL, serum leptin concentrations corrected for body mass index correlated positively with the number of vertebrae with OPLL involvement. In females, serum leptin levels were significantly higher in patients in whom OPLL extended to the thoracic and/or lumbar spine than in patients in whom OPLL was limited to the cervical spine. Our results suggest that hyperleptinemia, in combination with hyperinsulinemia, may contribute to the development of heterotopic ossification of the spinal ligament in female patients with OPLL. PMID:21258825

Ikeda, Yoshikazu; Nakajima, Arata; Aiba, Atsuomi; Koda, Masao; Okawa, Akihiko; Takahashi, Kazuhisa; Yamazaki, Masashi

2011-01-22

216

Cancer risk estimates from radiation therapy for heterotopic ossification prophylaxis after total hip arthroplasty.  

PubMed

Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. This study was conducted to calculate the radiation dose to organs-at-risk and estimate the probability of cancer induction from radiotherapy for HO prophylaxis.Methods: Hip irradiation for HO with a 6 MV photon beam was simulated with the aid of a Monte Carlo model. A realistic humanoid phantom representing an average adult patient was implemented in Monte Carlo environment for dosimetric calculations. The average out-of-field radiation dose to stomach, liver, lung, prostate, bladder, thyroid, breast, uterus, and ovary was calculated. The organ-equivalent-dose to colon, that was partly included within the treatment field, was also determined. Organ dose calculations were carried out using three different field sizes. The dependence of organ doses upon the block insertion into primary beam for shielding colon and prosthesis was investigated. The lifetime attributable risk for cancer development was estimated using organ, age, and gender-specific risk coefficients.Results: For a typical target dose of 7 Gy, organ doses varied from 1.0 to 741.1 mGy by the field dimensions and organ location relative to the field edge. Blocked field irradiations resulted in a dose range of 1.4-146.3 mGy. The most probable detriment from open field treatment of male patients was colon cancer with a high risk of 564.3 × 10(-5) to 837.4 × 10(-5) depending upon the organ dose magnitude and the patient's age. The corresponding colon cancer risk for female patients was (372.2-541.0) × 10(-5). The probability of bladder cancer development was more than 113.7 × 10(-5) and 110.3 × 10(-5) for males and females, respectively. The cancer risk range to other individual organs was reduced to (0.003-68.5) × 10(-5).Conclusions: The risk for cancer induction from radiation therapy for HO prophylaxis after total hip arthroplasty varies considerably by the treatment parameters, organ site in respect to treatment volume and patient's gender and age. The presented risk estimates may be useful in the follow-up studies of irradiated patients. PMID:24089892

Mazonakis, Michalis; Berris, Theoharris; Lyraraki, Efrossyni; Damilakis, John

2013-10-01

217

Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach  

PubMed Central

Background: The optimal approach to provide satisfactory decompression and minimize complications for ossification of the posterior longitudinal ligament (OPLL) involving multiple levels (3 levels or more) remains controversial. The purpose of this study was to compare the results of two surgical approaches for cervical OPLL involving multiple levels; anterior direct decompression and fixation, and posterior indirect decompression and fixation. We present a retrospective review of 56 cases followed at a single Institution. Materials and Methods: We compared patients of multiple levels cervical OPLL that were treated at a single institution either with anterior direct decompression and fixation or with posterior indirect decompression and fixation. The clinical records of the patients with a minimum duration of follow-up of 2 years were reviewed. The associated complications were recorded. Results: Fifty-six patients constitute the clinical material. 26 cases were treated by anterior corpectomy and fixation and 30 cases received posterior laminectomy and fixation. The two populations were similar. It was found that both anterior and posterior decompression and fixation can achieve satisfactory outcomes, and posterior surgery was accomplished in a shorter period of time with lesser blood loss. Although patients had comparable preoperative Japanese Orthopaedics Association (JOA) scores, those with a canal occupancy by OPLL more than 50% and managed anteriorly had better outcomes. However, for those with more severe stenosis, anterior approach was more difficult and associated with higher risks and complications. Despite its limitations in patients with high occupancy OPLLs, through the multiple level laminectomy, posterior fixation can achieve effective decompression, maintaining or restoring stability of the cervical spine, and thereby improving neural outcome and preventing the progression of OPLL. Conclusions: The posterior indirect decompression and fixation has now been adopted as the primary treatment for cervical OPLL involving multiple levels with the canal occupancy by OPLL <50% at our institution because this approach leads to significantly less implant failures. Those patients with the occupancy ?50% managed with anterior approach surgeries had better outcomes, but approach was more difficult and associated with higher risk and complications.

Lin, Dasheng; Ding, Zhenqi; Lian, Kejian; Hong, Jiayuan; Zhai, Wenliang

2012-01-01

218

Slow Dissociation of a Charged Ligand: Analysis of the Primary Quinone QA Site of Photosynthetic Bacterial Reaction Centers  

PubMed Central

Reaction centers (RCs) are integral membrane proteins that undergo a series of electron transfer reactions during the process of photosynthesis. In the QA site of RCs from Rhodobacter sphaeroides, ubiquinone-10 is reduced, by a single electron transfer, to its semiquinone. The neutral quinone and anionic semiquinone have similar affinities, which is required for correct in situ reaction thermodynamics. A previous study showed that despite similar affinities, anionic quinones associate and dissociate from the QA site at rates ?104 times slower than neutral quinones indicating that anionic quinones encounter larger binding barriers (Madeo, J.; Gunner, M. R. Modeling binding kinetics at the QA site in bacterial reaction centers. Biochemistry2005, 44, 10994–11004). The present study investigates these barriers computationally, using steered molecular dynamics (SMD) to model the unbinding of neutral ground state ubiquinone (UQ) and its reduced anionic semiquinone (SQ–) from the QA site. In agreement with experiment, the SMD unbinding barrier for SQ– is larger than for UQ. Multi Conformational Continuum Electrostatics (MCCE), used here to calculate the binding energy, shows that SQ– and UQ have comparable affinities. In the QA site, there are stronger binding interactions for SQ– compared to UQ, especially electrostatic attraction to a bound non-heme Fe2+. These interactions compensate for the higher SQ– desolvation penalty, allowing both redox states to have similar affinities. These additional interactions also increase the dissociation barrier for SQ– relative to UQ. Thus, the slower SQ– dissociation rate is a direct physical consequence of the additional binding interactions required to achieve a QA site affinity similar to that of UQ. By a similar mechanism, the slower association rate is caused by stronger interactions between SQ– and the polar solvent. Thus, stronger interactions for both the unbound and bound states of charged and highly polar ligands can slow their binding kinetics without a conformational gate. Implications of this for other systems are discussed.

2011-01-01

219

Stimulation of experimental endochondral ossification by low-energy pulsing electromagnetic fields  

SciTech Connect

Pulsed electromagnetic fields (PEMFs) of certain configuration have been shown to be effective clinically in promoting the healing of fracture nonunions and are believed to enhance calcification of extracellular matrix. In vitro studies have suggested that PEMFs may also have the effect of modifying the extracellular matrix by promoting the synthesis of matrix molecules. This study examines the effect of one PEMF upon the extracellular matrix and calcification of endochondral ossification in vivo. The synthesis of cartilage molecules is enhanced by PEMF, and subsequent endochondral calcification is stimulated. Histomorphometric studies indicate that the maturation of bone trabeculae is also promoted by PEMF stimulation. These results indicate that a specific PEMF can change the composition of cartilage extracellular matrix in vivo and raises the possibility that the effects on other processes of endochondral ossification (e.g., fracture healing and growth plates) may occur through a similar mechanism.

Aaron, R.K.; Ciombor, D.M.; Jolly, G.

1989-04-01

220

The roles of inflammatory cytokines in the pathogenesis of ossification of ligamentum flavum  

PubMed Central

Ossification of Ligamentum Flavum (OLF) is associated with serious neurologic symptoms including thoracic myelopathy and spinal stenosis. The pathogenesis of thoracic OLF is mainly due to the localized mechanical stress on the ligament induced enchondral ossification. However, despite numerous epidemiological and basic science studies, the mechanism of this process remains unclear. Studies have suggested that inflammatory cytokines, such as IL-6, TNF-?, seem to play a crucial role in OLF. In this review, we summarise the mechanistic information on the roles of inflammation cytokines in OLF and discuss about several therapeutic methods for OLF. Further studies on the role of cytokines in OLF should provide important insights into the designation of therapeutic strategies in preventing human spinal stenosis caused by OLF.

Ren, Liang; Hu, Hongtao; Sun, Xianze; Li, Feng; Zhou, Jimmy Jianheng; Wang, Yuan Min

2013-01-01

221

Intra-Articular Giant Heterotopic Ossification following Total Knee Arthroplasty for Charcot Arthropathy  

PubMed Central

Although the Charcot arthropathy may be associated with serious complications, total knee arthroplasty (TKA) is the preferred choice of treatment by patients. This case report presents an 80-year-old man with intra-articular giant heterotopic ossification following loosening of femoral and tibial implants and femoral condylar fracture. He had undergone TKA because of Charcot neuropathy seven years ago and had been doing well since. Immediately after a left knee sprain, he became unable to walk. Because he had developed a skin ulcer on his left calf where methicillin-resistant Staphylococcus aureus was detected, we postponed revision surgery until the ulcer was completely healed. While waiting, intra-articular bony fragments grew larger and formed giant heterotopic ossified masses. Eventually, the patient underwent revision surgery, and two major ossified masses were carefully and successfully extirpated. It should be noted that intra-articular heterotopic giant ossification is a significant complication after TKA for neuropathic arthropathy.

Tsuge, Shintaro; Aoki, Yasuchika; Sonobe, Masato; Shibata, Yoshifumi; Sasaki, Yu; Nakagawa, Koichi

2013-01-01

222

Ossification and mineralization in the tendons of the chicken (Gallus domesticus).  

PubMed Central

Fifty broiler chickens of both sexes were used in this study. The chickens were bought at 8 weeks old and kept until 40 weeks old. During this period the development of ossification and mineralization was followed. The chickens were killed at weekly intervals. After having been examined fresh, the tendons were fixed in appropriate fixatives and processed for histological and histochemical examination. The earliest signs of mineralization were noted at 15 weeks and mineralization was apparent on X-ray photographs at 20 weeks.The development of ossification of the tendons has been described. The fibroblasts transformed into osteoblasts which secreted around the cells and later between the fibres. This was followed by the appearance of osteoblasts and resorption cavities and then the latter became lined by osteoblasts, and osteones were formed. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11

Abdalla, O

1979-01-01

223

Matrix metalloproteinase expression and localization in turkey (Meleagris gallopavo) during the endochondral ossification process.  

PubMed

Vertebrate long bones are formed by endochondral ossification, a process accompanied by changes in extracellular matrix synthesis and remodeling, performed mainly by the matrix metalloproteinases (MMP). The temporal/spatial expression patterns of 5 members of the MMP family known to be important for endochondral ossification were studied, for the first time, in the turkey growth plate during embryonic and juvenile stages. The expression of MMP-2 was detected in the proliferative zone, MMP-3, MMP-9, and MMP-13 in cells lining the blood vessels; MMP-13 was also detected in hypertrophic chondrocytes. The MMP-16 expression was detected in the reserve zone of the growth plate. These results present a detailed survey of turkey MMP, serving as a data source (atlas) for further studies in this subject. PMID:17296767

Simsa, S; Genina, O; Ornan, E Monsonego

2007-02-12

224

Intensity modulated radiotherapy (IMRT) combined with concurrent but not adjuvant chemotherapy in primary nasopharyngeal cancer - a retrospective single center analysis  

PubMed Central

Background We report our experience in 49 consecutive patients with nasopharyngeal carcinoma who were treated by Intensity-modulated radiation therapy (IMRT) combined with simultaneous but not adjuvant chemotherapy (CHT). Methods The medical records of 49 patients with histologically proven primary nasopharygeal carcinoma treated with IMRT and concurrent platin-based CHT (predominantly cisplatin weekly) were retrospectively reviewed. The majority of patients showed advanced clinical stages (stage III/IV:72%) with undifferentiated histology (82%). IMRT was performed in step-and-shoot technique using an integrated boost concept in 84%. In this concept, the boost volume covered the primary tumor and involved nodes with doses of 66–70.4 Gy (single dose 2.2 Gy). Uninvolved regional nodal areas were covered with doses of 54–59.4 Gy (median single dose 1.8 Gy). At least one parotid gland was spared. None of the patients received adjuvant CHT. Results The median follow-up for the entire cohort was 48 months. Radiation therapy was completed without interruption in all patients and 76% of the patients received at least 80% of the scheduled CHT. Four local recurrences have been observed, transferring into 1-, 3-, and 5-year Local Control (LC) rates of 98%, 90% and 90%. One patient developed an isolated regional nodal recurrence, resulting in 1-, 3-, and 5-year Regional Control (RC) rates of 98%. All locoregional failures were located inside the radiation fields. Distant metastases were found in six patients, transferring into 1-, 3, and 5-year Distant Control (DC) rates of 92%, 86% and 86%. Progression free survival (PFS) rates after 1, 3 and 5 years were 86%, 70% and 69% and 1-, 3- and 5-year Overall Survival (OS) rates were 96%, 82% and 79%. Acute toxicity???grade III mainly consisted of dysphagia (32%), leukopenia (24%), stomatitis (16%), infection (8%) and nausea (8%). Severe late toxicity (grade III) was documented in 18% of the patients, mainly as xerostomia (10%). Conclusion Concurrent chemoradiation without the addition of adjuvant chemotherapy cycles using IMRT with an integrated boost concept yielded good disease control and overall survival in patients suffering from primary nasopharyngeal cancer with acceptable acute side effects and limited rates of late toxicity.

2013-01-01

225

Absence of endochondral ossification and craniosynostosis in posterior frontal cranial sutures of Axin2(-/-) mice.  

PubMed

During the first month of life, the murine posterior-frontal suture (PF) of the cranial vault closes through endochondral ossification, while other sutures remain patent. These processes are tightly regulated by canonical Wnt signaling. Low levels of active canonical Wnt signaling enable endochondral ossification and therefore PF-suture closure, whereas constitutive activation of canonical Wnt causes PF-suture patency. We therefore sought to test this concept with a knockout mouse model. PF-sutures of Axin2(-/-) mice, which resemble a state of constantly activated canonical Wnt signaling, were investigated during the physiological time course of PF-suture closure and compared in detail with wild type littermates. Histological analysis revealed that the architecture in Axin2(-/-) PF-sutures was significantly altered in comparison to wild type. The distance between the endocranial layers was dramatically increased and suture closure was significantly delayed. Moreover, physiological endochondral ossification did not occur, rather an ectopic cartilage appeared between the endocranial and ectocranial bone layers at P7 which eventually involutes at P13. Quantitative PCR analysis showed the lack of Col10?1 upregulation in Axin2(-/-) PF-suture. Immunohistochemistry and gene expression analysis also revealed high levels of type II collagen as compared to type I collagen and absence of Mmp-9 in the cartilage of Axin2(-/-) PF-suture. Moreover, TUNEL staining showed a high percentage of apoptotic chondrocytes in Axin2(-/-) PF-sutures at P9 and P11 as compared to wild type. These data indicated that Axin2(-/-) PF-sutures lack physiological endochondral ossification, contain ectopic cartilage and display delayed suture closure. PMID:23936395

Behr, Björn; Longaker, Michael T; Quarto, Natalina

2013-08-01

226

Heterotopic mesenteric ossification: report of a case and review of the literature.  

PubMed

Heterotopic mesenteric ossification (HMO) is a distinct intra-abdominal ossifying pseudotumour that typically occurs in men, almost always after surgery or abdominal trauma, and frequently presents with symptoms of intestinal obstruction. We herein describe a case of HMO occurring in a 42-year-old Iranian man with a history of abdominal blunt trauma. He underwent partial small intestinal and its mesentery resection. The postoperative course was uneventful. Now he is in good condition after 6 months. PMID:23045437

Binesh, Fariba; Akhavan, Ali; Navabii, Hossein; Ostadi, Mussa

2012-10-06

227

Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament  

Microsoft Academic Search

We evaluated the clinical results of posterior decompression with instrumented fusion (PDF) for thoracic myelopathy due to\\u000a ossification of the posterior longitudinal ligament (OPLL). A total of 24 patients underwent PDF, and their surgical outcomes\\u000a were evaluated by the Japanese Orthopaedic Association (JOA) scores (0–11 points) and by recovery rates calculated at 3, 6,\\u000a 9 and 12 months after surgery and

Masashi Yamazaki; Akihiko Okawa; Takayuki Fujiyoshi; Takeo Furuya; Masao Koda

2010-01-01

228

Ossification of the posterior longitudinal ligament in dizygotic twins with schizophrenia: a case report  

Microsoft Academic Search

The pathogenesis of ossification of the posterior longitudinal ligaments (OPLL) has not been clarified. We here report dizygotic\\u000a twin sisters with OPLL of the cervical spine and propose a new pathogenesis of OPLL. This is the first report of dizygotic\\u000a twins with OPLL. The twins suffered from schizophrenia, which might be related to the pathogenesis of OPLL. In addition, we

Shunji Matsunaga; Hiroaki Koga; Naoya Kawabata; Ichiro Kawamura; Masaki Otusji; Takanori Imakiire; Setsuro Komiya

2008-01-01

229

Bone mineral density in patients with ossification of the posterior longitudinal ligament in the cervical spine  

Microsoft Academic Search

:   Bone mineral density (BMD) has not been clearly determined in patients with ossification of the posterior longitudinal ligament\\u000a (OPLL) in the cervical spine. BMD in patients with OPLL was measured in the third vertebral body in the lateral projection\\u000a and in the distal part of the radius in the anteroposterior projection using dual-energy X-ray absorptiometry (DXA). Patients\\u000a with OPLL

Tsuneto Yamauchi; Eiji Taketomi; Shunji Matsunaga; Takashi Sakou

1999-01-01

230

Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament  

Microsoft Academic Search

Background context: The diagnosis and treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL) is continuing to evolve as its effects become more readily recognized and surgical alternatives expand.Purpose: To review the clinical, neurodiagnostic and surgical management of OPLL. Study design\\/setting: Patients with early OPLL, often in their mid-forties, present with radiculopathy or mild\\/moderate myelopathy. Radiographically, hypertrophy of

Nancy Epstein

2002-01-01

231

Histomorphometric study of iliac bones in cervical myelopathy with ossification of the posterior longitudinal ligament  

Microsoft Academic Search

:   To investigate whether there was any abnormal systemic bone metabolism in patients with ossification of the posterior longitudinal\\u000a ligament (OPLL), we measured various histomorphometric indices of the iliac trabecular bones in 19 patients with OPLL (14\\u000a men, 5 women). For each index, the Z-score for each patient was calculated, using the SD and mean value for non-OPLL control\\u000a group

Ikuo Aita; Atsuya Ohno; Hitoshi Amagai; Hiroyuki Hirabayashi; Koichiro Hayashi

1998-01-01

232

Immunohistochemistry of symptomatic hypertrophy of the posterior longitudinal ligament with special reference to ligamentous ossification  

Microsoft Academic Search

Study design:Immnunohistochemical staining of the thickened posterior longitudinal ligament of the cervical spine.Objectives:To clarify the histological characteristics of hypertrophy of the posterior longitudinal ligament (HPLL) of the cervical spine and the relationship between HPLL and ossification of the posterior longitudinal ligament (OPLL).Setting:Aichi Medical University, Aichi, Japan.Methods:Eight specimens of HPLL and two of OPLL were obtained during anterior decompressive surgery on

J Song; J Mizuno; Y Hashizume; H Nakagawa

2006-01-01

233

Transcriptional regulation of endochondral ossification by HIF-2? during skeletal growth and osteoarthritis development  

Microsoft Academic Search

Chondrocyte hypertrophy followed by cartilage matrix degradation and vascular invasion, characterized by expression of type X collagen (COL10A1), matrix metalloproteinase-13 (MMP-13) and vascular endothelial growth factor (VEGF), respectively, are central steps of endochondral ossification during normal skeletal growth and osteoarthritis development. A COL10A1 promoter assay identified hypoxia-inducible factor-2? (HIF-2?, encoded by EPAS1) as the most potent transactivator of COL10A1. HIF-2?

Taku Saito; Atsushi Fukai; Akihiko Mabuchi; Toshiyuki Ikeda; Fumiko Yano; Shinsuke Ohba; Nao Nishida; Toru Akune; Noriko Yoshimura; Takumi Nakagawa; Kozo Nakamura; Katsushi Tokunaga; Ung-il Chung; Hiroshi Kawaguchi

2010-01-01

234

Limb ossification patterns of the ichthyosaur Stenopterygius , and a discussion of the proximal tarsal row of ichthyosaurs and other neodiapsid reptiles  

Microsoft Academic Search

Limb ossification patterns for the Lower Jurassic (Toarcian) ichthyosaur,Stenopterygius, are described. It is found that limb ossification follows a continuous proximal to distal sequence from the propodial elements through to the terminal elements of 1st to 4th digit in the manus and the 1st to 3rd digit in the pes. The 5th manal and 4th pedal digit begin ossification later

MICHAEL W. CALDWELL

1997-01-01

235

Diaphanospondylodysostosis (DSD): confirmation of a recessive disorder with abnormal vertebral ossification and nephroblastomatosis.  

PubMed

We report on four patients from three families, with similar radiological findings: absent (or severely delayed) ossification of vertebral bodies and associated anomalies. The babies were stillborn or died soon after birth of respiratory insufficiency. Two patients are sibs (female and male) born to first cousin Malian parents. The two others were non-consanguineous. This perinatally lethal entity comprises short neck, short wide thorax, and normally shaped limbs. Associated, inconstant anomalies are myelomeningocele, cystic kidneys with nephrogenic rests (in the sibs), and cleft palate. Radiologically, the hallmarks are absence of ossification of the vertebral bodies and sacrum, abnormal position of the vertebral pedicles, which are lamellar and angulated, ribbon-like ribs reduced in number, narrow pelvis, upward widening of the iliac wings, and unusual tilt of the ischiopubic rami, contrasting with the normal appendicular skeleton. Maroteaux briefly described one of the patients in the 2002 edition of "Maladies osseuses de l'enfant" and three sibs with similar renal and radiological findings were reported in 2003 in this Journal. Combined with the latter cases, these four new patients allow delineation of a specific lethal AR syndrome with ossification defect of the axial skeleton and renal dysplasia. We propose to name this entity diaphanospondylodysostosis. PMID:15988748

Gonzales, Marie; Verloes, Alain; Saint Frison, Marie-Hélène; Perrotez, Chantal; Bourdet, Odile; Encha-Razavi, Ferechte; Joyé, Nicole; Taillemite, Jean-Louis; Walbaum, Roland; Pfeiffer, Rudolf; Maroteaux, Pierre

2005-08-01

236

[Parent satisfaction with a child and family-centered treatment program for primary headache in childhood and adolescence].  

PubMed

Patient satisfaction represents a significant outcome criterion in the context of systemic psychotherapeutic therapy research. This study investigated parent satisfaction with a psychosocial treatment program (comprising three components: child group therapy, parents' evenings, systemic family sessions) for pediatric primary headache (diagnosed according to IHS criteria). 10 weeks after the end of the treatment program, the parents were sent a questionnaire containing open questions and ten-point numerical rating scales. The sample comprised n=48 families. The return rate was 89%. The qualitative content analysis showed a hierarchical category system consisting of 3 major categories, 7 main groups and 69 sub-categories. The parents stated that they were satisfied with (1.) the effects of the treatment program, (2.) the specific treatment techniques and the medical and psychosocial headache-related information provided, and (3.) the therapeutic relationship. The mean satisfaction for all three therapy components on the ten-point numerical rating scale was 8.1 with a standard deviation of 2.0 (child headache group: 8.5; parents' evenings: 8.2; family sessions: 7.5). The results are discussed with reference to methodological aspects: avoidance of ceiling effects and social desirability in measuring customer satisfaction, order effects of items, weighting of the significance of satisfaction levels as an outcome criterion. PMID:17410930

Quiring, Juliane; Ochs, Matthias; Franck, Gideon; Wredenhagen, Nora; Seemann, Hanne; Verres, Rolf; von Schlippe, Arist; Schweeitzer, Jochen

2007-01-01

237

Effects of airborne World Trade Center dust on cytokine release by primary human lung cells in vitro.  

PubMed

There are continuing concerns regarding the respiratory health effects of airborne particulate matter (PM) after the destruction of the World Trade Centre (WTC). We examined cytokine (interleukin [IL]-8, IL-6, tumor necrosis factor-alpha) release by primary human lung alveolar macrophages (AM) and type II epithelial cells after exposure to WTC PM2.5 (indoor and outdoor), PM10-2.5 (indoor), and PM53-10 (outdoor), fractionated from settled dusts within 2 months of the incident. There was an increase in AM cytokine/chemokine release at 5 and/or 50 microg/well WTC PM, which fell at 500 microg/well. Type II cells did not release tumor necrosis factor-alpha, and the increase in IL-8 and IL-6, although significant, was lower than that of AM. Respirable PM generated by the WTC collapse stimulates inflammatory mediator release by lung cells, which may contribute to the increased incidence of respiratory illness since September 11th 2001. PMID:15167388

Payne, J P; Kemp, S J; Dewar, A; Goldstraw, P; Kendall, M; Chen, L C; Tetley, T D

2004-05-01

238

Chagas Disease among the Latin American Adult Population Attending in a Primary Care Center in Barcelona, Spain  

PubMed Central

Background/Aims The epidemiology of Chagas disease, until recently confined to areas of continental Latin America, has undergone considerable changes in recent decades due to migration to other parts of the world, including Spain. We studied the prevalence of Chagas disease in Latin American patients treated at a health center in Barcelona and evaluated its clinical phase. We make some recommendations for screening for the disease. Methodology/Principal Findings We performed an observational, cross-sectional prevalence study by means of an immunochromatographic test screening of all continental Latin American patients over the age of 14 years visiting the health centre from October 2007 to October 2009. The diagnosis was confirmed by serological methods: conventional in-house ELISA (cELISA), a commercial kit (rELISA) and ELISA using T cruzi lysate (Ortho-Clinical Diagnostics) (oELISA). Of 766 patients studied, 22 were diagnosed with T. cruzi infection, showing a prevalence of 2.87% (95% CI, 1.6–4.12%). Of the infected patients, 45.45% men and 54.55% women, 21 were from Bolivia, showing a prevalence in the Bolivian subgroup (n?=?127) of 16.53% (95% CI, 9.6–23.39%). All the infected patients were in a chronic phase of Chagas disease: 81% with the indeterminate form, 9.5% with the cardiac form and 9.5% with the cardiodigestive form. All patients infected with T. cruzi had heard of Chagas disease in their country of origin, 82% knew someone affected, and 77% had a significant history of living in adobe houses in rural areas. Conclusions We found a high prevalence of T. cruzi infection in immigrants from Bolivia. Detection of T. cruzi–infected persons by screening programs in non-endemic countries would control non-vectorial transmission and would benefit the persons affected, public health and national health systems.

Roca, Carme; Pinazo, Maria Jesus; Lopez-Chejade, Paolo; Bayo, Joan; Posada, Elizabeth; Lopez-Solana, Jordi; Gallego, Montserrat; Portus, Montserrat; Gascon, Joaquim

2011-01-01

239

Alkoxyl- and carbon-centered radicals as primary agents for degrading non-phenolic lignin-substructure model compounds.  

PubMed

Lignin degradation by white-rot fungi proceeds via free radical reaction catalyzed by oxidative enzymes and metabolites. Basidiomycetes called selective white-rot fungi degrade both phenolic and non-phenolic lignin substructures without penetration of extracellular enzymes into the cell wall. Extracellular lipid peroxidation has been proposed as a possible ligninolytic mechanism, and radical species degrading the recalcitrant non-phenolic lignin substructures have been discussed. Reactions between the non-phenolic lignin model compounds and radicals produced from azo compounds in air have previously been analysed, and peroxyl radical (PR) is postulated to be responsible for lignin degradation (Kapich et al., FEBS Lett., 1999, 461, 115-119). However, because the thermolysis of azo compounds in air generates both a carbon-centred radical (CR) and a peroxyl radical (PR), we re-examined the reactivity of the three radicals alkoxyl radical (AR), CR and PR towards non-phenolic monomeric and dimeric lignin model compounds. The dimeric lignin model compound is degraded by CR produced by reaction of 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH), which under N(2) atmosphere cleaves the ?-? bond in 1-(4-ethoxy-3-methoxyphenyl)-2-(2-methoxyphenoxy)-1,3-propanediol to yield 4-ethoxy-3-methoxybenzaldehyde. However, it is not degraded by the PR produced by reaction of Ce(4+)/tert-BuOOH. In addition, it is degraded by AR produced by reaction of Ti(3+)/tert-BuOOH. PR and AR are generated in the presence and absence of veratryl alcohol, respectively. Rapid-flow ESR analysis of the radical species demonstrates that AR but not PR reacts with the lignin model compound. Thus, AR and CR are primary agents for the degradation of non-phenolic lignin substructures. PMID:21327224

Ohashi, Yasunori; Uno, Yukiko; Amirta, Rudianto; Watanabe, Takahito; Honda, Yoichi; Watanabe, Takashi

2011-02-15

240

Mutations in the environment of the primary quinone facilitate proton delivery to the secondary quinone in bacterial photosynthetic reaction centers.  

SciTech Connect

In Rhodobacter capsulatus, we constructed a quadruple mutant that reversed a structural asymmetry that contributes to the functional asymmetry of the two quinone sites. In the photosynthetically incompetent quadruple mutant RQ, two acidic residues near QB, L212Glu and L213Asp, have been mutated to Ala; conversely, in the QA pocket, the symmetry-related residues M246Ala and M247Ala have been mutated to Glu and Asp. We have selected photocompetent phenotypic revertants (designated RQrev3 and RQrev4) that carry compensatory mutations in both the QA and QB pockets. Near QA, the M246Ala {yields} Glu mutation remains in both revertants, but M247Asp is replaced by Tyr in RQrev3 and by Ala in RQrev4. The engineered L212Ala and L213Ala substitutions remain in the QB site of both revertants but are accompanied by an additional electrostatic-type mutation. To probe the respective influences of the mutations occurring near the QA and QB sites on electron and proton transfer, we have constructed two additional types of strains. First, 'half' revertants were constructed that couple the QB site of the revertants with a wild-type QA site. Second, the QA sites of the two revertants were linked with the L212Glu-L213Asp {yields} Ala-Ala mutations of the QB site. We have studied the electron and proton-transfer kinetics on the first and second flashes in reaction centers from these strains by flash-induced absorption spectroscopy. Our data demonstrate that substantial improvements of the proton-transfer capabilities occur in the strains carrying the M246Ala {yields} Glu + M247Ala {yields} Tyr mutations near QA. Interestingly, this is not observed when only the M246Ala {yields} Glu mutation is present in the QA pocket. We suggest that the M247Ala {yields} Tyr mutation in the QA pocket, or possibly the coupled M246Ala {yields} Glu + M247Ala {yields} Tyr mutations, accelerates the uptake and delivery of protons to the QB anions. The M247Tyr substitution may enable additional pathways for proton transfer that are located near QA.

Valerio-Lepiniec, M.; Schiffer, M.; Hanson, D. K.; Sebban, P.; Center for Mechanistic Biology and Biotechnology; CNRS

1999-01-01

241

Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia  

PubMed Central

Purpose: The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia. Materials and Methods: A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant. Results: The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 – 72.02%). The non-compliance of males (69.34%) was higher than females (65.45%, P = .003). The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023) in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57),level of education (Illiteracy) (OR = 5.27, CI = 4.63 – 7.19), urban population (OR =5.22, CI= 3.65 – 8.22), irregularity of the follow-up (OR = 8.41, CI = 4.90 – 11.92), non-adherence to drug prescription (OR = 4.55 , CI = 3.54 – 5.56), non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 – 6.), insulin (OR = 1.29, CI = .71 – 1.87), and insulin with oral Metformin (OR = 1.20, CI = .65 – 1.75). Conclusion: The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need for improvement in the healthcare system, health education, and training of diabetic patients.

Khan, Ataur R.; Al-Abdul Lateef, Zaki N.; Al Aithan, Mohammad A.; Bu-Khamseen, Montaser A.; Ibrahim, Ibrahim Al; Khan, Shabbir A.

2012-01-01

242

Primary testicular diffuse large B-cell lymphoma: A case report focusing on touch imprint cytology and a non-germinal center B-cell-like phenotype  

PubMed Central

Primary diffuse large B-cell lymphoma (DLBCL) of the testis is a rare subtype of testicular tumor. While the histomorphology of testicular DLBCL is well described, a paucity of information in the literature exists with regard to the cytological diagnosis of this subtype of tumor. Touch imprint specimens were obtained from a testicular DLBCL occurring in a 64-year-old man. The cytological features of imprints were compared with the results obtained from histological and immunohistochemical examinations. Smears obtained from the touch imprints exhibited a high cellular yield consisting of discretely arranged monomorphic large cells with irregular nuclear membranes, scant cytoplasm and conspicuous nucleoli. Histologically, the tumor consisted of discohesive neoplastic lymphocytes that infiltrated diffusely and produced a wide separation of intact seminiferous tubules. Diffuse, intense immunostaining for CD45, CD20, MUM1 and Ki-67 led to the diagnosis of primary DLBCL of the testis with a non-germinal center B-cell-like phenotype. Careful observation of the touch imprint specimens of testicular DLBCL revealed a high cellularity with a predominant single-cell pattern of monomorphic cells demonstrating irregular nuclear membranes and conspicuous nucleoli. In addition, DLBCL is capable of developing in the testis and forming a predominantly discohesive cell population, suggesting the presence of a lymphoid malignancy. Thus, it may be possible to detect morphological features that are characteristic of DLBCL using imprint cytology. To the best of our knowledge, this is the first study reporting the diagnosis of testicular DLBCL using touch imprint cytology.

KIM, HYUN-SOO

2013-01-01

243

Prevalence of childhood and early adolescence mental disorders among children attending primary health care centers in Mosul, Iraq: a cross-sectional study  

PubMed Central

Background Children and adolescents are more vulnerable to the affects of war and violence than adults. At the time of initiation of this study, nothing was known about the prevalence of childhood and early adolescence mental disorders. The aim of the present study is to measure the point prevalence of mental disorders among children of 1–15 years age in the city of Mosul, Iraq. Methods A cross-sectional study design was adopted. Four primary health care centers were chosen consecutively as a study setting. The subjects of the present study were mothers who came to the primary health care center for vaccination of their children. The chosen mothers were included by systematic sampling randomization. All children (aged 1–15) that each mother had were considered in the interview and examination. Results Out of 3079 children assessed, 1152 have childhood mental disorders, giving a point prevalence of 37.4%, with a male to female ratio of to 1.22:1. The top 10 disorders among the examined children are post-traumatic stress disorder (10.5%), enuresis (6%), separation anxiety disorder (4.3%), specific phobia (3.3%) stuttering and refusal to attend school (3.2% each), learning and conduct disorders (2.5% each), stereotypic movement (2.3%) and feeding disorder in infancy or early childhood (2.0%). Overall, the highest prevalence of mental disorders was among children 10–15 years old (49.2%) while the lowest was among 1–5 year olds (29.1%). Boys are more affected than girls (40.2% and 33.2%, respectively). Conclusion Childhood mental disorders are a common condition highly prevalent amongst the children and early adolescents in Mosul. Data from the present study mirrors the size of the problem in local community. Several points deserve attention, the most important of which include giving care at the community level, educating the public on mental health, involving communities and families, monitoring community mental health indicators, and providing treatment at primary health care level.

Al-Jawadi, Asma A; Abdul-Rhman, Shatha

2007-01-01

244

Surgical treatment for ossification of the posterior longitudinal ligament and the yellow ligament in the thoracic and cervico-thoracic spine  

Microsoft Academic Search

This study analyzed the postoperative results of surgical treatment for thoracic and cervico-thoracic myelopathy caused by ossification of the posterior longitudinal ligaments (OPLL) or ossification of the yellow ligaments (OYL) in 22 patients using magnetic resonance imaging (MRI), myelography and computed tomography (CT).Anterior procedures were performed in 11 patients for OPLL, while posterior approaches were adopted for the management of

Kazuhiro Ido; Katsuji Shimizu; Hirokazu Iida; Takashi Nakamura

1998-01-01

245

Sonographic assessment of the ossification of the medial clavicular epiphysis in 616 individuals.  

PubMed

Establishing radiation-free imaging methods for the assessment of clavicular ossification in forensic age determination is desirable as it reduces radiation exposure in living individuals. For this purpose the stage of ossification of the right medial clavicular epiphysis was determined prospectively using sonography in 309 male and 307 female healthy volunteers. The classification of stages according to Schulz et al. was used for this purpose. Stage 2 was first noticed at the age of 14.4 years in males, and at the age of 14.1 years in females. Stage 3 was first achieved by males at the age of 17.6 years and by females at the age of 17.4 years. Stage 4 first occurred in males at the age of 19.3 years and at the age of 18.9 years in females. The mean age for stage 1 was 13.6 years. The mean age of stage 2 ranged between 17.3 and 17.6 years. For stage 3 the mean age varied from 20.7 to 21.2 years, and for stage 4 from 23.3 to 23.5 years. It was concluded that sonographically determined stage 4 clavicular ossification provides evidence for the completion of the nineteenth year of life in males and the eighteenth year of life in females. In order to increase the reliability of age determination using this method it is recommended that findings be recorded by at least two experienced independent examiners who then reach a consensus. PMID:23615796

Schulz, Ronald; Schiborr, Manfred; Pfeiffer, Heidi; Schmidt, Sven; Schmeling, Andreas

2013-04-25

246

Primary sacral non-germinal center type diffuse large B-cell lymphoma with MYC translocation: a case report and a review of the literature.  

PubMed

An 85-year-old man presented with pain and numbness in the left buttock, and physical examination revealed an approximately 7 cm mass extending from the first to the third sacral vertebrae; biopsy of the mass led to the diagnosis of CD10-negative, BCL6-weakly positive, MUM1-positive, non-germinal center (non-GC) type diffuse large B-cell lymphoma (DLBCL). Furthermore, serological testing showed negative results for Epstein-Barr virus (EBV) infection, and fluorescence in situ hybridization (FISH) revealed a MYC translocation. Radiographs showed no remarkable osteolytic bone destruction, and the patient was staged with Stage IAE. After 8 cycles of rituximab therapy and 6 cycles of CHOP therapy, complete remission has been maintained until now, approximately 1 year after the treatment. Primary sacral lymphoma is very rare, with only 6 reported cases, including the present one. A review of the reported cases revealed that the disease predominantly affects elderly men, is usually non-GC-type DLBCL and stage IAE, measures approximately 2-7 cm in diameter in general, and does not show early recurrence after chemotherapy or chemoradiotherapy. There is no report in the literature yet of primary sacral DLBCL with MYC translocation, and this is the first case report. On the other hand, 35 cases of CD10-negative DLBCL with MYC translocation, including the present one, have been reported, and a review of the reported cases showed that the disease predominantly affects Asians, middle-aged or elderly men, shows positivity for either BCL6 or MUM1 and negativity for EBV, and has a high international prognostic index and poor prognosis. PMID:24040459

Shimada, Asami; Sugimoto, Kei-Ji; Wakabayashi, Mutsumi; Imai, Hidenori; Sekiguchi, Yasunobu; Nakamura, Noriko; Sawada, Tomohiro; Ota, Yasunori; Komatsu, Norio; Noguchi, Masaaki

2013-08-15

247

Primary sacral non-germinal center type diffuse large B-cell lymphoma with MYC translocation: a case report and a review of the literature  

PubMed Central

An 85-year-old man presented with pain and numbness in the left buttock, and physical examination revealed an approximately 7 cm mass extending from the first to the third sacral vertebrae; biopsy of the mass led to the diagnosis of CD10-negative, BCL6-weakly positive, MUM1-positive, non-germinal center (non-GC) type diffuse large B-cell lymphoma (DLBCL). Furthermore, serological testing showed negative results for Epstein-Barr virus (EBV) infection, and fluorescence in situ hybridization (FISH) revealed a MYC translocation. Radiographs showed no remarkable osteolytic bone destruction, and the patient was staged with Stage IAE. After 8 cycles of rituximab therapy and 6 cycles of CHOP therapy, complete remission has been maintained until now, approximately 1 year after the treatment. Primary sacral lymphoma is very rare, with only 6 reported cases, including the present one. A review of the reported cases revealed that the disease predominantly affects elderly men, is usually non-GC-type DLBCL and stage IAE, measures approximately 2-7 cm in diameter in general, and does not show early recurrence after chemotherapy or chemoradiotherapy. There is no report in the literature yet of primary sacral DLBCL with MYC translocation, and this is the first case report. On the other hand, 35 cases of CD10-negative DLBCL with MYC translocation, including the present one, have been reported, and a review of the reported cases showed that the disease predominantly affects Asians, middle-aged or elderly men, shows positivity for either BCL6 or MUM1 and negativity for EBV, and has a high international prognostic index and poor prognosis.

Shimada, Asami; Sugimoto, Kei-Ji; Wakabayashi, Mutsumi; Imai, Hidenori; Sekiguchi, Yasunobu; Nakamura, Noriko; Sawada, Tomohiro; Ota, Yasunori; Komatsu, Norio; Noguchi, Masaaki

2013-01-01

248

Articulated radial head replacement and elbow release for post head-injury heterotopic ossification.  

PubMed

This is a case report of the release of an elbow ankylosed by post-head-injury heterotopic ossification. An extensive bony resection and soft-tissue release was required. At surgery a pathological, osteoporotic fracture of the radial head was found that could not be preserved and thus was removed. In its place an articulated "floating radial head prosthesis" was used that allowed immediate rehabilitation and avoided the need for temporary joint distraction or stabilization. The initial excellent function achieved has been maintained, at a > 3-year follow-up and without the complications experienced with silicone radial head prostheses. PMID:8926557

Charnley, G; Judet, T; de Loubresse, C G; Piriou, P

1996-01-01

249

Systematic review of cohort studies comparing surgical treatment for multilevel ossification of posterior longitudinal ligament: anterior vs posterior approach.  

PubMed

There have been no standards or guidelines for the treatment of ossification of posterior longitudinal ligament, especially multilevel ossification of posterior longitudinal ligament. The purpose of this study was to compare results of major surgical treatment for multilevel ossification of posterior longitudinal ligament. Databases including MEDLINE, EMBASE, the Cochrane library, and bibliographies of identified and review articles were searched to find randomized, controlled trials or retrospective cohort studies comparing anterior and posterior approach from 1980 to December 2010. Approximately 1375 articles were found initially, 92 abstracts were screened, 23 articles were retrieved in full; 3 studies were included in the review. No randomized, controlled studies were identified. Because all the studies included in this study are cohort studies with disparity of surgical interventions, heterogeneity of outcome measures and different qualities, we were unable to perform a meta-analysis. All comparison studies are retrospective cohort studies, comparing surgical outcomes of anterior approach (corpectomy and fusion) with that of posterior approach (laminoplasty or laminectomy) for the treatment of multilevel ossification of posterior longitudinal ligament in the cervical spine. A systematic review of retrospective cohort studies was performed to determine which surgical treatment is the most effective in patients with multilevel ossification of posterior longitudinal ligament. Definitive conclusions regarding the surgical treatment of multilevel ossification of posterior longitudinal ligament could not be made in this article. Multilevel corpectomy and fusion are more technical and have a significantly higher rate of cerebrospinal fluid leakage and graft, instrumentation related complications. A well-designed, prospective, randomized controlled, multicenter trial is needed. PMID:21815583

Xu, JunJie; Zhang, Kai; Ma, XiangYang; Yin, QingShui; Wu, ZengHui; Xia, Hong; Wang, ZhiYun

2011-08-08

250

Primary processes of charge separation in reaction centers of YM210L/FM197Y and YM210L mutants of Rhodobacter sphaeroides.  

PubMed

Difference femtosecond absorption spectroscopy with 20-fsec temporal resolution was applied to study a primary stage of charge separation and transfer processes in reaction centers of YM210L and YM210L/FM197Y site-directed mutants of the purple bacterium Rhodobacter sphaeroides at 90 K. Photoexcitation was tuned to the absorption band of the primary electron donor P at 880 nm. Coherent oscillations in the kinetics of stimulated emission of P* excited state at 940 nm and of anion absorption of monomeric bacteriochlorophyll B(A)(-) at 1020 nm were monitored. The absence of tyrosine YM210 in RCs of both mutants leads to strong slowing of the primary reaction P* --> P(+)B(A)(-) and to the absence of stabilization of separated charges in the state P(+)B(A)(-). Mutation FM197Y increases effective mass of an acetyl group of pyrrole ring I in the bacteriochlorophyll molecule P(B) of the double mutant YM210L/FM197Y by a hydrogen bond with OH-TyrM197 group that leads to a decrease in the frequency of coherent nuclear motions from 150 cm(-1) in the single mutant YM210L to ~100 cm(-1) in the double mutant. Oscillations with 100-150 cm(-1) frequencies in the dynamics of the P* stimulated emission and in the kinetics of the reversible formation of P(+)B(A)(-) state of both mutants reflect a motion of the P(B) molecule relatively to P(A) in the area of mutual overlapping of their pyrrole rings I. In the double mutant YM210L/FM197Y the oscillations in the P* emission band and the B(A)(-) absorption band are conserved within a shorter time ~0.5 psec (1.5 psec in the YM210L mutant), which may be a consequence of an increase in the number of nuclei forming a wave packet by adding a supplementary mass to the dimer P. PMID:19916934

Yakovlev, A G; Vasilieva, L G; Shkuropatov, A Y; Shuvalov, V A

2009-11-01

251

Registry-based Diabetes Risk Detection Schema for the Systematic Identification of Patients at Risk for Diabetes in West Virginia Primary Care Centers  

PubMed Central

Approximately 466,000 West Virginians, or about 25 percent of the state population, have prediabetes and are at high risk for developing type 2 diabetes. Appropriate lifestyle intervention can prevent or delay the onset of type 2 diabetes if individuals at risk are identified and treated early. The West Virginia Diabetes Prevention and Control Program and the West Virginia University Office of Health Services Research are developing a systematic approach to diabetes prevention within primary care. This study aims to demonstrate the viability of patient registry software for the analysis of disparate electronic health record (EHR) data sets and standardized identification of at-risk patients for early detection and intervention. Preliminary analysis revealed that of 94,283 patients without a documented diagnosis of diabetes or prediabetes, 10,673 (11.3 percent) meet one or more of the risk criteria. This study indicates that EHR data can be repurposed into an actionable registry for prevention. This model supports meaningful use of EHRs, the Patient-Centered Medical Home program, and improved care through enhanced data management.

Baus, Adam; Wood, Gina; Pollard, Cecil; Summerfield, Belinda; White, Emma

2013-01-01

252

A 240 GHz high-field transient EPR study of the primary donor triplet state g-tensor in photosynthetic reaction centers of Rhodobacter sphaeroides R-26.  

NASA Astrophysics Data System (ADS)

We report time-resolved 240 GHz EPR spectra of the primary donor triplet state ^3P from photosynthetic reaction centers of Rhodobacter sphaeroides R26.1 as a function of temperature in the range 10-230K. The data allow the determination of the principal g-tensor values and the principal axes directions of the ^3P g-tensor with respect to its zero-field axes. The g-tensor measured at 240 GHz differs appreciably from previous measurements of ^3P at lower frequencies and also differs from that of the cation radical state P^+, which has previously been characterized at high frequencies. In contrast to P^+, the ^3P state exhibits significant temperature dependence in its g-tensor, particularly in the direction of the principal axes. The ^3P yield anisotropy first observed by Boxer and coworkers at high field using photoselection methods is also evident in the high-field EPR spectrum as a significant variation of intensity across the spectrum. This variation is analyzed in terms of a radical pair and a yield ratio model.

van Tol, Johan; Budil, David; Zeng, Ronghui; Frank, Harry; Deal, Amanda

2003-03-01

253

Registry-based Diabetes Risk Detection Schema for the Systematic Identification of Patients at Risk for Diabetes in West Virginia Primary Care Centers.  

PubMed

Approximately 466,000 West Virginians, or about 25 percent of the state population, have prediabetes and are at high risk for developing type 2 diabetes. Appropriate lifestyle intervention can prevent or delay the onset of type 2 diabetes if individuals at risk are identified and treated early. The West Virginia Diabetes Prevention and Control Program and the West Virginia University Office of Health Services Research are developing a systematic approach to diabetes prevention within primary care. This study aims to demonstrate the viability of patient registry software for the analysis of disparate electronic health record (EHR) data sets and standardized identification of at-risk patients for early detection and intervention. Preliminary analysis revealed that of 94,283 patients without a documented diagnosis of diabetes or prediabetes, 10,673 (11.3 percent) meet one or more of the risk criteria. This study indicates that EHR data can be repurposed into an actionable registry for prevention. This model supports meaningful use of EHRs, the Patient-Centered Medical Home program, and improved care through enhanced data management. PMID:24159274

Baus, Adam; Wood, Gina; Pollard, Cecil; Summerfield, Belinda; White, Emma

2013-10-01

254

Retention: building a patient-centered medical home in HIV primary care through PUFF (Patients Unable to Follow-up Found).  

PubMed

Here, we describe our patient-centered medical home (PCMH) quality improvement retention project conducted by a Health Resources and Services Administration (HRSA) Ryan White-funded Primary Care HIV clinic. The single urban academic clinic serving 2,776 active HIV positive patients identified 25.8% (716/2,776) patients who had not been retained in care within the prior six months during two separate six-month interval analyses. Multiple modalities including a retention specialist, a secure clinic phone message line, algorithms, flyers, brochures, database, and staff education were built to facilitate re-engagement. The project located 87.7% (628/716) patients who had not been retained. The retention specialist was directly responsible for the return of 16.2% (116/716) patients. Results from the project demonstrated that a formalized approach is a necessary component to effective retention efforts. We believe that this work will provide a strategic framework for the development of randomized control trials to formally evaluate an HIV retention intervention. PMID:22864489

Sitapati, Amy M; Limneos, Jan; Bonet-Vázquez, Militza; Mar-Tang, Moira; Qin, Huifang; Mathews, W Christopher

2012-08-01

255

Leptin increases extracellular matrix mineralization of human osteoblasts from heterotopic ossification and normal bone.  

PubMed

Heterotopic ossification (HO) is the pathologic formation of bone in soft tissue. The exact pathomechanism is unknown but probably involves a disturbed osteoblast differentiation. Leptin, known as the obesity gene, may regulate normal osteoblast function in vitro. The aim of the present in vitro study was to further analyze the pathomechanisms of HO, including a possible role of leptin in ectopic bone formation. Human osteoblasts were cultivated either from normal bone or from resected HO. Both groups were incubated with increasing doses of leptin. Phenotype expression and mineralization of extracellular matrix were measured after 7, 14, and 21 days. In both groups, leptin increased both the formation of bone nodules and Ca-45 incorporation. This is the first study to analyze the effect of leptin on bone cells from ectopic ossification. Similar to the in vitro behavior of normal osteoblasts, cells from HO respond to leptin exposure with an increased mineralization of the extracellular matrix. This mechanism may be involved in the pathogenesis of ectopic bone formation in vivo. PMID:17721225

Handschin, Alexander E; Trentz, Omana A; Hemmi, Sonja; Wedler, Volker; Trentz, Otmar; Giovanoli, Pietro; Wanner, Guido A

2007-09-01

256

Endochondral ossification process of the turkey (Meleagris gallopavo) during embryonic and juvenile development.  

PubMed

The long bones of the developing skeleton arise from the process of endochondral ossification, which begins during the embryonic stages and resumes later in the growth plates located at the extremities of the long bones. This process includes commitment of cells to the chondrocytic lineage and further differentiation into hypertrophic chondrocytes, which subsequently undergo apoptosis and are replaced by osteoblasts laying down the trabecular bone. In this study we characterize, for the first time, the endochondral bone development of the turkey during embryonic and juvenile stages. Turkey tibias were collected on embryonic d 11, 14, and 18; and at 3 and 7 d posthatching, alcian blue and Von Kossa staining, alkaline phosphatase activity, and in situ expression of collagen types II and X were studied in these samples. We showed that the principles of bone development in the turkey follow the known vertebrate pattern, and that the initiation of ossification is related to the perichondrium and compact bone. These results increase the knowledge about this process in the turkey, which is an important animal in the agricultural industries. PMID:17297170

Simsa, S; Ornan, E Monsonego

2007-03-01

257

Ossification of the midpalatal suture after surgically assisted rapid maxillary expansion.  

PubMed

The purpose of this study was to evaluate ossification of the midpalatal suture in adult patients immediately after surgically assisted rapid maxillary expansion (SARME) until 120 days post-surgery. The sample comprised 126 standardized occlusal radiographs of 21 adults (14 females and 7 males; mean age: 25.33 years) taken pre-expansion (T1), immediately after expansion (T2), and post-expansion (30, 60, 90, and 120 days of retention, respectively: T3, T4, T5, and T6) who had undergone SARME. The radiographs were digitized and the images were analysed and compared in relation to the morphology and radiopacity at the different treatment stages, especially concerning the characteristics of the midpalatal suture. Data were statistically analysed using analysis of variance and Tukey's test. The results demonstrated that from T2 to T6, the mean optical density (OD) increased. However, these values were not similar to those observed at T1. A retention period of 120 days was not sufficient for the re-establishment of OD and complete ossification within the suture in the evaluated patients. PMID:21300726

Gurgel, Júlio de Araújo; Malmström, Márcia Ferreira Vasconcelos; Pinzan-Vercelino, Célia Regina Maio

2011-02-07

258

Work in progress report - Cardiac general Primary treatment of deep sternal wound infection after cardiac surgery: a survey of German heart surgery centers  

Microsoft Academic Search

There are various primary treatment modalities of managing deep sternal wound infection (DSWI) following cardiac surgery, namely surgical debridement with primary reclosure in conjunction with irrigation, Vacuum-assisted closure (V.A.C. ) therapy, and primary or delayed flap closure. The purpose of this study was to assess whether there is consensus of the primary management of DSWI using one method as a

Christoph Schimmer; Sebastian-Patrick Sommer; Marc Bensch; Rainer Leyh

259

Effectiveness of an intervention in groups of family caregivers of dependent patients for their application in primary health centers. Study protocol  

PubMed Central

Background Although Primary Health Care (PHC) Teams are used to deal with prevention and treatment of sanitary problems in adults with chronic diseases, they usually have a lack of experience in development of psychotherapeutic interventions. However, these interventions are the ones that achieve better results to reduce symptomatology and improve emotional state of caregivers. The study aims to evaluate the effectiveness of an intervention of psychotherapy in improving the mental health and Quality of life of caregivers. This intervention is based on theoretical approaches to care adjusted to cognitive theory, in order to be applied in primary health care centres. Methods/Design This is multicentre clinical trials study, randomized in two parallel groups, carry out in two PHC, Study population: 150 caregivers will be included by consecutive sampling and they will be randomized the half to experimental group and the other half to control group. They provide mostly all the assistance to care-dependent familiars receiving attention in PHC Centers. Measurements: Each caregiver will be evaluated on a personal interview. The caregivers' assessment protocol: 1) Assessment of different socio-demographic related to care, and caregiver's personal situation. 2)Care-dependent individuals will also be assessed by Barthel Index and Pfeiffer Questionnaire (SPMSQ). 3)Change in caregivers will be the principal measure: family function (Family APGAR Questionnaire), burden short questionnaire (Short Zarit Burden Interview), quality of life (Ruiz & Baca: 1993 Questionnaire), the Duke-UNK Functional Social Support Questionnaire, the General Health Questionnaire-12, and changes in Dysfunctional Thoughts about caring. 4) Intervention implementation measures will also be assessed. Intervention: A psychotherapeutic intervention will be 8 sessions of 90 minutes in groups. This intervention has been initially developed for family caregivers of patients with dementia. Discussion Psychotherapeutic interventions have been proved to obtain better results to reduce symptomatology and improve emotional state of caregivers. Moreover, this intervention has been proved to be effective in a different setting other than PHC, and was developed by professionals of Mental Health. If we found that this intervention is effective in PHC and with our professionals, it would be an important instrument to offer to caregivers of care-dependent patients. Trial Registration ClinicalTrials.gov Identifier NCT01177696

2010-01-01

260

Involvement of MET \\/ TWIST \\/ APC Combination or the Potential Role of Ossification Factors in Pediatric High-Grade Osteosarcoma Oncogenesis  

Microsoft Academic Search

Dysregulated cell growth or differentiation due to mis- expression of developmental critical factors seems to be a decisive event in oncogenesis. As osteosarcomas are histologically defined by malignant osteoblasts pro- ducing an osteoid component, we prospected in pe- diatric osteosarcomas treated with OS94 protocol the genomic status of several genes implied in ossification processes. In 91 osteosarcoma cases, we focused

Natacha Entz-Werle; Thomas Lavaux; Nadia Metzger; Corinne Stoetzel; Christelle Lasthaus; Perrine Marec; Chantal Kalifa; Laurence Brugieres; Hélène Pacquement; Claudine Schmitt; Marie-Dominique Tabone; Jean-Claude Gentet; Patrick Lutz; Annie Babin; Pierre Oudet; Marie-Pierre Gaub; Fabienne Perrin-Schmitt

2007-01-01

261

Permanent heterotopic ossification at the injection site after diphtheria-tetanus-pertussis immunizations in children who have fibrodysplasia ossificans progressiva  

Microsoft Academic Search

In patients who have fibrodysplasia ossificans progressiva, routine childhood diphtheria-tetanus-pertussis immunizations administered by intramuscular injection caused a significant risk of permanent heterotopic ossification at the site of injection ( p <10 \\\\-8 ), whereas measles-mumps-rubella immunizations administered by subcutaneous injection posed no significant risk. Intramuscular injections should be avoided, if possible, once a diagnosis of fibrodysplasia ossificans progressiva has been

Thomas F. Lanchoney; Randolph B. Cohen; David M. Rocke; Michael A. Zasloff; Frederick S. Kaplan

1995-01-01

262

Static versus dynamic factors for the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament  

Microsoft Academic Search

We studied 27 patients with cervical ossification of the posterior longitudinal ligament (OPLL) but no clinical symptoms of myelopathy. We investigated the occupation ratio of the spinal canal by OPLL with cervical radiographs, assessed the morphological types of OPLL, and measured the segmental range of motion (ROM) at the level of maximum cord compression on flexion and extension radiographs. Patients

Takayuki Fujiyoshi; Masashi Yamazaki; Akihiko Okawa; Junko Kawabe; Koichi Hayashi; Tomonori Endo; Takeo Furuya; Masao Koda; Kazuhisa Takahashi

2010-01-01

263

Myelopathy secondary to ossification of the posterior longitudinal ligament of the thoracic spine treated by anterior decompression and bony fusion  

Microsoft Academic Search

We examined the utility of anterior decompression and bony fusion via the extrapleural approach in the treatment of thoracic myelopathy secondary to ossification of the posterior longitudinal ligament (OPLL). Patient outcome and complications were analyzed in 48 patients treated with this procedure, with a follow-up of at least 2 years. The Japanese Orthopaedic Association score was used to evaluate the

Y Fujimura; Y Nishi; M Nakamura; M Watanabe; M Matsumoto

1997-01-01

264

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. Clinical, neuroradiological and neurophysiological study on 9 cases  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is considered to be uncommon in western countries, although widely known and studied in Japan. We report on 9 cases of OPLL cervical myelopathy, investigated by x-ray films and cervical CT and by somatosensory evoked potentials. The patients reported spastic tetraparesis, sensory disorders of the limbs and, in one

L. Conte; T. Tassinari; M. Trucco; O. Serrato; R. Badino

1992-01-01

265

[Preferences of antibiotic use in children less than five in physicians working health centers of primary level in peri-urban areas of Lima, Peru].  

PubMed

Objectives. To describe physicians' preferences of antibiotic use in children less than 5 years in health centers of primary level in three periurban districts in Lima, Perú. Material and methods. A structured survey was applied to 218 general practitioners from three health networks of Lima. The survey included six typical clinical cases in children under 5 years with questions about antibiotic use: the cases were common cold, pharyngitis, pneumonia, bronchial obstructive syndrome, watery diarrhea and dysentery. Results. 81.6% of the physicians responded that more than a quarter of the patients they attended were children under five years. 15.6% of the general physicians would use an antibiotic for common cold treatment. For dysentery treatment 90.4% would use antibiotics, the frequently used were Trimethoprim-Sulfamethoxazole (TMP-SMX) and Furazolidone. 86.2% of physicians would recommend an antibiotic for pharyngitis. In a watery diarrhea case 32.7% of the doctors would use. In the case of bronchospasm, 73% of the doctors would recommend an antibiotic. 96.3% would recommend antibiotics for pneumonia. The perception of the degree of mother's satisfaction increased the risk of inappropriate prescription of antibiotics OR: 1.6, p=0.031, 95% CI: 1.1-2.6). Conclusions. There is tendency to overuse antibiotics for diagnoses such as pharyngitis and bronchospasm, as well as in cases of watery diarrhea and common cold, the reason could be that a large number of children under five years are treated by general practitioners without training in pediatric care. PMID:23949500

Ecker, Lucie; Ochoa, Theresa J; Vargas, Martha; Del Valle, Luis J; Ruiz, Joaquim

2013-06-01

266

Fibrodysplasia ossificans progressiva in a Maine Coon cat with prominent ossification in dorsal muscle.  

PubMed

A one-year and six-month-old female Maine Coon cat presented with skin problems and paravertebral induration with a history of seven months. Survey radiographs and computed tomography revealed prominent calcifications in both sides of cervical, thoracic and lumbar vertebrae and soft tissue in femoral regions, below knee regions and in brachial regions. Histopathological findings from muscle biopsy samples showed connective tissue proliferation around adjacent skeletal muscle, cartilage formation and endochondral ossification. On the basis of these findings, this feline patient was diagnosed with fibrodysplasia ossificans progressiva (FOP). The most prominent signs observed in this FOP case were significant calcifications of dorsal muscle and presentation of cutaneous signs at the early stage. PMID:20046034

Yabuzoe, Atsushi; Yokoi, Shin-ichi; Sekiguchi, Maiko; Momoi, Yasuyuki; Ide, Kaori; Nishifuji, Koji; Iwasaki, Toshiroh

2009-12-01

267

Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis  

SciTech Connect

Heterotopic ossification (HO) is a benign condition of abnormal formation of bone in soft tissue. HO is frequently asymptomatic, though when it is more severe it typically manifests as decreased range of motion at a nearby joint. HO has been recognized to occur in three distinct contexts-trauma, neurologic injury, and genetic abnormalities. The etiology of HO is incompletely understood. A posited theory is that HO results from the presence of osteoprogenitor cells pathologically induced by an imbalance in local or systemic factors. Individuals at high risk for HO development frequently undergo prophylaxis to prevent HO formation. The two most commonly employed modalities for prophylaxis are nonsteroidal anti-inflammatory drugs and radiation therapy. This review discusses HO pathophysiology, clinical features, and the role of radiotherapy for prophylaxis.

Balboni, Tracy A. [Harvard Radiation Oncology Program, Brigham and Women's Hospital, Boston, MA (United States); Gobezie, Reuben [Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA (United States); Mamon, Harvey J. [Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA (United States)]. E-mail: hmamon@partners.org

2006-08-01

268

Ontogenetic and structural variation of mineralizations and ossifications in the integument within ceratophryid frogs (anura, Ceratophryidae).  

PubMed

Ceratophryidae represent a monophyletic group of terrestrial and aquatic frogs inhabiting lowlands of South America where they are more diverse in semiarid environments of the Chaco region. Adult morphology of ceratophryids presents some features associated to terrestrial and fossorial life such as hyper-ossified skulls, spade feet for digging, among others. For anurans, different mineralized structures have been described in the integument as calcium reservoirs and related to the terrestrial life and water balance (e.g., the calcified layer and dermal ossifications). We describe the ontogeny of the integument in the three genera of ceratophryids (Chacophrys, Ceratophrys, and Lepidobatrachus) that inhabit in semiarid environments. Data obtained demonstrated the early acquisition of metamorphic transformations in the integument layers in larvae of Ceratophrys cranwelli and Lepidobatrachus spp. and a continuous increment in the thickness of them up to old postmetamorphic stages. The integument of ceratophryids develops calcium deposits as the calcified layer during postmetamorphic stages. Furthermore, dorsal shields are also present in adult stages independently of terrestrial versus aquatic lifestyles. While the calcified layer seems to be a feature of a fully developed integument, in which their layers have acquired the adult thickness, dorsal shields develop at premetamorphic stages in L. llanensis and postmetamorphic individuals of C. cranwelli. In ceratophryids, similar to other studied taxa (e.g., Brachycephalus spp.) dorsal shields develop via an intramembranous ossification in which the calcified layer does not precede its differentiation. Within anurans, the occurrence of dorsal shields in the monophyletic ceratophryids suggested a distinctive evolutionary history in the lineage. PMID:23074148

Quinzio, Silvia; Fabrezi, Marissa

2012-10-16

269

TARGETING RUNX2 EXPRESSION IN HYPERTROPHIC CHONDROCYTES IMPAIRS ENDOCHONDRAL OSSIFICATION DURING EARLY SKELETAL DEVELOPMENT  

PubMed Central

Runx2 is a known master transcription factor for osteoblast differentiation, as well as an essential regulator for chondrocyte maturation. Recently, more and more data has shown that Runx2 regulates hypertrophic chondrocyte-specific type X collagen gene (Col10a1) expression in different species. However, how Runx2 regulation of Col10a1 expression impacts chondrocyte maturation, an essential step of endochondral bone formation, remains unknown. We have recently generated transgenic mice in which flag-tagged Runx2 was driven by a cell-specific Col10a1 control element. Significantly increased level of Runx2 and Col10a1 mRNA transcripts were detected in transgenic mouse limbs at both E17.5 (embryonic day 17.5) and P1 (postnatal day1) stages, suggesting an in vivo correlation of Runx2 and Col10a1 expression. Surprisingly, skeletal staining suggested delayed ossification in both the axial and the appendicular skeleton of transgenic mice from E14.5 until P6. Histological analysis showed elongated hypertrophic zones in transgenic mice, with less von Kossa and TUNEL staining in long bone sections at both E17.5 and P1 stages, suggesting defective mineralization due to delayed chondrocyte maturation or apoptosis. Indeed, we detected increased level of anti-apoptotic genes Bcl-2, Opn, and Sox9 in transgenic mice by real-time RT-PCR. Moreover, immunohistochemistry and Western blotting analysis also suggested increased Sox9 expression in hypertrophic chondrocytes of transgenic mice. Together, our data suggest that targeting Runx2 in hypertrophic chondrocytes upregulates expression of Col10a1 and other marker genes (such as Sox9 etc.). This will change the local matrix environment, delay chondrocyte maturation, reduce apoptosis and matrix mineralization, and eventually, lead to impaired endochondral ossification.

Ding, Ming; Lu, Yaojuan; Abbassi, Sam; Li, Feifei; Li, Xin; Song, Yu; Geoffroy, Valerie; Im, Hee-Jeong; Zheng, Qiping

2012-01-01

270

Biomechanical study of the spinal cord in thoracic ossification of the posterior longitudinal ligament  

PubMed Central

Background Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine produces myelopathy. This is often progressive and is not affected by conservative treatment. Therefore, decompressive surgery is usually chosen. Objective To conduct a stress analysis of the thoracic OPLL. Methods The three-dimensional finite element spinal cord model was established. We used local ossification angle (LOA) for the degree of compression of spinal cord. LOA was the medial angle at the intersection between a line from the superior posterior margin at the cranial vertebral body of maximum OPLL to the top of OPLL with beak type, and a line from the lower posterior margin at the caudal vertebral body of the maximum OPLL to the top of OPLL with beak type. LOA 20°, LOA 25°, and LOA 30° compression was applied to the spinal cord in a preoperative model, the posterior decompressive model, and a model for the development of kyphosis. Results In a preoperative model, at more than LOA 20° compression, high stress distributions in the spinal cord were observed. In a posterior decompressive model, the stresses were lower than in the preoperative model. In the model for development of kyphosis, high-stress distributions were observed in the spinal cord at more than LOA 20° compression. Conclusions Posterior decompression was an effective operative method. However, when the preoperative LOA is more than 20°, it is very likely that symptoms will worsen. If operation is performed at greater than LOA 20°, then correction of kyphosis by fixation of instruments or by forward decompression should be considered.

Nishida, Norihiro; Kato, Yoshihiko; Imajo, Yasuaki; Kawano, Syunichi; Taguchi, Toshihiko

2011-01-01

271

The effects of a training program on knowledge, attitude and practice of the staff of primary health care centers towards growth monitoring: an intervention study.  

PubMed

This study was carried out aiming at assessing the effects of a training program on the knowledge, attitude and practices (KAP) of health care workers (HCWs) in primary health care centers (PHCCs) regarding growth monitoring (GM). It included 148 health care workers (30 General Practitioners (GPs) and 118 nurses), from 17 PHCCs in Jeddah city, Kingdom of Saudi Arabia (KSA). Tests on KAP were held before and six months following a training program on GM conducted by the investigators. Results showed significant improvements in the KAP of the trained health care workers after training, the 44 trained HCWs obtained higher mean comprehension score (7.9 +/- 1.2), higher mean practice score (11.6 +/- 3.0), and higher mean general scores (32.3 +/- 4.6) compared to the mean scores they obtained in the pre-test (5.7 +/- 1.5; 7.4 +/- 2.2 and 25.7 +/- 4.4, respectively). These differences were statistically significant (P < 0.001). However; the difference in the mean knowledge scores, before and after the GM training program was not significant. The training has also led to the disappearance of the significant knowledge gap between GPs and nurses. And also, the 44 trained HCWs had higher mean comprehension score (7.9 +/- 1.2), mean practice score (11.6 +/- 3.0), and mean general scores (32.3 +/- 4.6) compared to those among untrained group (controls) (6.3 +/- 2.1; 8.5 +/- 3.7, and 27 +/- 6.1, respectively). These differences were statistically significant (P < 0.0005). Nevertheless, the difference in the mean knowledge scores, between the two groups, was not statistically significant. It also has led to some changes in the attitude of the trained HCWs towards GM compared to the untrained group. In conclusion, We credit the significant improvements in KAP of HCWs to the training program and recommend its adoption by the national MCH program in KSA. We also recommend new methods of teaching and training based on sound educational concept of active participation and practical work as well as supportive supervision and evaluation. PMID:17219866

Salem, K A; Balahmar, M K; Milaat, W; Gabal, M S

1999-01-01

272

Effects of zwitterionic detergents on the electronic structure of the primary donor and the charge recombination kinetics of P + Q A ? in native and mutant reaction centers from Rhodobacter sphaeroides  

Microsoft Academic Search

The effects of detergents on the electronic structure of the oxidized primary donor P+ and the time constant tAP of the P+QA- charge recombination at ambient temperatures have been investigated in native and mutant reaction centers (RCs) from Rhodobacter sphaeroides. It is shown that N-lauryl-N,N-dimethyl-3-ammonio-1-propane sulfonate (SB12) induces a transition to a second distinct conformation of the RC. In the

Frank Müh; Claudia Schulz; Eberhard Schlodder; Michael R. Jones; Joachim Rautter; Matthias Kuhn; Wolfgang Lubitz

1998-01-01

273

Heterotopic Ossification in Combat Amputees from Afghanistan and Iraq wars: Five Case Histories and Results from a Small Series of Patients.  

National Technical Information Service (NTIS)

Heterotopic ossification (HO) is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can inter...

B. Belnap G. J. Walker M. Galarneau P. Konoske T. Melcer

2011-01-01

274

Cabine primarie AT/MT dell'ENEL per l'alimentazione dei centri urbani. (ENEL high and medium voltage electrical substations for power supply to urban centers).  

National Technical Information Service (NTIS)

Modular high and medium voltage gas insulated electrical substations are being used by ENEL (Italian Electricity Board) to meet the specific needs of urban centers with special design and sizing constraints of a historical/architectural nature. This paper...

A. Bargigia C. Boatto A. Di Mario N. Fava S. Sciarra

1991-01-01

275

[Updates on ossification of posterior longitudinal ligament. Clinical results and problems of posterior decompression for OPLL of the cervical spine].  

PubMed

Clinical results of expansive laminoplasty (ELAP) for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine are satisfactory and are preserved for long period. ELAP is also thought to be easier and safer procedure than anterior fusion for OPLL of the cervical spine. However, appropriate decompression can not be achieved by ELAP without sufficient dorsal shift of the spinal cord, because pathological lesion exists ventral to the spinal cord in patients with OPLL. Kyphotic alignment, high OPLL occupying ratio, hill-shaped ossification are considered to be risk factors contributing to inappropriate decompression. To acquire satisfactory operative results, careful consideration for the indication of ELAP should be necessary for each patient. PMID:19794259

Ogawa, Yuto

2009-10-01

276

Protein influence on charge-asymmetry of the primary donor in photosynthetic bacterial reaction centers containing a heterodimer: effects on photophysical properties and electron transfer.  

PubMed

The substantial electronic distinctions between bacteriochlorophyll (BChl) and its Mg-free analogue bacteriopheophytin (BPh) are exploited in two sets of Rhodobacter capsulatus reaction center (RC) mutants that contain a heterodimeric BChl-BPh primary electron donor (D). The BPh component of the M-heterodimer (Mhd) or L-heterodimer (Lhd) obtains from substituting a Leu for His M200 or for His L173, respectively. Lhd-? and Mhd-? RCs serve as the initial templates in the two mutant sets, where ? denotes that the L-side BPh acceptor (HL) has been replaced by a BChl (due to substituting His for Leu M212). Three variants each of Lhd-? and Mhd-? mutants were constructed: (1) a swap (denoted YF) of the native Phe (L181) and Tyr (M208) residues, which flank D and the nearby M- and L-side monomeric BChl cofactors, respectively, giving Tyr (L181) and Phe (M208); (2) addition of a hydrogen bond (denoted L131LH) to the ring V keto group of the L-macrocycle of D, via replacing the native Leu at L131 with His; (3) the combination of 1 and 2. A low yield of electron transfer (ET) to the M-side BPh (HM) is observed in all four Lhd-containing RCs. Comparison with the yield of ET to ? on the L-side shows that electron density on the L-macrocycle of D* favors ET to the M-side cofactors and vice versa. Increasing or decreasing the electronic asymmetry of D* via the YF, L131LH mutations or the combination results in consistent trends in the characteristics of the long-wavelength ground state absorption band of D, the rate constant of internal conversion of D* to the ground state, and the rate constants for ET to both the L- and M-side cofactors. A surprising correlation is that an increase in the charge asymmetry in D* not only increases the D* internal-conversion rate constant, but also the rate constants for ET to both the L- and M-side cofactors, spanning time scales of tens of picoseconds to several nanoseconds. The YF swap has a previously unrecognized effect on the electronic asymmetry of D*, resulting in increased charge asymmetry for the Mhd and decreased charge asymmetry for the Lhd. This result indicates that the native Tyr (M208) and Phe (L181) in the wild-type RC promote an electron distribution in P* that is the reverse of that favorable for ET to the photoactive L-branch. This conclusion reinforces the view that the native configuration of these residues promotes ET to the L branch primarily by poising the free energies of the charge-separated states. Overall, this work addresses the extent to which electronic couplings complement energetics in underpinning the directionality of ET in the bacterial RC. PMID:23560569

Harris, Michelle A; Luehr, Craig A; Faries, Kaitlyn M; Wander, Marc; Kressel, Lucas; Holten, Dewey; Hanson, Deborah K; Laible, Philip D; Kirmaier, Christine

2013-04-05

277

Gender-specific haplotype association of collagen ?2 (XI) gene in ossification of the posterior longitudinal ligament of the spine  

Microsoft Academic Search

Among Japanese, ossification of the posterior longitudinal ligament of the spine (OPLL) is a leading cause of myelopathy,\\u000a showing ectopic bone formation in the paravertebral ligament. We have provided genetic evidence that the collagen ?2 (XI)\\u000a (COL11A2) locus of chromosome 6 constitutes susceptibility for OPLL. Five distinct single nucleotide polymorphisms (SNPs), identified\\u000a in COL11A2, were combined to construct possible haplotypes

Shingo Maeda; Hiroaki Koga; Shunji Matsunaga; Takuya Numasawa; Katsunori Ikari; Kozo Furushima; Seiko Harata; Jun Takeda; Takashi Sakou; Setsuro Komiya; Ituro Inoue

2001-01-01

278

Ossification of the proximal thoracic ligamenta flava causing acute myelopathy in a Caucasian: case report and literature review  

Microsoft Academic Search

Study design:Case report and literature review.Objective:To illustrate that ossification of the proximal thoracic ligamenta flava can be a rare cause of acute myelopathy in a Caucasian patient and that timely surgery can lead to a good outcome.Setting:Nottingham, UK.Methods:Proximal multiple contiguous ossified thoracic ligamenta flava from T3\\/T4 to T5\\/T6 causing acute myelopathy was diagnosed in a Caucasian man based on history

D P Tokala; K S Lam; H G Prince

2007-01-01

279

Bilateral diffuse pulmonary ectopic ossification after marrow allograft in a dog. Evidence for allotransplantation of hemopoietic and mesenchymal stem cells  

SciTech Connect

In light of recent studies showing successful transplantation of both bony and stromal elements by marrow transplantation, we report an unexpected phenomenon occurring in a canine radiation chimera. Nine hundred fifty-six days after a successful and uneventful DLA-matched marrow allograft, a dog suddenly died of respiratory failure. Autopsy revealed extensive ossification of the lungs with multiple sites of trilineage marrow engraftment. The entire complement of bony elements can apparently be allografted using marrow grafting techniques.

Sale, G.E.; Storb, R.

1983-11-01

280

Involvement of Insulin-Like Growth Factor I in Development of Ossification of the Posterior Longitudinal Ligament of the Spine  

Microsoft Academic Search

.   In order to investigate the pathogenesis of ossification of the posterior longitudinal ligament (OPLL) of the spine, we examined\\u000a the distribution of insulin-like growth factor I (IGF-I) in the posterior longitudinal ligaments of OPLL patients, and analyzed\\u000a the effects of IGF-I on the cultured spinal ligament cells. For that purpose we established eight varieties of OPLL and non-OPLL\\u000a cell

K. Goto; M. Yamazaki; M. Tagawa; S. Goto; T. Kon; H. Moriya; S. Fujimura

1998-01-01

281

A review of prognostic factors for surgical outcome of ossification of the posterior longitudinal ligament of cervical spine  

Microsoft Academic Search

For patients with ossification of the posterior longitudinal ligament (OPLL) who have neurological-symptoms, surgery is necessary\\u000a but not always effective. Various clinical factors influence the surgical outcome. The studies identifying these factors have\\u000a been inconclusive and conflicting. It is essential for surgeons to understand the significance of the factors and choose the\\u000a optimal therapeutic strategy for OPLL. The objective of

Hai Li; Lei-Sheng Jiang; Li-Yang Dai

2008-01-01

282

Ossification of the posterior longitudinal ligament in three geographically and genetically different populations of ankylosing spondylitis and other spondyloarthropathies  

Microsoft Academic Search

STUDY DESIGNCross sectional.RESEARCH QUESTIONS(a) Is any clinical variable of ankylosing spondylitis (AS) associated with the presence of ossification of the posterior longitudinal ligament (OPLL)? and (b) Is OPLL present in patients with AS from different geographical or genetic backgrounds?METHODSThree groups were assembled: (1) a prospective group of 103 consecutive AS patients from two community based rheumatology clinics from Guadalajara, who

Cesar Ramos-Remus; Anthony S Russell; Amparo Gomez-Vargas; Abel Hernandez-Chavez; Walter P Maksymowych; Jorge I Gamez-Nava; Laura Gonzalez-Lopez; Alicia García-Hernández; Esther Meoño-Morales; Ruben Burgos-Vargas; Maria E Suarez-Almazor

1998-01-01

283

A large-scale genetic association study of ossification of the posterior longitudinal ligament of the spine  

Microsoft Academic Search

Research to date has identified several genes that are implicated in the etiology of ossification of the posterior longitudinal ligament of the spine (OPLL); however, their pathogenetic relevance remains obscure. The aim of this study is to identify susceptibility genes for OPLL through a large-scale case–control association study and to re-examine previously reported associations. A total of 109 single nucleotide

Taizo Horikoshi; Koichi Maeda; Yoshiharu Kawaguchi; Kazuhiro Chiba; Kanji Mori; Yu Koshizuka; Shigeru Hirabayashi; Kazuhito Sugimori; Morio Matsumoto; Hiroshi Kawaguchi; Makoto Takahashi; Hisashi Inoue; Tomoatsu Kimura; Yoshitaka Matsusue; Itsuro Inoue; Hisatoshi Baba; Kozo Nakamura; Shiro Ikegawa

2006-01-01

284

Mechanical strain induces Cx43 expression in spinal ligament fibroblasts derived from patients presenting ossification of the posterior longitudinal ligament  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) is characterized by ectopic bone formation in spinal ligaments.\\u000a Some evidence indicates that mechanical strain can lead to the development of OPLL, although the signaling mechanism is not\\u000a fully understood. Connexin43 (Cx43), a gap-junction protein, has been shown to be of particular importance in bone formation.\\u000a We hypothesized that Cx43 may play an

Hai-song Yang; Xu-hua Lu; De-yu Chen; Wen Yuan; Li-li Yang; Yu Chen; Hai-long He

285

Bone Morphogenetic Protein2 Stimulates Differentiation of Cultured Spinal Ligament Cells from Patients with Ossification of the Posterior Longitudinal Ligament  

Microsoft Academic Search

.   Ossification of the posterior longitudinal ligament (OPLL) of the spine is characterized by heterotopic bone formation occurring\\u000a in spinal ligament, causing severe compression myelopathy. In order to investigate the mechanism of OPLL development, we isolated\\u000a spinal ligament cells from OPLL patients as well as non-OPLL patients, and established 10 OPLL cell lines and 7 non-OPLL cell\\u000a lines, respectively. We

T. Kon; M. Yamazaki; M. Tagawa; S. Goto; A. Terakado; H. Moriya; S. Fujimura

1997-01-01

286

Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical\\u000a myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the\\u000a latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a\\u000a retrospective study on

Hai-song YangDe-yu; De-yu Chen; Xu-hua Lu; Wang-jun Yan; Wen Yuan; Yu Chen

2010-01-01

287

Mast cells and hypoxia drive tissue metaplasia and heterotopic ossification in idiopathic arthrofibrosis after total knee arthroplasty  

PubMed Central

Background Idiopathic arthrofibrosis occurs in 3-4% of patients who undergo total knee arthroplasty (TKA). However, little is known about the cellular or molecular changes involved in the onset or progression of this condition. To classify the histomorphologic changes and evaluate potential contributing factors, periarticular tissues from the knees of patients with arthrofibrosis were analyzed for fibroblast and mast cell proliferation, heterotopic ossification, cellular apoptosis, hypoxia and oxidative stress. Results The arthrofibrotic tissue was composed of dense fibroblastic regions, with limited vascularity along the outer edges. Within the fibrotic regions, elevated numbers of chymase/fibroblast growth factor (FGF)-expressing mast cells were observed. In addition, this region contained fibrocartilage and associated heterotopic ossification, which quantitatively correlated with decreased range of motion (stiffness). Fibrotic, fibrocartilage and ossified regions contained few terminal dUTP nick end labeling (TUNEL)-positive or apoptotic cells, despite positive immunostaining for lactate dehydrogenase (LDH)5, a marker of hypoxia, and nitrotyrosine, a marker for protein nitrosylation. LDH5 and nitrotyrosine were found in the same tissue areas, indicating that hypoxic areas within the tissue were associated with increased production of reactive oxygen and nitrogen species. Conclusions Taken together, we suggest that hypoxia-associated oxidative stress initiates mast cell proliferation and FGF secretion, spurring fibroblast proliferation and tissue fibrosis. Fibroblasts within this hypoxic environment undergo metaplastic transformation to fibrocartilage, followed by heterotopic ossification, resulting in increased joint stiffness. Thus, hypoxia and associated oxidative stress are potential therapeutic targets for fibrosis and metaplastic progression of idiopathic arthrofibrosis after TKA.

2010-01-01

288

NCI-Designated Cancer Centers  

Cancer.gov

NCI’s 67 Designated Cancer Centers form a nationwide network for studying and controlling cancer. The Centers are the primary source of new discoveries into cancer’s causes, prevention, diagnosis, and treatment.

289

Intensity-Modulated Radiotherapy for Cervical Node Squamous Cell Carcinoma Metastases From Unknown Head-and-Neck Primary Site: M. D. Anderson Cancer Center Outcomes and Patterns of Failure  

SciTech Connect

Purpose: Conventional therapy for cervical node squamous cell carcinoma metastases from an unknown primary can cause considerable toxicity owing to the volume of tissues to be irradiated. In the present study, hypothesizing that using intensity-modulated radiotherapy (IMRT) would provide effective treatment with minimal toxicity, we reviewed the outcomes and patterns of failure for head-and-neck unknown primary cancer at a single tertiary cancer center. Methods and Materials: We retrospectively reviewed the records of 52 patients who had undergone IMRT for an unknown primary at M.D. Anderson Cancer Center between 1998 and 2005. The patient and treatment characteristics were extracted and the survival rates calculated using the Kaplan-Meier method. Results: Of the 52 patients, 5 presented with Stage N1, 11 with Stage N2a, 23 with Stage N2b, 6 with Stage N2c, 4 with Stage N3, and 3 with Stage Nx disease. A total of 26 patients had undergone neck dissection, 13 before and 13 after IMRT; 14 patients had undergone excisional biopsy and presented for IMRT without evidence of disease. Finally, 14 patients had received systemic chemotherapy. All patients underwent IMRT to targets on both sides of the neck and pharyngeal axis. The median follow-up time for the surviving patients was 3.7 years. The 5-year actuarial rate of primary mucosal tumor control and regional control was 98% and 94%, respectively. Only 3 patients developed distant metastasis with locoregional control. The 5-year actuarial disease-free and overall survival rate was 88% and 89%, respectively. The most severe toxicity was Grade 3 dysphagia/esophageal stricture, experienced by 2 patients. Conclusion: The results of our study have shown that IMRT can produce excellent outcomes for patients who present with cervical node squamous cell carcinoma metastases from an unknown head-and-neck primary tumor. Severe late complications were uncommon.

Frank, Steven J., E-mail: sjfrank@mdanderson.or [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I.; Petsuksiri, Janjira; Ang, K. Kian; Morrison, William H. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic /Head and Neck Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Chao, K.S. Clifford; Schwartz, David L.; Chronowski, Gregory M. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2010-11-15

290

Right-sided myxomas with extramedullary hematopoiesis and ossification in Carney complex.  

PubMed

The authors report the case of multiple right-sided myxomas in a 42-year-old man with Carney complex. He had previously been diagnosed as Cushing's syndrome and undergone resection of pituitary adenoma at the age of 21. After 10 years, bilateral adrenalectomy had been performed with recurrence of Cushing's syndrome. Recently, he complained of palpitation and intracardiac masses were detected. On physical examination, he had nevi on the lips and in the oral cavity. A tiny eyelid nodule was noted and histopathological analysis confirmed the diagnosis of skin myxoma. Thyroid ultrasonography revealed multiple hypoechoic nodules, which were confirmed pathologically as follicular adenomas. Scrotal ultrasonography also revealed small multiple testicular tumors. Echocardiography demonstrated intracardiac masses in right atrium and right ventricle. Right atriotomy revealed a right atrial mass attached to the annulus of the tricuspid valve and another mass arising from the interatrial septum. In right ventricle, a polypoid mass arose from the anterior leaflet of the tricuspid valve. Also, there were multiple tiny to small masses on the interatrial septum. The masses were completely excised and the tricuspid valve was repaired with annuloplasty. Histopathological analysis confirmed myxomas with foci of extramedullary hematopoiesis and ossification. PMID:18230408

Lee, Bora; Sir, Jung-Ju; Park, Sung-Won; Kim, Seong-Beom; Nah, Jong-Chun; Kang, Yun Kyung; Lee, Hye-Kyung; Kim, Yong-In; Cho, Wook Hyun; Choi, Suk-Koo

2008-01-29

291

Potent Inhibition of Heterotopic Ossification by Nuclear Retinoic Acid Receptor ? Agonists  

PubMed Central

Heterotopic ossification (HO) consists of ectopic bone formation within soft tissues following surgery or trauma and can have debilitating consequences, but no definitive cure is available. Here we show that HO was essentially prevented in mice receiving nuclear retinoic acid receptor ? (RAR?) agonists. Side effects were minimal, and there was no significant rebound effect. To uncover mechanisms, mesenchymal stem cells were treated with RAR? agonist and transplanted into nude mice. Whereas control cells formed ectopic bone masses, the RAR? agonist-pretreated cells did not, suggesting that they had lost their skeletogenic potentials. Indeed, the cells became unresponsive to rBMP-2 and exhibited reduction of Smad1/5/8 phosphorylation and overall Smad levels. As importantly, the RAR? agonists blocked HO in transgenic mice expressing constitutive-active ALK2Q207D mutant that is related to ALK2R206H found in Fibrodysplasia Ossificans Progressiva patients. The data indicate that the RAR? agonists are potent inhibitors of HO and could also be as effective against congenital HO.

Shimono, Kengo; Tung, Wei-en; Macolino, Christine; Chi, Amber Hsu-Tsai; Didizian, Johanna J.; Mundy, Christina; Chandraratna, Roshantha A.; Mishina, Yuji; Iwamoto, Motomi Enomoto; Pacifici, Maurizio; Iwamoto, Masahiro

2011-01-01

292

Sciatic nerve compression related to ossification of the sacrospinous ligament secondary to pelvic balance abnomalities.  

PubMed

The authors report an isolated case of right sacrospinous ligament ossification causing sciatic pain because of compression of the proximal sciatic nerve. The initial conservative treatment of injections in the conflict zone and the intervertebral joints was insufficient. Surgical exploration was undertaken via a posterior approach, demonstrating the conflict between the nerve and the ossified ligament. Resection of the ossified ligament eliminated the symptoms at the cost of transitory buttock hypesthesia. The anatomic and pathologic exam identified simple osseous metaplasia. Lumbar-pelvic coxometry analysis showed sagittalization of the acetabular roofs, excessive bilateral femoral torsion, and a step-off attenuation at the anterior cervicocephalic junction (low anterior cervico-cephalic femoral offset). In addition, reduced lumbar lordosis and accentuated sacral slope were noted, factors that could be related to modifications in the static balance of the lumbar-pelvic complex. This imbalance could be correlated to an increase in the forces applied to the pelvic ligament layers. The etiological hypothesis retained was that this osseous metaplasia was a reaction to excessive stresses on the sacrospinous ligament. PMID:19910274

Goddyn, C; Passuti, N; Leconte, R; Redon, H; Gouin, F

2009-12-01

293

Runx2 haploinsufficiency ameliorates the development of ossification of the posterior longitudinal ligament.  

PubMed

Ossification of the Posterior Longitudinal Ligament (OPLL) is a disease that is characterized by the ectopic calcification of the ligament; however, the pathogenesis of OPLL remains to be investigated. We attempted to identify the in vivo role of Runx2, a master regulator of osteoblast differentiation and skeletal mineralization, in the pathogenesis of OPLL. The expression of Runx2 in the ligament was examined using in situ hybridization and immunohistochemistry and by monitoring the activity of a LacZ gene that was inserted into the Runx2 gene locus. To investigate the functional role of Runx2, we studied ENPP1(ttw/ttw) mice, a mouse model of OPLL, that were crossed with heterozygous Runx2 mice to decrease the expression of Runx2, and we performed histological and quantitative radiological analyses using 3D-micro CT. Runx2 was expressed in the ligament of wild-type mice. The induction of Runx2 expression preceded the development of ectopic calcification in the OPLL-like region of the ENPP1(ttw/ttw) mice. Runx2 haploinsufficiency ameliorated the development of ectopic calcification in the ENPP1(ttw/ttw) mice. Collectively, this study demonstrated that Runx2 is expressed in an OPLL-like region, and its elevation is a prerequisite for developing the complete OPLL-like phenotype in a mouse model of OPLL. PMID:22927960

Iwasaki, Makiko; Piao, Jinying; Kimura, Ayako; Sato, Shingo; Inose, Hiroyuki; Ochi, Hiroki; Asou, Yoshinori; Shinomiya, Kenichi; Okawa, Atsushi; Takeda, Shu

2012-08-21

294

Association of interferon gamma polymorphism with ossification of the posterior longitudinal ligament in the korean population.  

PubMed

In this study, we investigated whether genetic polymorphisms of the interferon gamma (IFNG) gene were associated with the susceptibility of ossification of the posterior longitudinal ligament (OPLL) in the Korean population. To observe the association between the IFNG gene and the susceptibility of OPLL, we genotyped 135 OPLL patients and 222 control subjects for a single nucleotide polymorphism (SNP, rs2430561) and a microsatellite (CA(n) repeats, rs3138557) located in the first intron of the IFNG gene, using the direct sequencing and gene scan method. The numbers of microsatellites (CA(13) and CA(15)) were significantly changed in the OPLL patients. A combined analysis of the genotype of rs2430561 and the number of microsatellites revealed that the OPLL was associated with frequencies of CA(13)-AA, CA(15)-AA and CA(15)-AT. Our results suggest that the IFNG gene may be one of the factors determining the OPLL in the Korean population. However, larger collaborative and biological studies are needed to confirm these results. PMID:23061992

Kim, Ki Tack; Kim, Dong Hwan; Chung, Jun-Young; Lee, Soojeong; Joo, Jaesoon; Nah, Seong-Su; Song, Ho-Yeon; Kim, Hak-Jae

2012-10-12

295

Runx2 Haploinsufficiency Ameliorates the Development of Ossification of the Posterior Longitudinal Ligament  

PubMed Central

Ossification of the Posterior Longitudinal Ligament (OPLL) is a disease that is characterized by the ectopic calcification of the ligament; however, the pathogenesis of OPLL remains to be investigated. We attempted to identify the in vivo role of Runx2, a master regulator of osteoblast differentiation and skeletal mineralization, in the pathogenesis of OPLL. The expression of Runx2 in the ligament was examined using in situ hybridization and immunohistochemistry and by monitoring the activity of a LacZ gene that was inserted into the Runx2 gene locus. To investigate the functional role of Runx2, we studied ENPP1ttw/ttw mice, a mouse model of OPLL, that were crossed with heterozygous Runx2 mice to decrease the expression of Runx2, and we performed histological and quantitative radiological analyses using 3D-micro CT. Runx2 was expressed in the ligament of wild-type mice. The induction of Runx2 expression preceded the development of ectopic calcification in the OPLL-like region of the ENPP1ttw/ttw mice. Runx2 haploinsufficiency ameliorated the development of ectopic calcification in the ENPP1ttw/ttw mice. Collectively, this study demonstrated that Runx2 is expressed in an OPLL-like region, and its elevation is a prerequisite for developing the complete OPLL-like phenotype in a mouse model of OPLL.

Iwasaki, Makiko; Piao, Jinying; Kimura, Ayako; Sato, Shingo; Inose, Hiroyuki; Ochi, Hiroki; Asou, Yoshinori; Shinomiya, Kenichi; Okawa, Atsushi; Takeda, Shu

2012-01-01

296

Management of pelvic heterotopic ossification post-myocutaneous flap reconstruction of a sacral pressure ulcer  

PubMed Central

Heterotopic ossification (HO) is a process whereby lamellar bone forms in the soft tissues surrounding a joint. The most common type of HO is traumatic myositis ossificans, which develops following traumatic injuries, burns or arthroplasty. A variety of other forms of HO also exist, such as those associated with central nervous system injury and systemic forms that can manifest at other joints simultaneously. Clinically, patients can present with decreased range of motion, pressure ulcers, nerve compression, swelling, pain or asymptomatically. Symptomatic patients are most commonly treated with surgical debridement of the affected heterotopic deposits. Spinal dysraphism (SD) is a term describing a wide range of congenital malformations of the neural tube, ranging from spina bifida occulta to the more severe form, myelomeningocele. The cause of SD is multifactorial and has been associated with chromosomal disorders, teratogenic exposure and folate deficiency. Many patients with SD experience neuropathy below the affected neurological level, making them particularly susceptible to pressure ulcers. If these ulcers are severe and do not respond to conservative therapy, they often require surgical debridement and flap reconstruction – a clinical scenario that rarely results in HO. The present article describes a case involving a patient with pelvic HO following myocutaneous flap reconstruction of a pressure ulcer. The patient was successfully treated with oral bisphosphonate and aggressive physiotherapy.

McInnes, Colin W; Reynolds, Richard AK; Arneja, Jugpal S

2011-01-01

297

Management of pelvic heterotopic ossification post-myocutaneous flap reconstruction of a sacral pressure ulcer.  

PubMed

Heterotopic ossification (HO) is a process whereby lamellar bone forms in the soft tissues surrounding a joint. The most common type of HO is traumatic myositis ossificans, which develops following traumatic injuries, burns or arthroplasty. A variety of other forms of HO also exist, such as those associated with central nervous system injury and systemic forms that can manifest at other joints simultaneously. Clinically, patients can present with decreased range of motion, pressure ulcers, nerve compression, swelling, pain or asymptomatically. Symptomatic patients are most commonly treated with surgical debridement of the affected heterotopic deposits.Spinal dysraphism (SD) is a term describing a wide range of congenital malformations of the neural tube, ranging from spina bifida occulta to the more severe form, myelomeningocele. The cause of SD is multifactorial and has been associated with chromosomal disorders, teratogenic exposure and folate deficiency. Many patients with SD experience neuropathy below the affected neurological level, making them particularly susceptible to pressure ulcers. If these ulcers are severe and do not respond to conservative therapy, they often require surgical debridement and flap reconstruction - a clinical scenario that rarely results in HO.The present article describes a case involving a patient with pelvic HO following myocutaneous flap reconstruction of a pressure ulcer. The patient was successfully treated with oral bisphosphonate and aggressive physiotherapy. PMID:22654535

McInnes, Colin W; Reynolds, Richard Ak; Arneja, Jugpal S

2011-01-01

298

Clock genes influence gene expression in growth plate and endochondral ossification in mice.  

PubMed

We have previously shown transient promotion by parathyroid hormone of Period-1 (Per1) expression in cultured chondrocytes. Here we show the modulation by clock genes of chondrogenic differentiation through gene transactivation of the master regulator of chondrogenesis Indian hedgehog (IHH) in chondrocytes of the growth plate. Several clock genes were expressed with oscillatory rhythmicity in cultured chondrocytes and rib growth plate in mice, whereas chondrogenesis was markedly inhibited in stable transfectants of Per1 in chondrocytic ATDC5 cells and in rib growth plate chondrocytes from mice deficient of brain and muscle aryl hydrocarbon receptor nuclear translocator-like (BMAL1). Ihh promoter activity was regulated by different clock gene products, with clear circadian rhythmicity in expression profiles of Ihh in the growth plate. In BMAL1-null mice, a predominant decrease was seen in Ihh expression in the growth plate with a smaller body size than in wild-type mice. BMAL1 deficit led to disruption of the rhythmic expression profiles of both Per1 and Ihh in the growth plate. A clear rhythmicity was seen with Ihh expression in ATDC5 cells exposed to dexamethasone. In young mice defective of BMAL1 exclusively in chondrocytes, similar abnormalities were found in bone growth and Ihh expression. These results suggest that endochondral ossification is under the regulation of particular clock gene products expressed in chondrocytes during postnatal skeletogenesis through a mechanism relevant to the rhythmic Ihh expression. PMID:22936800

Takarada, Takeshi; Kodama, Ayumi; Hotta, Shogo; Mieda, Michihiro; Shimba, Shigeki; Hinoi, Eiichi; Yoneda, Yukio

2012-08-30

299

Clock Genes Influence Gene Expression in Growth Plate and Endochondral Ossification in Mice*  

PubMed Central

We have previously shown transient promotion by parathyroid hormone of Period-1 (Per1) expression in cultured chondrocytes. Here we show the modulation by clock genes of chondrogenic differentiation through gene transactivation of the master regulator of chondrogenesis Indian hedgehog (IHH) in chondrocytes of the growth plate. Several clock genes were expressed with oscillatory rhythmicity in cultured chondrocytes and rib growth plate in mice, whereas chondrogenesis was markedly inhibited in stable transfectants of Per1 in chondrocytic ATDC5 cells and in rib growth plate chondrocytes from mice deficient of brain and muscle aryl hydrocarbon receptor nuclear translocator-like (BMAL1). Ihh promoter activity was regulated by different clock gene products, with clear circadian rhythmicity in expression profiles of Ihh in the growth plate. In BMAL1-null mice, a predominant decrease was seen in Ihh expression in the growth plate with a smaller body size than in wild-type mice. BMAL1 deficit led to disruption of the rhythmic expression profiles of both Per1 and Ihh in the growth plate. A clear rhythmicity was seen with Ihh expression in ATDC5 cells exposed to dexamethasone. In young mice defective of BMAL1 exclusively in chondrocytes, similar abnormalities were found in bone growth and Ihh expression. These results suggest that endochondral ossification is under the regulation of particular clock gene products expressed in chondrocytes during postnatal skeletogenesis through a mechanism relevant to the rhythmic Ihh expression.

Takarada, Takeshi; Kodama, Ayumi; Hotta, Shogo; Mieda, Michihiro; Shimba, Shigeki; Hinoi, Eiichi; Yoneda, Yukio

2012-01-01

300

Tuning Cofactor Redox Potentials: The 2-Methoxy Dihedral Angle Generates a Redox Potential Difference of >160 mV between the Primary (QA) and Secondary (QB) Quinones of the Bacterial Photosynthetic Reaction Center.  

PubMed

Only quinones with a 2-methoxy group can act simultaneously as the primary (QA) and secondary (QB) electron acceptors in photosynthetic reaction centers from Rhodobacter sphaeroides. (13)C hyperfine sublevel correlation measurements of the 2-methoxy in the semiquinone states, SQA and SQB, were compared with quantum mechanics calculations of the (13)C couplings as a function of the dihedral angle. X-ray structures support dihedral angle assignments corresponding to a redox potential gap (?Em) between QA and QB of ?180 mV. This is consistent with the failure of a ubiquinone analogue lacking the 2-methoxy to function as QB in mutant reaction centers with a ?Em of ?160-195 mV. PMID:24079813

Taguchi, Alexander T; Mattis, Aidas J; O'Malley, Patrick J; Dikanov, Sergei A; Wraight, Colin A

2013-10-02

301

Imaging features of primary Sarcomas of the great vessels in CT, MRI and PET/CT: a single-center experience  

PubMed Central

Background To investigate the imaging features of primary sarcomas of the great vessels in CT, MRI and 18?F-FDG PET/CT. Methods Thirteen patients with a primary sarcoma of the great vessels were retrospectively evaluated. All available images studies including F-18 FDG PET(/CT) (n?=?4), MDCT (n?=?12) and MRI (n?=?6) were evaluated and indicative image features of this rare tumor entity were identified. Results The median interval between the first imaging study and the final diagnosis was 11 weeks (0–12 weeks). The most frequently observed imaging findings suggestive of malignant disease in patients with sarcomas of the pulmonary arteries were a large filling defect with vascular distension, unilaterality and a lack of improvement despite effective anticoagulation. In patients with aortic sarcomas we most frequently observed a pedunculated appearance and an atypical location of the filling defect. The F-18 FDG PET(/CT) examinations demonstrated an unequivocal hypermetabolism of the lesion in all cases (4/4). MRI proved lesion vascularization in 5/6 cases. Conclusion Intravascular unilateral or atypically located filling defects of the great vessels with vascular distension, a pedunculated shape and lack of improvement despite effective anticoagulation are suspicious for primary sarcoma on MDCT or MRI. MR perfusion techniques can add information on the nature of the lesion but the findings may be subtle and equivocal. F-18 FDG PET/CT may have a potential role in these patients and may be considered as part of the imaging workup.

2013-01-01

302

Thanksgiving in Primary Literature.  

ERIC Educational Resources Information Center

Examines how the holiday of Thanksgiving is treated in primary books and offers comparisons of 28 popular titles in print. Innovative classroom and media center projects are described, including discussions, drawings, bulletin boards, problem-solving activities, and cooking. (LRW)

Branum, Nell Carter

1996-01-01

303

Roles of the Endoplasmic Reticulum Stress Transducer OASIS in Ossification of the Posterior Longitudinal Ligament.  

PubMed

STUDY DESIGN:: Vitro molecular research on the posterior longitudinal ligament fibroblasts. OBJECTIVE:: To investigate different expression of OASIS between spinal ligament fibroblasts from the patients with ossification of the posterior longitudinal ligament (OPLL) and non-OPLL patients and demonstrate knockdown of OASIS protein expression by RNA interference inhibiting expression of type I collagen in OPLL cells. SUMMARY OF BACKGROUND DATA:: OPLL is characterized by ectopic bone formation in spinal ligaments. Some evidence indicates that ligament fibroblasts from OPLL patients have osteogenic characteristics. However, the relevant intracellular signaling pathways remain unclear. METHODS:: Spinal ligament cells were cultured using tissue fragment cell culture and identified via immunocytochemistry and immunofluorescence. The messenger RNA expression of osteoblast-specific genes of osteocalcin (OCN), alkaline phosphatase (ALP), and type I collagen (COL I) were detected in OPLL and non-OPLL cells by semiquantitative reverse transcription-polymerase chain reaction. The protein expression of OASIS was detected via Western blotting. And then, after 72 hours, when RNA interference against OASIS was performed in OPLL cells, expression of the osteoblast-specific genes was compared again between the transfection group and the nontransfection group. RESULTS:: Spinal ligament fibroblasts were observed 7 to 10 days after cell culture. Immunocytochemistry and immunofluorescence exhibited positive results of vimentin staining. The messenger RNA expressions of OCN, ALP and COL I and protein expressions of OASIS from OPLL cells were significantly greater than those from non-OPLL cells. In addition, knockdown of OASIS protein expression inhibited the messenger RNA expressions of COL I remarkably in the transfection group compared with the nontransfection group, at 72 hours after RNA interference targeting OASIS was performed in OPLL cells. CONCLUSIONS:: The cultured fibroblasts from OPLL patients exhibited osteogenic characteristics, and OASIS expression plays an important role in the development of OPLL through the expression of type I collagen. PMID:23563343

Chen, Yu; Yang, Haisong; Miao, Jinhao; Liu, Xiaowei; Wang, Xinwei; Chen, Deyu

2013-04-01

304

Cost of Radiotherapy Versus NSAID Administration for Prevention of Heterotopic Ossification After Total Hip Arthroplasty  

SciTech Connect

Purpose: Heterotopic ossification (HO), or abnormal bone formation, is a common sequela of total hip arthroplasty. This abnormal bone can impair joint function and must be surgically removed to restore mobility. HO can be prevented by postoperative nonsteroidal anti-inflammatory drug (NSAID) use or radiotherapy (RT). NSAIDs are associated with multiple toxicities, including gastrointestinal bleeding. Although RT has been shown to be more efficacious than NSAIDs at preventing HO, its cost-effectiveness has been questioned. Methods and Materials: We performed an analysis of the cost of postoperative RT to the hip compared with NSAID administration, taking into account the costs of surgery for HO formation, treatment-induced morbidity, and productivity loss from missed work. The costs of RT, surgical revision, and treatment of gastrointestinal bleeding were estimated using the 2007 Medicare Fee Schedule and inpatient diagnosis-related group codes. The cost of lost wages was estimated using the 2006 median salary data from the U.S. Census Bureau. Results: The cost of administering RT was estimated at $899 vs. $20 for NSAID use. After accounting for the additional costs associated with revision total hip arthroplasty and gastrointestinal bleeding, the corresponding estimated costs were $1,208 vs. $930. Conclusion: If the costs associated with treatment failure and treatment-induced morbidity are considered, the cost of NSAIDs approaches that of RT. Other NSAID morbidities and quality-of-life differences that are difficult to quantify add to the cost of NSAIDs. These considerations have led us to recommend RT as the preferred modality for use in prophylaxis against HO after total hip arthroplasty, even when the cost is considered.

Strauss, Jonathan B. [Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (United States)], E-mail: Jonathan_Strauss@rush.edu; Chen, Sea S.; Shah, Anand P.; Coon, Alan B. [Department of Radiation Oncology, Rush University Medical Center, Chicago, IL (United States); Dickler, Adam [Department of Radiation Oncology, Little Company of Mary Hospital, Evergreen Park, IL (United States)

2008-08-01

305

A Systematic Review of Therapeutic Interventions for Heterotopic Ossification Following Spinal Cord Injury  

PubMed Central

Study Design Systematic Review Objective To conduct a systematic review of the effectiveness of interventions used to prevent and treat heterotopic ossification (HO) after spinal cord injury (SCI). Setting St. Joseph’s Parkwood Hospital, London, Ontario, Canada Methods MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched for articles addressing the treatment of HO post SCI. Studies were selected by two reviewers and were only included for analysis if at least 50% of the subjects had a SCI, there were at least three SCI subjects, and study subjects participated in a treatment or intervention. Study quality was assessed by two independent reviewers using the Downs and Black evaluation tool for all studies as well as PEDro assessment scale for randomized control trials only. Levels of evidence were assigned using a modified Sackett scale. Results Total of 13 studies met inclusion criteria. Selected articles were divided into prevention or treatment of post-SCI HO. Non-steroidal anti-inflammatory drugs, warfarin and pulse low-intensity electrogmagnetic field therapy were reviewed as prophylactic measures. Bisphosphonates, radiotherapy and excision were reviewed as treatments of post-SCI HO. Conclusions Pharmacological treatments of HO post SCI had the highest level of research evidence supporting their use. Of these, non-steroidal anti-inflammatory drugs demonstrated greatest efficacy in prevention of HO when administered early after a SCI, while bisphosphonates were the intervention with strongest supportive evidence once HO had developed. Of the non-pharmacological interventions, pulse low-intensity electromagnetic field was supported by the highest level of evidence; however, more research is needed to fully understand its role.

Teasell, Robert W.; Mehta, Swati; Aubut, Jo-Anne L.; Ashe, Maureen C.; Sequeira, Keith; Macaluso, Steven; Tu, Linh

2011-01-01

306

TGFBR2 gene polymorphism is associated with ossification of the posterior longitudinal ligament.  

PubMed

This preliminary study assessed the association between ossification of the posterior longitudinal ligament (OPLL) and the transforming growth factor ? receptor type 2 (TGFBR2) gene, with autoimmune disease examined as a possible underlying factor. Twenty-one patients diagnosed with OPLL and 42 control patients without OPLL (non-OPLL) were enrolled in the study. The TGFBR2 gene, composed of one promoter and seven exons, including the 5' untranslated region and flanking introns of each exon, was sequenced. Laboratory tests, including indirect immunofluorescence, were performed to detect autoimmune antibodies. The most common types of OPLL were the continuous (n=8, 38.1%) and segmental (n=8, 38.1%) types, with the fifth cervical veterbra (C5) the most common level of cervical spine involvement (n=15, 71.4%). In addition, significant associations between 455-4T?A (p=0.007) and 571G?A (p=0.024) gene variation and OPLL were found. The 95-35C?T variation in intron 1, a previously unreported variation, was also found in all patients with OPLL. Four patients revealed positive results for autoimmune antibodies and exhibited a nucleolar pattern by indirect immunofluorescence. Of these four patients, two were diagnosed with Sjogren's syndrome. The previously reported association of 455-4T?A and 571G?A polymorphisms of the TGFBR2 gene with OPLL was confirmed in this study. In addition, the 95-35C?T polymorphism in intron 1, which to our knowledge is a novel, previously unreported, nucleotide variation, was detected in all patients. Additional functional studies are required to verify the association between OPLL and the genetic variations found in this study. PMID:23228659

Jekarl, Dong Wook; Paek, Cheol-Min; An, Yeon Ju; Kim, Yun Jin; Kim, Myungshin; Kim, Yonggoo; Lee, Jehoon; Sung, Choon Ho

2012-12-08

307

Novel surgical technique for ossification of posterior longitudinal ligament in the thoracic spine.  

PubMed

Several surgical procedures have been developed to treat thoracic ossification of the posterior longitudinal ligament (OPLL). However, favorable surgical results are not always achieved, and consistent protocols and procedures for surgical treatment of thoracic OPLL have not been established. This technical note describes a novel technique to achieve anterior decompression via a single posterior approach. Three patients with a beak-type thoracic OPLL underwent surgery in which the authors' technique was used. Complete removal of the ossified PLL was achieved in all cases. With the patient in the prone position, the authors performed total resection of the posterior elements at the anterior decompression levels. This maneuver included not only laminectomies but also removal of the transverse processes and pedicles, which allowed space to be created bilaterally at the sides of the dural sac for the subsequent anterior decompression. The thoracic nerves at the levels of anterior decompression were ligated bilaterally and lifted up to manipulate the ossified ligament and the dural sac. An anterior decompression was then performed posteriorly. The PLL was floated without any difficulty. After exfoliation of the adhesions between the ossified ligament and the ventral aspect of the dural sac, the ossified PLL was removed. In every step of the anterior decompression, the space created in the bilateral sides of the dural sac allowed the surgeons to see the OPLL and anterolateral aspect of the dural sac directly and easily. After removal of the ossified PLL, posterior instrumented fusion was performed. This surgical procedure allows the surgeon to perform, safely and effectively, anterior decompression via a posterior approach for thoracic OPLL. PMID:23039177

Kato, Satoshi; Murakami, Hideki; Demura, Satoru; Yoshioka, Katsuhito; Hayashi, Hiroyuki; Tsuchiya, Hiroyuki

2012-10-05

308

Preoperative irradiation for the prevention of heterotopic ossification induces local inflammation in humans.  

PubMed

Radiation of the hip is an established method to prevent heterotopic ossification (HO) following total hip arthroplasty (THA) but the precise mechanism is unclear. As inflammatory processes are suggested to be involved in the pathogenesis of HO, we hypothesized that the preoperative irradiation impacts local immune components. Therefore, we quantified immune cell populations and cytokines in hematomas resulting from the transection of the femur in two groups of patients receiving THA: patients irradiated preoperatively (THA-X-hematoma: THA-X-H group) in the hip region (7 Gy) in order to prevent HO and patients who were not irradiated (THA-H group) but were postoperatively treated with non-steroidal anti-inflammatory drugs (NSAIDs). Radiation resulted in significantly increased frequencies of T cells, cytotoxic T cells, NKT cells and CD25+CD127- Treg cells, whereas the number of naive CD45RA-expressing cytotoxic T cells was reduced. These results indicate differential immune cell activation, corroborated by our findings of significantly higher concentrations of pro-inflammatory cytokines (e.g., IL-6, IFN?) and chemokines (e.g., MCP-1, RANTES) in the THA-X-H group as compared to THA-H group. In contrast, the concentration of the angiogenic VEGF was significantly suppressed in the THA-X-H group. We conclude that preoperative irradiation results in significant changes in immune cell composition and cytokine secretion in THA-hematomas, establishing a specific - rather proinflammatory - milieu. This increase of inflammatory activity together with the observed suppression in VEGF secretion may contribute to the prevention of HO. PMID:23571050

Hoff, Paula; Rakow, Anastasia; Gaber, Timo; Hahne, Martin; Sentürk, Ufuk; Strehl, Cindy; Fangradt, Monique; Schmidt-Bleek, Katharina; Huscher, Dörte; Winkler, Tobias; Matziolis, Dörte; Matziolis, Georg; Badakhshi, Harun; Burmester, Gerd-Rüdiger; Duda, Georg N; Perka, Carsten; Buttgereit, Frank

2013-04-06

309

Vessel Formation Is Induced Prior to the Appearance of Cartilage in BMP-2-Mediated Heterotopic Ossification  

PubMed Central

Heterotopic ossification (HO), or endochondral bone formation at nonskeletal sites, often results from traumatic injury and can lead to devastating consequences. Alternatively, the ability to harness this phenomenon would greatly enhance current orthopedic tools for treating segmental bone defects. Thus, understanding the earliest events in this process potentially would allow us to design more targeted therapies to either block or enhance this process. Using a murine model of HO induced by delivery of adenovirus-transduced cells expressing bone morphogenetic protein 2 (BMP-2), we show here that one of the earliest stages in this process is the establishment of new vessels prior to the appearance of cartilage. As early as 48 hours after induction of HO, we observed the appearance of brown adipocytes expressing vascular endothelial growth factors (VEGFs) simultaneous with endothelial progenitor replication. This was determined by using a murine model that possesses the VEGF receptor 2 (Flk1) promoter containing an endothelial cell enhancer driving the expression of nuclear-localized yellow fluorescent protein (YFP). Expression of this marker has been shown previously to correlate with the establishment of new vasculature, and the nuclear localization of YFP expression allowed us to quantify changes in endothelial cell numbers. We found a significant increase in Flk1-H2B::YFP cells in BMP-2-treated animals compared with controls. The increase in endothelial progenitors occurred 3 days prior to the appearance of early cartilage. The data collectively suggest that vascular remodeling and growth may be essential to modify the microenvironment and enable engraftment of the necessary progenitors to form endochondral bone. © 2010 American Society for Bone and Mineral Research.

Dilling, Christine Fouletier; Wada, Aya M; Lazard, Zawaunyka W; Salisbury, Elizabeth A; Gannon, Francis H; Vadakkan, Tegy J; Gao, Liang; Hirschi, Karen; Dickinson, Mary E; Davis, Alan R; Olmsted-Davis, Elizabeth A

2010-01-01

310

Feeling labeled, judged, lectured, and rejected by family and friends over depression: Cautionary results for primary care clinicians from a multi-centered, qualitative study  

PubMed Central

Background Family and friends may help patients seek out and engage in depression care. However, patients’ social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental. Methods We conducted 15 focus groups in 3 cities. Participants (n?=?116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis. Results Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families’ motivations for delivering the messages and described how hearing these messages affected depression care. Conclusions The richness of our results reflects the complexity of communication within depression sufferers’ social networks around this stigmatized issue. To leverage patients’ social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients’ experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.

2012-01-01

311

The Presence of an Ossific Nucleus Does Not Protect Against Osteonecrosis After Treatment of Developmental Dysplasia of the Hip  

Microsoft Academic Search

Background  Osteonecrosis (ON) is a major complication after treatment of developmental dysplasia of the hip (DDH). Several studies have\\u000a explored the absence of the femoral head ossific nucleus at the time of hip reduction as a risk factor for the development\\u000a of ON, but findings have been inconsistent.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore determined the incidence of ON in children who underwent reduction of

Andreas Roposch; Odeh Odeh; Andrea S. Doria; John H. Wedge

312

Lumbar spinal stenosis in a young individual as a result of ligamantum flavum ossification: A case report  

PubMed Central

INTRODUCTION Symtomatic lumbar ligamantum flavum calcification is quite rare in the young age group. PRESENTATION OF CASE The authors report a case of young adult with diagnosis of lumbar spinal stenosis, presenting with leg pain and neurological deficits. Computerized tomography (CT) scan and magnetic resonance (MR) imaging studies revealed ossification of the ligamantum flavum as the causative factor of the disease and the patient recovered completely after the decompressive operation. DISCUSSION It is emphasized that attention should be given to this rare etiological factor of lumbar spinal stenosis. CONCLUSION Complete relief can be achieved with early and adequate surgery.

Yilmaz, Murat; Kalemci, Orhan; Yilmaz, Hakan; Palaz, Necdet M.

2013-01-01

313

A cluster randomized trial of standard quality improvement versus patient-centered interventions to enhance depression care for African Americans in the primary care setting: study protocol NCT00243425  

PubMed Central

Background Several studies document disparities in access to care and quality of care for depression for African Americans. Research suggests that patient attitudes and clinician communication behaviors may contribute to these disparities. Evidence links patient-centered care to improvements in mental health outcomes; therefore, quality improvement interventions that enhance this dimension of care are promising strategies to improve treatment and outcomes of depression among African Americans. This paper describes the design of the BRIDGE (Blacks Receiving Interventions for Depression and Gaining Empowerment) Study. The goal of the study is to compare the effectiveness of two interventions for African-American patients with depression--a standard quality improvement program and a patient-centered quality improvement program. The main hypothesis is that patients in the patient-centered group will have a greater reduction in their depression symptoms, higher rates of depression remission, and greater improvements in mental health functioning at six, twelve, and eighteen months than patients in the standard group. The study also examines patient ratings of care and receipt of guideline-concordant treatment for depression. Methods/Design A total of 36 primary care clinicians and 132 of their African-American patients with major depressive disorder were recruited into a cluster randomized trial. The study uses intent-to-treat analyses to compare the effectiveness of standard quality improvement interventions (academic detailing about depression guidelines for clinicians and disease-oriented care management for their patients) and patient-centered quality improvement interventions (communication skills training to enhance participatory decision-making for clinicians and care management focused on explanatory models, socio-cultural barriers, and treatment preferences for their patients) for improving outcomes over 12 months of follow-up. Discussion The BRIDGE Study includes clinicians and African-American patients in under-resourced community-based practices who have not been well-represented in clinical trials to improve depression care. The patient-centered and culturally targeted approach to depression care is a relatively new one that has not been tested in most previous studies. The study will provide evidence about whether patient-centered accommodations improve quality of care and outcomes to a greater extent than standard quality improvement strategies for African Americans with depression. Trial Registration ClinicalTrials.gov NCT00243425

2010-01-01

314

Predictors of packed red cell transfusion after isolated primary coronary artery bypass grafting - The experience of a single cardiac center: A prospective observational study  

PubMed Central

Background Preoperative patients' characteristics can predict the need for perioperative blood component transfusion in cardiac surgical operations. The aim of this prospective observational study is to identify perioperative patient characteristics predicting the need for allogeneic packed red blood cell (PRBC) transfusion in isolated primary coronary artery bypass grafting (CABG) operations. Patients and Methods 105 patients undergoing isolated, first-time CABG were reviewed for their preoperative variables and followed for intraoperative and postoperative data. Patients were 97 males and 8 females, with mean age 58.28 ± 10.97 years. Regression logistic analysis was used for identifying the strongest perioperative predictors of PRBC transfusion. Results PRBC transfusion was used in 71 patients (67.6%); 35 patients (33.3%) needed > 2 units and 14 (13.3%) of these needed > 4 units. Univariate analysis identified female gender, age > 65 years, body weight ? 70 Kg, BSA ? 1.75 m2, BMI ? 25, preoperative hemoglobin ? 13 gm/dL, preoperative hematocrit ? 40%, serum creatinine > 100 ?mol/L, Euro SCORE (standard/logistic) > 2, use of CPB, radial artery use, higher number of distal anastomoses, and postoperative chest tube drainage > 1000 mL as significant predictors. The strongest predictors using multivariate analysis were CPB use, hematocrit, body weight, and serum creatinine. Conclusion The predictors of PRBC transfusion after primary isolated CABG are use of CPB, hematocrit ? 40%, weight ? 70 Kg, and serum creatinine > 100 ?mol/L. This leads to better utilization of blood bank resources and cost-efficient targeted use of expensive blood conservation modalities.

Elmistekawy, Elsayed M; Errett, Lee; Fawzy, Hosam F

2009-01-01

315

An application of Indian public health standard for evaluation of primary health centers of an EAG and a Non-EAG state.  

PubMed

National Rural Health Mission (NRHM) has provided the opportunities to develop a standard for Sub centers, PHCs and CHCs in the country, popularly known as Indian Public Health Standards (IPHS). The study was carried out to find out and compare to what extent the IPHS were followed by the PHCs in the selected districts of both the Empowered Action Group (EAG) state of Assam and non EAG state of Karnataka. It was a Cross sectional observational study conducted during September-October 2008 where the quality of care and services provided in the selected PHCs as per the IPHS norms was assessed. All the PHCs in both the studied districts were rendering the assured services of OPD, 24hrs general emergency service and referral services while 24 hour delivery services were being provided by 80% of the PHCs of the selected districts of both the states. Functional labor rooms were available only in 80% and 90% of the studied PHCs in Assam and Karnataka respectively. Basic laboratory facilities, for routine blood, urine and stool examination were available in 80% of the studied PHCs in the non-EAG state of Karnataka while it was only in 20% of the studied PHCs of the EAG state of Assam. The findings of the present study revealed important deficiencies as per IPHS norms in the studied PHCs of both Assam and Karnataka. PMID:20859050

Zaman, Forhad Akhtar; Laskar, Nasrin Banu

316

Vaccine effectiveness evaluation during a varicella outbreak among children of primary schools and day-care centers in a region which adopted UMV.  

PubMed

This study describes an outbreak of varicella, in a small town in the region of Puglia, Southern Italy, in the period between February-March 2011. This outbreak presented the opportunity to assess varicella vaccine effectiveness and its determinants. The outbreak occurred in a small community in Puglia; parents of the children attending the schools of the community were contacted by telephone and information was gathered on current disease and varicella history. Varicella vaccination history was verified through the immunization registry of the Local Health Unit. Before the outbreak, immunization coverage was 86.6% of children attending preschool and 51.9% of children attending elementary school. In day care center where the outbreak was happened, the attack rate in vaccinated individuals was 32.1% and 80% in susceptible unvaccinated individuals. VE is therefore estimated as 59.9% (95% CI = 48.3-69.8). In the elementary school the VE can be calculated as 69.2% (95% CI = 50.5-88.1), since the attack rate in unvaccinated children was of 23.1% and in vaccinated of 7.1. The time between vaccination and the onset of the epidemic appears higher in children with a vaccine failure. The results of this study highlight the need for a reflection on the desirability of adopting a shorter schedule in Italy, with a minimum 1 mo interval between MMRV doses. PMID:23108354

Tafuri, Silvio; Martinelli, Domenico; Prato, Rosa; Germinario, Cinzia

2012-10-29

317

Delayed endochondral ossification in early medial coronoid disease (MCD): A morphological and immunohistochemical evaluation in growing Labrador retrievers.  

PubMed

Medial coronoid disease (MCD) is a common joint disease of dogs. It has a multifactorial aetiology, but the relationship between known causal factors and the disease has yet to be elucidated. As most of the published literature is clinical and it reports changes associated with advanced disease, it is not known whether the changes reflect the cause or consequences of the condition. The aim of this study was to investigate early micromorphological changes occurring in articular cartilage and to describe the postnatal development of the medial coronoid process (MCP) before MCD develops. Three litters of MCD-prone young Labrador retrievers were purpose-bred from a dam and two sires with MCD. Comparisons of the micromorphological appearance of the MCP in MCD-negative and MCD-positive joints demonstrated that MCD was initially associated with a disturbance of endochondral ossification, namely a delay in the calcification of the calcifying zone, without concurrent abnormalities in the superficial layers of the joint cartilage. Cartilage canals containing patent blood vessels were only detected in dogs <12weeks old, but the role of these channels in impaired ossification requires further investigation. Retained hyaline cartilage might ossify as the disease progresses, but weak areas can develop into cracks between the retained cartilage and the subchondral bone, leading to cleft formation and fragmentation of the MCP. PMID:23746870

Lau, S F; Hazewinkel, H A W; Grinwis, G C M; Wolschrijn, C F; Siebelt, M; Vernooij, J C M; Voorhout, G; Tryfonidou, M A

2013-06-06

318

Proton and carbon ion radiotherapy for primary brain tumors delivered with active raster scanning at the Heidelberg Ion Therapy Center (HIT): early treatment results and study concepts  

PubMed Central

Background Particle irradiation was established at the University of Heidelberg 2 years ago. To date, more than 400 patients have been treated including patients with primary brain tumors. In malignant glioma (WHO IV) patients, two clinical trials have been set up-one investigating the benefit of a carbon ion (18 GyE) vs. a proton boost (10 GyE) in addition to photon radiotherapy (50 Gy), the other one investigating reirradiation with escalating total dose schedules starting at 30 GyE. In atypical meningioma patients (WHO °II), a carbon ion boost of 18 GyE is applied to macroscopic tumor residues following previous photon irradiation with 50 Gy. This study was set up in order to investigate toxicity and response after proton and carbon ion therapy for gliomas and meningiomas. Methods 33 patients with gliomas (n = 26) and meningiomas (n = 7) were treated with carbon ion (n = 26) and proton (n = 7) radiotherapy. In 22 patients, particle irradiation was combined with photon therapy. Temozolomide-based chemotherapy was combined with particle therapy in 17 patients with gliomas. Particle therapy as reirradiation was conducted in 7 patients. Target volume definition was based upon CT, MRI and PET imaging. Response was assessed by MRI examinations, and progression was diagnosed according to the Macdonald criteria. Toxicity was classified according to CTCAE v4.0. Results Treatment was completed and tolerated well in all patients. Toxicity was moderate and included fatigue (24.2%), intermittent cranial nerve symptoms (6%) and single episodes of seizures (6%). At first and second follow-up examinations, mean maximum tumor diameters had slightly decreased from 29.7 mm to 27.1 mm and 24.9 mm respectively. Nine glioma patients suffered from tumor relapse, among these 5 with infield relapses, causing death in 8 patients. There was no progression in any meningioma patient. Conclusions Particle radiotherapy is safe and feasible in patients with primary brain tumors. It is associated with little toxicity. A positive response of both gliomas and meningiomas, which is suggested in these preliminary data, must be evaluated in further clinical trials.

2012-01-01

319

Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia  

PubMed Central

Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection. Conclusions Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.

2011-01-01

320

Factors Associated with Intramedullary MRI Abnormalities in Patients with Ossification of the Posterior Longitudinal Ligament.  

PubMed

STUDY DESIGN:: A retrospective clinical study of 113 patients with ossification of the posterior longitudinal ligament (OPLL) who underwent either anterior or posterior surgery between 2006 and 2009. OBJECTIVE:: To evaluate the risk factors affecting the intramedullary spinal cord changes in signal intensity on MRI for the patients with OPLL. SUMMARY OF BACKGROUND DATA:: The relationship between the intramedullary spinal cord changes in signal intensity on MRI and neurological deficits, as well as the surgical outcomes, has been described. To obtain better prognosis, early surgery should be conducted in patients with OPLL who have potential abilities to develop intramedullary spinal cord changes in signal intensity on MRI. Various factors may be affecting the development of intramedullary spinal cord changes in signal intensity on MRI. METHODS:: The clinical and radiographic data of 113 patients with OPLL who underwent either anterior or posterior surgery between 2006 and 2009 were reviewed. Age, gender, complication, mean occupying ratio of OPLL(the greatest thickness of OPLL divided by the anteroposterior diameter of the bony spinal canal), duration of symptoms, type of OPLL, preoperative Japanese Orthopaedic Association (JOA) score, and range of motion of the cervical spine were collected. Logistic regression analysis was used. RESULTS:: Changes in the intramedullary signal intensity on MRI were observed in 33 of the 113 patients. Statistical results show that duration of symptoms, occupying ratio of OPLL, preoperative JOA score, kyphosis, and instability of the cervical spine are the relevant risk factors for intramedullary spinal cord changes in signal intensity on MRI, with regression coefficients of 2.437, 0.953, -1.952, 2.093, and 1.516, respectively. For patients with OPLL, the longer the duration of the symptoms, or the higher occupying ratio of OPLL, or the lower preoperative JOA score, the greater the likelihood of intramedullary spinal cord changes in signal intensity on MRI. CONCLUSION:: Since intramedullary spinal cord changes in signal intensity on MRI indicated severe damage to spinal cord and poor prognosis as we described before, early surgery is suggested for patients with OPLL who manifest one of the following factors: prolonged symptoms, high occupying ratio, low preoperative JOA score, kyphosis, or instability of the cervical spine. These factors are closely related to the intramedullary spinal cord changes in signal intensity on MRI. PMID:23511645

Qizhi, Sun; Lili, Yang; Ce, Wang; Yu, Chen; Wen, Yuan

2013-03-18

321

The therapy of primary adult systemic CD30-positive anaplastic large cell lymphoma: results of 40 cases treated in a single center.  

PubMed

The outcome of a series of adult patients, affected by primary systemic CD30-positive anaplastic large cell lymphoma (ALCL), treated with a sequential intensive therapeutic program, has been analyzed and all data available in the literature have been reviewed. Forty consecutive, unselected patients with ALCL were treated with the F-MACHOP regimen, followed by radiotherapy (RT) for residual mediastinal disease (15 cases) and by autologous stem cell transplantation (ASCT) conditioned with BAVC (29 cases). Eighty-nine percent (32/36) of the patients younger than 60 years were eligible for completing the sequential treatment. Since then, 3 patients in CR refused ASCT, 1 was excluded for cardiac toxicity and 3 progressed and died of disease. Thus, 29 have been so far submitted to the transplant procedure. CR and PR rates were 40% and 45% respectively after CHT; 52.5% and 35% after RT; 80% and 5% after ASCT, with 78% of patients transplanted in PR convertin to a CR. Actuarial overall survival is 85% at 48.5 months (93% at 66 months for the 29 transplanted patients) and disease free survival is 100% at 54 and 64 months respectively, with no relapses observed among patients who reached a CR. Considering our data and those of the literature, it can be concluded that although the role of ASCT in the therapy of ALCL must not be considered as definitive, its efficacy in converting PR into CR and in preventing relapses, suggests that a randomized trial comparing CHT alone vs CHT+ASCT should be undertaken. PMID:10512173

Fanin, R; Sperotto, A; Silvestri, F; Cerno, M; Geromin, A; Stocchi, R; Infanti, L; Patriarca, F; Zaja, F; Damiani, D; Baccarani, M

1999-09-01

322

East-West Center  

NSDL National Science Digital Library

Started in 1960 by the U.S. Congress, the East-West Center's primary purpose is "to strengthen relations and understanding among the peoples and nations of Asia, the Pacific, and the United States." To accomplish this purpose, the Center serves as a functional hub for education, cooperative research, and scholarly dialogue. On their homepage, visitors can look over the latest news from scholars at the Center, look over a list of upcoming events sponsored by the Center, and also learn about some of their most recent publications. Academics visiting the site may wish to click on over to the "Research" area. Here they will find information on their primary areas of interest, which include population and health, environmental change, and politics and governance. Finally, visitors should look at their "Publications" area, as it includes free downloads, abstracts, and access to ordering information.

323

Assessing Age-Related Ossification of the Petro-Occipital Fissure: Laying the Foundation for Understanding the Clinicopathologies of the Cranial Base  

PubMed Central

The petro-occitpital fissure (POF) lies within a critical interface of cranial growth and development in the posterior cranial fossa. The relationships between skeletal and soft tissues make this region especially important for examining biomechanical and basic biologic forces that may mold the cranial base and contribute to significant clinicopathologies associated with the structures located near the POF. Therefore, this study investigates the POF in adults in both preserved human cadavers and dried crania in order to determine if developmental changes can be observed and, if so, their value in age assessment as a model system for describing normal morphogenesis of the POF. This study demonstrates that tissue within the POF undergoes characteristic changes in ossification with age, the onset of which is considerably later than that of other synchondroses of the cranial base. Statistically, there is a moderate to strong correlation between age and stage of ossification within the POF. Further, male crania were observed to reach greater degrees of ossification at a younger age than female crania and that individual asymmetry in ossification of the tissue within the POF was not uncommon. An understanding of the basic temporal biological processes of the POF may yield insight into the development of clinicopathologies in this region of the cranial base.

BALBONI, ARMAND L.; ESTENSON, THOMAS L.; REIDENBERG, JOY S.; BERGEMANN, ANDREW D.; LAITMAN, JEFFREY T.

2005-01-01

324

Laboratory Investigations Bone Formation Zones in Heterotopic Ossifications: Histologic Findings and Increased Expression of Bone Morphogenetic Protein 2 and Transforming Growth Factors ß2 and ß3  

Microsoft Academic Search

Heterotopic ossifications (HOs) formed after total endoprosthetic replacement of the hip joint were collected during revision surgery (n = 7). Tissues col- lected during regular hip arthroplasty (n = 12) were used as reference. Histomorphometric analysis was per- formed for assessment of bone formation activity in HOs and reference bone. HOs were dissected with histological guidance into three zones: formed

A. Toom; A. Arend; D. Gunnarsson; R. Ulfsparre; S. Suutre; T. Haviko; G. Selstam

325

Uniaxial cyclic stretch induces osteogenic differentiation and synthesis of bone morphogenetic proteins of spinal ligament cells derived from patients with ossification of the posterior longitudinal ligaments  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the spinal ligaments. Mechanical stress, which acts on the posterior ligaments, is thought to be an important factor in the progression of OPLL. To elucidate this mechanism, we investigated the effects of in vitro sinusoidal cyclic stretch (120% peak to peak, at 1

M Tanno; K.-I Furukawa; K Ueyama; S Harata; S Motomura

2003-01-01

326

Uniaxial Cyclic Stretch Induces Cbfa1 Expression in Spinal Ligament Cells Derived from Patients with Ossification of the Posterior Longitudinal Ligament  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the spinal ligaments. Mechanical stress, which acts on the posterior ligaments, is thought to be an important factor in the progression of OPLL. To clarify this mechanism, we investigated the effects of in vitro cyclic stretch (120% peak to peak, at 0.5 Hz)

K. Iwasaki; K.-I. Furukawa; M. Tanno; T. Kusumi; K. Ueyama; M. Tanaka; H. Kudo; S. Toh; S. Harata; S. Motomura

2004-01-01

327

Dietary habits and risk of ossification of the posterior longitudinal ligaments of the spine (OPLL); findings from a case-control study in Japan  

Microsoft Academic Search

The relation between dietary habits and the risk of ossification of the posterior longitudinal ligaments of the spine (OPLL) was investigated in a case-control study conducted in Japan from 1998 to 2001. Prevalent OPLL cases ( n = 69) were identified and individually matched by age and sex with community controls ( n = 138) randomly selected from the general

Kazushi Okamoto; Gen Kobashi; Masakazu Washio; Satoshi Sasaki; Tetsuji Yokoyama; Yoshihiro Miyake; Naomasa Sakamoto; Kaori Ohta; Yutaka Inaba; Heizo Tanaka

2004-01-01

328

Influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine  

Microsoft Academic Search

The influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine was evaluated retrospectively. Out of 118 patients treated in our clinic for cervical OPLL between 1976 and 1992, 27 had sustained minor trauma to the cervical spine. Of these 27 patients, 13 developed myelopathy,

S Katoh; T Ikata; N Hirai; Y Okada; K Nakauchi

1995-01-01

329

Does ossification of the posterior longitudinal ligament progress after laminoplasty? Radiographic and clinical evidence of ossification of the posterior longitudinal ligament lesion growth and the risk factors for late neurologic deterioration.  

PubMed

Ossification of the posterior longitudinal ligament (OPLL) is a disease process characterized by progressive growth and calcification resulting in spinal canal compromise and serious neurological sequelae in advanced cases. Historically, OPLL has most commonly been treated with posterior surgical decompression. Although this procedure indirectly decompresses the spinal cord, it does not address the offending pathological entity, and further growth of the lesion may result in delayed neurological deterioration. This fact is particularly relevant because a number of long-term studies have revealed both longitudinal and transverse disease progression in individuals treated both surgically and conservatively. Despite these high rates of radiographically documented progression, however, the rate of neurological decline in patients undergoing posterior surgery with laminoplasty is low. In this article, the authors review the pathophysiology of OPLL, evidence of disease progression, and outcome data addressing conservative and surgical treatments. PMID:23062177

Fargen, Kyle M; Cox, J Bridger; Hoh, Daniel J

2012-10-12

330

Primary lymphomas of bone.  

PubMed

Primary lymphomas of bone are uncommon malignancies. The vast majority of them are non-Hodgkin lymphoma (NHL), whereas primary Hodgkin lymphoma (HL) of bone is extremely rare. Patients with primary NHL of bone commonly present with local bone pain, soft tissue swelling, and a mass or a pathological fracture. There is a slight male preponderance, and most patients are over 45-50 years of age. Primary NHL of bone can arise in any part of the skeleton, but long bones (femurs, tibia) are the most common sites of presentation. Comprehensive immunohistochemical studies are required to establish an accurate histological diagnosis of primary NHL of bone. Most cases of primary NHL of bone are classified as diffuse large B-cell lymphomas (DLBCL) in the World Health Organisation (WHO) classification of hematological malignancies. On full staging evaluation, most patients have disease of stage IE or IIE according to the Ann Arbor system. Several studies indicate that patients with primary NHL of bone have a favorable outcome, especially when treated by combined modality therapy. A number of studies reported that clinical stage is the most important prognostic variable in predicting overall survival. Interestingly, the rare occurrence of primary lymphoma of bone is in contrast with the frequency of plasma cell tumors in bone. This could be due to the fact that, during normal B-cell differentiation, the bone marrow is the normal site of homing of plasma cells which are terminally-differentiated, immunoglobulin-secreting post-germinal center B-cells. In this respect, there is circumstancial evidence that primary NHL of bone may represent tumors of post-germinal center B-cells. The present review summarizes data on the histogenesis of primary NHL of bone in view of the recent histogenetic classification of DLBCL on the basis of the B-cell differentiation gene expression profiles (germinal center vs. post-germinal center B-cell differentiation). PMID:16475714

Kitsoulis, Panagiotis; Vlychou, Marianna; Papoudou-Bai, Alexandra; Karatzias, Georgios; Charchanti, Antonia; Agnantis, Niki John; Bai, Maria

331

Internet Stroke Center  

NSDL National Science Digital Library

"A web resource for information about stroke care and research," the Internet Stroke Center provides updated stroke information for patients and families, as well as health care professionals. A nonprofit, educational service, the Internet Stroke Center is a product of the Stroke Center at Barnes-Jewish Hospital, Washington University Medical Center, and the Cerebrovascular Diseases Section of the Department of Neurology at Washington University School of Medicine in St. Louis. Dedicated to advancing the understanding of stroke research and clinical care, the Center's Web site also provides links to primary acute stroke facilities in St. Louis and Missouri, and a stroke trails directory that offers a select registry of clinical trials. All information provided on the site is obtained from "published accounts, meeting presentations, Internet searches, and direct correspondence."

1997-01-01

332

A review of prognostic factors for surgical outcome of ossification of the posterior longitudinal ligament of cervical spine  

PubMed Central

For patients with ossification of the posterior longitudinal ligament (OPLL) who have neurological-symptoms, surgery is necessary but not always effective. Various clinical factors influence the surgical outcome. The studies identifying these factors have been inconclusive and conflicting. It is essential for surgeons to understand the significance of the factors and choose the optimal therapeutic strategy for OPLL. The objective of this review is to determine the clinical factors predictive of the surgical outcome of cervical OPLL. The authors conducted a review of literature published in the English language. They examined studies in which the correlation between clinical factors and outcome were statistically evaluated. The results showed that the traverse area of the spinal cord, the spinal cord-evoked potentials (SCEPs), the increase of the range of motion in the cervical spine (ROM), diabetes, history of trauma, the onset of ossification of the ligament flavum (OLF) in the thoracic spine, snake-eye appearance (SEA) and incomplete decompression may be predictive factors. Age at surgery seems to be closely related to the outcome of posterior surgical procedure. Whether the neurological score, OPLL type, pre-operative duration of symptoms, focal intra-medullar high signal intensity in T2-weighted (IMHSI) and progression of OPLL or kyphosis and expansion of the spinal canal predict the surgical outcome remains unclear. The use of uniform neurological score and proper statistic analysis should facilitate comparison of data from different studies. It is important to analyze the effect of each factor on groups with different surgical procedures as well as patients with different compressive pathology. Research on the etiology and pathology of cervical myelopathy due to OPLL should be helpful in precisely understanding these clinical factors and predicting surgical outcome.

Li, Hai; Jiang, Lei-Sheng

2008-01-01

333

Posterior Hybrid Technique for Ossification of the Posterior Longitudinal Ligament Associated With Segmental Instability in the Cervical Spine.  

PubMed

STUDY DESIGN:: Retrospective case series. OBJECTIVE:: To discuss the indications for a posterior hybrid technique for ossification of the posterior longitudinal ligament (OPLL) associated with segmental instability in the cervical spine and evaluate its effectiveness and safety. SUMMARY OF BACKGROUND DATA:: Dynamic factors have been shown to play an important role in the progression of ossification and OPLL myelopathy. Laminoplasty has been widely used to treat cervical OPLL, but progressive kyphosis and progression of ossified lesions are often detected in long-term follow-up. METHODS:: Fifteen patients were treated by a posterior hybrid technique including laminoplasty and lateral mass screw fixation at unstable levels. Preoperatively, the extent and type of OPLL, spinal cord compression, and presence of high-intensity zones (HIZ) were investigated by X-ray, computed tomography, and magnetic resonance imaging. Segmental instability in the cervical spine was investigated by dynamic X-ray. Postoperatively, clinical outcomes were evaluated with the Japanese Orthopaedic Association (JOA) scoring system and visual analogue scale scores for neck pain. Radiological results included cervical alignment and progression of OPLL. RESULTS:: A total of 17 intervertebral levels in 15 patients (11 mixed-type and 4 continuous-type OPLL) had segmental instability, which was consistent with the presence of HIZ levels in 10 (66.7%) patients. Neurological function as evaluated by JOA scores was significantly improved 6 months postoperatively and well maintained 4 years postoperatively. Neck pain was significantly improved 4 years postoperatively. No patients developed progressive kyphosis or progression of ossified lesions during the follow-up. Only 1 patient developed unilateral C5 palsy and completely recovered 2 months later. CONCLUSIONS:: This hybrid posterior technique appears to be effective and safe in the treatment of selected patients with OPLL associated with segmental instability. The potential benefits of this technique include a stable environment for spinal cord recovery and prevention of progressive kyphosis and OPLL. PMID:22576720

Chen, Yu; Wang, Xinwei; Chen, Deyu; Miao, Jinghao; Liao, Xinyuan; Yu, Fengbin

2012-05-10

334

Qualitative evidence from a systematic review of prognostic predictors for surgical outcomes following cervical ossification of the posterior longitudinal ligament.  

PubMed

Ossification of the posterior longitudinal ligament (OPLL) is a pathological ectopic ossification of this ligament that usually occurs in the cervical spine. For patients with cervical OPLL and neurological symptoms, surgical intervention is necessary but not always effective. Various prognostic factors influence the surgical outcome. The results of studies identifying these prognostic predictors are often inconclusive or contradictory. These predictors have not been well identified or summarized. The present study was designed to identify the prognostic predictors for the surgical outcome of cervical OPLL based on the available evidence in the literature. Non-interventional studies were searched in Medline, Embase, Science Direct, OVID and the Cochrane library. Forty-two observational studies involving 2791 patients were included. The quality of the included studies was assessed with a modified quality assessment tool, which was originally designed for use with observational studies. The effects of the studies were combined with the study quality score using a model of best-evidence synthesis. There was strong evidence for five predictors: (i) age, (ii) duration of symptoms, (iii) pre-operative neurological score, (iv) transverse area of the spinal cord, and (v) intramedullary high signal intensity on the T2-weighted MRI. We also identified eight predictors with moderate supporting evidence, seven with limited evidence, four with conflicting evidence and four predictors without supporting evidence. While there is no conclusive evidence regarding the surgical outcomes following cervical OPLL, these data provide evidence to guide the clinician in choosing an optimal therapeutic strategy for patients with cervical OPLL. Further research is necessary to fully evaluate the effects of the predictors described in this study. PMID:23540890

Xing, Dan; Wang, Jie; Ma, Jian-Xiong; Chen, Yang; Yang, Yang; Zhu, Shao-Wen; Ma, Xin-Long

2013-03-27

335

Triangle Centers  

NSDL National Science Digital Library

A listing, with description and illustration, of 20th-century triangle centers (including: Schiffler Point, Exeter Point, Parry Point, congruent isoscelizers point, Yff Center of Congruence, isoperimetric point and equal detour point, Ajima-Malfatti Points, Apollonius Point, Morley Centers, Hofstadter Points, and equal parallelians points) and some classical triangle centers (including: centroid, incenter, circumcenter, orthocenter, Fermat Point, nine-point center, symmedian (or Lemoine) point, Gergonne point, Nagel point, Mittenpunkt, Spieker center, Feuerbach point, isodynamic points, and Napoleon points), as well as other references (to print works) and a list of journals that frequently publish items of interest to triangle geometers.

Kimberling, Clark, 1942-

2008-09-22

336

A Learner Centered Education.  

ERIC Educational Resources Information Center

This paper proposes a learner-centered educational system, focusing on aspects that are intrinsically associated with the modern educational system, such as the curriculum, school community, parents, learners, and educational support personnel. It examines: primary level preparation (literacy, numeracy, and basic knowledge; examination and…

Ballard, Florence N.

337

A Learner Centered Education.  

ERIC Educational Resources Information Center

|This paper proposes a learner-centered educational system, focusing on aspects that are intrinsically associated with the modern educational system, such as the curriculum, school community, parents, learners, and educational support personnel. It examines: primary level preparation (literacy, numeracy, and basic knowledge; examination and…

Ballard, Florence N.

338

Immune and inflammatory responses in TNF alpha-deficient mice: a critical requirement for TNF alpha in the formation of primary B cell follicles, follicular dendritic cell networks and germinal centers, and in the maturation of the humoral immune response  

PubMed Central

To investigate the role of TNF alpha in the development of in vivo immune response we have generated TNF alpha-deficient mice by gene targeting. Homozygous mutant mice are viable and fertile, develop lymph nodes and Peyer's patches and show no apparent phenotypic abnormalities, indicating that TNF alpha is not required for normal mouse development. In the absence of TNF alpha mice readily succumb to L. monocytogenes infections and show reduced contact hypersensitivity responses. Furthermore, TNF alpha knockout mice are resistant to the systemic toxicity of LPS upon D-galactosamine sensitization, yet they remain sensitive to high doses of LPS alone. Most interestingly, TNF alpha knockout mice completely lack splenic primary B cell follicles and cannot form organized follicular dendritic cell (FDC) networks and germinal centers. However, despite the absence of B cell follicles, Ig class-switching can still occur, yet deregulated humoral immune responses against either thymus-dependent (TD) or thymus-independent (TI) antigens are observed. Complementation of TNF alpha functioning by the expression of either human or murine TNF alpha transgenes is sufficient to reconstitute these defects, establishing a physiological role for TNF alpha in regulating the development and organization of splenic follicular architecture and in the maturation of the humoral immune response.

1996-01-01

339

In photosynthetic reaction centers, the free energy difference for electron transfer between quinones bound at the primary and secondary quinone-binding sites governs the observed secondary site specificity.  

PubMed Central

The secondary quinone-binding site (QB site) of bacterial reaction centers from Rhodobacter sphaeroides is generally regarded to be highly specific for its native ubiquinone-10 molecule. We demonstrate here that this is a misconception rooted in the kinetic methods used to assay for occupancy of a quinone in the QB site. We show that observance of occupancy of the QB site, revealed by kinetic assay, is sensitive to the free-energy difference for electron transfer between the quinone at the primary quinone-binding site (QA site) and the QB site (-delta G0e-). For many of the compounds previously tested for binding at the QB site, the -delta G0e- between QA and QB is too small to permit detection of the functional quinone in the QB site. With an increased -delta G0e- achieved by replacing the native ubiquinone-10 at the QA site with lower-potential quinones or by testing higher-potential QB candidates, it is shown that the QB site binds and functions with the unsubstituted 1,4-benzoquinone, 1,4-naphthoquinone, and 9,10-phenanthraquinone, as well as with their various substituted forms. Moreover, quinones with the ortho-carbonyl configuration appear to function in a similar manner to quinones with the para-carbonyl configuration.

Giangiacomo, K M; Dutton, P L

1989-01-01

340

Bone Formation Zones in Heterotopic Ossifications: Histologic Findings and Increased Expression of Bone Morphogenetic Protein 2 and Transforming Growth Factors ß2 and ß3  

Microsoft Academic Search

Heterotopic ossifications (HOs) formed after total endoprosthetic replacement of the hip joint were collected during revision\\u000a surgery (n = 7). Tissues collected during regular hip arthroplasty (n = 12) were used as reference. Histomorphometric analysis was performed for assessment of bone formation activity in HOs and\\u000a reference bone. HOs were dissected with histological guidance into three zones: formed bone, zone

A. Toom; A. Arend; D. Gunnarsson; R. Ulfsparre; S. Suutre; T. Haviko; G. Selstam

2007-01-01

341

Do intramedullary spinal cord changes in signal intensity on MRI affect surgical opportunity and approach for cervical myelopathy due to ossification of the posterior longitudinal ligament?  

Microsoft Academic Search

Some controversy still exists over the optimal treatment time and the surgical approach for cervical myelopathy due to ossification\\u000a of the posterior longitudinal ligament (OPLL). The aim of the current study was first to analyze the effect of intramedullary\\u000a spinal cord changes in signal intensity (hyperintensity on T2-weighted imaging and hypointensity on T1-weighted imaging) on\\u000a magnetic resonance imaging (MRI) on

Qizhi SunHongwei; Hongwei Hu; Ying Zhang; Yang Li; Linwei Chen; Huajiang Chen; Wen Yuan

342

P2Y1 Transient Overexpression Induced Mineralization in Spinal Ligament Cells Derived from Patients with Ossification of the Posterior Longitudinal Ligament of the Cervical Spine  

Microsoft Academic Search

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the\\u000a spinal ligaments. We previously reported that P2 purinoceptor Y1 (P2Y1) expression is elevated in the spinal ligament cells\\u000a of OPLL patients, but the role of P2Y1 in the spinal ligament calcification process is unknown. To verify the hypothesis that\\u000a P2Y1 expression causes

Sunao Tanaka; Hitoshi Kudo; Toru Asari; Atsushi Ono; Shigeru Motomura; Satoshi Toh; Ken-Ichi Furukawa

2011-01-01

343

Significance of Serum Levels of Type I Procollagen Peptide and Intact Osteocalcin and Bone Mineral Density in Patients with Ossification of the Posterior Longitudinal Ligaments  

Microsoft Academic Search

.   This study was performed to evaluate the correlation between serum biochemical marker levels of bone metabolism and bone\\u000a mineral density (BMD) in patients with ossification of the posterior longitudinal ligaments (OPLL). In addition, the efficacy\\u000a of these markers in the prediction of the progression of OPLL was also examined. In 40 patients with OPLL, and in age- and\\u000a gender-matched

H. Matsui; K. Yudoh; H. Tsuji

1996-01-01

344

Ossification of the ligamentum flavum as cause of thoracic cord compression: Case report of a Latin American man and review of the literature  

PubMed Central

Background: Ossification of the ligamentum flavum is a widely described pathology in eastern Asia. Cases have been reported in northern Africa, the Middle-East, India, the Caribbean, Europe, and North America, but no cases from Latin America have been published in the literature. It affects mostly elderly men, with a possible association with obesity and type 2 diabetes. Case Description: A 38-year-old previously healthy Latin American male presented to the emergency room department with severe functional disability and a 3/5 paraparesis. Blood reports showed no abnormalities. Computed tomography and magnetic resonance imaging showed a ligamentum flavum ossification with myelopathy. The patient underwent a T3-T9 laminotomy. At hospital discharge, the patient remained with a 3/5 paraparesis, mild hypoesthesia in both lower limbs and bladder incontinence. Rectal sphincter was continent. At 6 months, he was able to walk with a cane, with no sphincter or sensory alterations. Conclusions: Ligamentum flavum ossification is rare. To our understanding, this is the first case reported in the Latin American population.

Toledo, Javier A.; Isseldyk, Facundo Van; Re, Martin; Garrote, Miguel

2013-01-01

345

Reliability of Schmeling's stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects.  

PubMed

Nowadays, due to the global increase in migration movements, forensic age estimation of living young adults has become an important focus of interest. Minors often have no identification documents providing their correct birth dates. Establishing the age of majority is therefore fundamental in order to determine whether juvenile penal systems or penal systems in force for adults are to be applied. Radiological examination of the clavicles is one of the methods recommended by the Study Group on Forensic Age Diagnostics. In this retrospective study, a sample of chest radiographs of 274 subjects, aged between 12 and 25 years, was studied according to Schmeling's method in order to examine the ossification of both medial clavicular epiphyses. All stage classifications were evaluated by five examiners. Intra- and inter-examiner reliability was analysed by Cohen's K statistic. Intra-examiner agreement was insufficient for two of the experts. Inter-examiner agreement, among the other three operators, was moderate (K?=?0.509). Study of reliability highlighted difficulties in interpretation, the need to select qualified personnel and choice of the best radiographic image in order to reduce any anatomic overlaps. Although ossification of the medial clavicular epiphyses is recommended to assess whether an individual has already reached the age of majority or not, these results suggested that it is very difficult to clearly identify the five stages of ossification by using conventional chest radiography. PMID:22968719

Cameriere, R; De Luca, S; De Angelis, D; Merelli, V; Giuliodori, A; Cingolani, M; Cattaneo, C; Ferrante, L

2012-09-12

346

The molecular and phenotypic profile of primary central nervous system lymphoma identifies distinct categories of the disease and is consistent with histogenetic derivation from germinal center-related B cells.  

PubMed

Primary central nervous system lymphoma (PCNSL) is a major cause of morbidity and mortality among human immunodeficiency virus (HIV)-infected individuals. The precise histogenetic derivation and the molecular pathogenesis of PCNSL is poorly understood. In an attempt to clarify the histogenesis and pathogenesis of these lymphomas, 49 PCNSL (26 acquired immunodeficiency syndrome [AIDS]-related and 23 AIDS-unrelated) were analyzed for multiple biologic markers, which are known to bear histogenetic and pathogenetic significance for mature B-cell neoplasms. PCNSL associated frequently (50.0%) with mutations of BCL-6 5' noncoding regions, which are regarded as a marker of B-cell transition through the germinal center (GC). Expression of BCL-6 protein, which is restricted to GC B cells throughout physiologic B-cell maturation, was detected in 100% AIDS-unrelated PCNSL and in 56.2% AIDS-related cases. Notably, among AIDS-related PCNSL, expression of BCL-6 was mutually exclusive with expression of Epstein-Barr virus (EBV)-encoded latent membrane protein (LMP)-1 and, with few exceptions, also of BCL-2. All but one PCNSL expressed hMSH2, which among mature B cells selectively stains GC B cells. These data suggest that PCNSL may be frequently related to GC B cells and may be segregated into two major biologic categories based on the expression pattern of BCL-6, LMP-1, and BCL-2. BCL-6(+)/LMP-1(-)/BCL-2(-) PCNSL occur both in the presence and in the absence of HIV infection and consistently display a large noncleaved cell morphology. Conversely, BCL-6(-)/LMP-1(+)/BCL-2(+) PCNSL are restricted to HIV-infected hosts and are represented by lymphomas with immunoblastic features. These data are relevant for the pathogenesis and histogenesis of PCNSL and may be helpful to segregate distinct biologic and prognostic categories of these lymphomas. PMID:9680371

Larocca, L M; Capello, D; Rinelli, A; Nori, S; Antinori, A; Gloghini, A; Cingolani, A; Migliazza, A; Saglio, G; Cammilleri-Broet, S; Raphael, M; Carbone, A; Gaidano, G

1998-08-01

347

Skills Center.  

ERIC Educational Resources Information Center

|The services of the Living Skills Center for the Visually Handicapped, a habilitative service for blind young adults, are described. It is explained that the Center houses its participants in their own apartments in a large complex and has served over 70 young people in 4 years. The evaluation section describes such assessment instruments as an…

Canter, Patricia; And Others

348

Hatching, growth, ion accumulation, and skeletal ossification of brook trout (Salvelinus fontinalis) alevins in acidic soft waters  

USGS Publications Warehouse

Brook trout eyed eggs and subsequent alevins were exposed to pH 5.0, 6.5, and 7.0 in soft reconstituted water and to pH 8.2 in hard well water for up to 72 d. Hatching was delayed and hatching success reduced (p K+ > Cl- during yolk absorption and early exogenous feeding. Whole-body monovalent ion concentrations were reduced for short periods during yolk absorption in alevins exposed to pH 6.5 and throughout most of the experiment for those exposed to pH 5.0. Whole-body Mg2+ concentrations were not affected by treatment pH and remained near their median hatch level throughout the exposure. The whole-body concentration of Ca2+ was reduced in fish exposed to pH 5.0, particularly near the end of the experiment. Calcium accumulation in fish was influenced by the interaction of pH and time at pH 5.0 but not at the other pH levels. Alevins exposed to pH 5.0 experienced delayed ossification of skeletal structures associated with feeding, respiration, and locomotion that usually persisted for up to 10 d. The detection of skeletal abnormalities early in life might aid in identifying fish populations at risk in acidified waters.

Steingraeber, M. T.; Gingerich, W. H.

1991-01-01

349

Simulation of the initial stage of endochondral ossification: in vitro sequential culture of growth cartilage cells and bone marrow cells.  

PubMed Central

Growth cartilage cells were isolated from the ribs of young rats and cultured at high cell density in Ham's F-12 medium supplemented with 10% fetal calf serum. During 7 days, glycosaminoglycans and proteoglycans were actively synthesized and secreted, forming a metachromatic matrix. When cultured together with growth cartilage cells precultured and biosynthetically prelabeled with 35SO4(2-) in their glycosaminoglycans, bone marrow cells caused release of 35S-labeled material into the culture medium. Glycosaminoglycan was also released by addition of conditioned medium obtained from cultures of bone marrow cells or peritoneal macrophages to the growth cartilage cell cultures. Electron microscopic studies of the extracellular matrix of growth cartilage cells cocultured with bone marrow cells showed that needles of apatite mineral were deposited within and in close apposition to the surfaces of matrix vesicles. These findings suggest that enzymes released from bone marrow cells or macrophages removed glycosaminoglycan or proteoglycans, which may be inhibitors of mineral growth, and consequently mineralization was initiated. From these findings, sequential culture of growth cartilage cells and bone marrow cells is promising as an experimental system for investigating the mechanism of the initial stage of endochondral ossification. Images

Suzuki, F; Takase, T; Takigawa, M; Uchida, A; Shimomura, Y

1981-01-01

350

Factors related to the development of myelopathy in patients with cervical ossification of the posterior longitudinal ligament.  

PubMed

This study evaluates factors related to myelopathic symptoms in patients with ossification of the posterior longitudinal ligament (OPLL). A total of 87 patients with OPLL were included. Of these, 53 (Group I) had no symptoms or presented with neck pain and radiculopathy and 34 (Group II) had myelopathic symptoms. Gender, age, and history of trauma were evaluated in the two groups. The range of movement of the cervical spine was measured using plain radiographs. The number of involved segments, type of OPLL, and maximal compression ratio were analysed using CT and signal change in the spinal cord was evaluated using MRI. The patients' age was found to be significant (p = 0.001). No difference was found between gender and the range of movement in the two groups. The maximum compression of the spinal canal showed a difference (p = 0.03). The signal change of the spinal cord was different between the two groups. In patients with OPLL of the cervical spine, myelopathic symptoms are not related to the range of movement or the number of involved segments. PMID:22733951

Chang, H; Song, K-J; Kim, H-Y; Choi, B-W

2012-07-01

351

A genome-wide sib-pair linkage analysis of ossification of the posterior longitudinal ligament of the spine.  

PubMed

Ossification of the posterior longitudinal ligament of the spine (OPLL) is a common musculoskeletal disease among people after middle age. The OPLL presents with serious neurological abnormalities due to compression of the spinal cord and nerve roots. The OPLL is caused by genetic and environment factors; however, its etiology and pathogenesis still remain to be elucidated. To determine the susceptibility loci for OPLL, we performed a genome-wide linkage study using 214 affected sib-pairs of Japanese. In stratification analyses for definite cervical OPLL, we found loci with suggestive linkage on 1p21, 2p22-2p24, 7q22, 16q24 and 20p12. Fine mapping using additional markers detected the highest non-parametric linkage score (3.43, P = 0.00027) at D20S894 on chromosome 20p12 in a subgroup that had no complication of diabetes mellitus. Our result would shed a new light on genetic aspects of OPLL. PMID:23138351

Karasugi, Tatsuki; Nakajima, Masahiro; Ikari, Katsunori; Tsuji, Takashi; Matsumoto, Morio; Chiba, Kazuhiro; Uchida, Kenzo; Kawaguchi, Yoshiharu; Mizuta, Hiroshi; Ogata, Naoshi; Iwasaki, Motoki; Maeda, Shingo; Numasawa, Takuya; Abumi, Kuniyoshi; Kato, Tsuyoshi; Ozawa, Hiroshi; Taguchi, Toshihiko; Kaito, Takashi; Neo, Masashi; Yamazaki, Masashi; Tadokoro, Nobuaki; Yoshida, Munehito; Nakahara, Shinnosuke; Endo, Kenji; Imagama, Shiro; Demura, Satoru; Sato, Kimiaki; Seichi, Atsushi; Ichimura, Shoichi; Watanabe, Masahiko; Watanabe, Kei; Nakamura, Yutaka; Mori, Kanji; Baba, Hisatoshi; Toyama, Yoshiaki; Ikegawa, Shiro

2012-11-09

352

Defective endochondral ossification-derived matrix and bone cells alter the lymphopoietic niche in collagen x mouse models.  

PubMed

Despite the appreciated interdependence of skeletal and hematopoietic development, the cell and matrix components of the hematopoietic niche remain to be fully defined. Utilizing mice with disrupted function of collagen X (ColX), a major hypertrophic cartilage matrix protein associated with endochondral ossification, our data identified a cytokine defect in trabecular bone cells at the chondro-osseous hematopoietic niche as a cause for aberrant B lymphopoiesis in these mice. Specifically, analysis of ColX transgenic and null mouse chondro-osseous regions via micro-computed tomography revealed an altered trabecular bone environment. Additionally, cocultures with hematopoietic and chondro-osseous cell types highlighted impaired hematopoietic support by ColX transgenic and null mouse derived trabecular bone cells. Further, cytokine arrays with conditioned media from the trabecular osteoblast cocultures suggested an aberrant hematopoietic cytokine milieu within the chondro-osseous niche of the ColX deficient mice. Accordingly, B lymphopoiesis was rescued in the ColX mouse derived trabecular osteoblast cocultures with interlukin-7, stem cell factor, and stromal derived factor-1 supplementation. Moreover, B cell development was restored in vivo after injections of interlukin-7. These data support our hypothesis that endrochondrally-derived trabecular bone cells and matrix constituents provide cytokine-rich niches for hematopoiesis. Furthermore, this study contributes to the emerging concept that niche defects may underlie certain immuno-osseous and hematopoietic disorders. PMID:23656481

Sweeney, Elizabeth; Roberts, Douglas; Lin, Angela; Guldberg, Robert; Jacenko, Olena

2013-06-18

353

Synergistic inhibition of endochondral bone formation by silencing Hif1? and Runx2 in trauma-induced heterotopic ossification.  

PubMed

Angiogenesis and osteogenesis are tightly coupled during bone development. We studied the effect of inhibition of Hif1? and Runt-related protein 2 (Runx2) on the formation of heterotopic ossification (HO). We constructed lentivirus vectors expressing Hif1? small interfering RNA (siRNA) and Runx2 siRNA. The inhibition of Hif1? function impaired osteoblast proliferation while osteoblasts differentiated normally. Osteoblasts lacking Runx2 proliferated normally while the differentiation was impaired. The osteoblast differentiation was significantly inhibited by co-Runx2 and Hif1? siRNA treatment. The formation of HO by inhibiting Runx2 and Hif1? in an animal model induced by Achilles tenotomy was investigated. The results showed that lacking of Runx2 and Hif1? could inhibit HO formation. Inhibition of Hif1? prevented HO formation only at the initial step and inhibition of Runx2 worked both at the initial step and after chondrogenesis. Angiogenesis and the expressions of osteogenic genes were downregulated in the Hif1? siRNA group. We found synergistic inhibition of endochondral bone formation by silencing Hif1? and Runx2. Our study provided new insight into the roles of Hif1? and Runx2 during the processes of endochondral bone formation, and had important implications for the new therapeutic methods to inhibit HO or to enhance bone formation. PMID:21629226

Lin, Lin; Shen, Qi; Leng, Huijie; Duan, Xiaoning; Fu, Xin; Yu, Changlong

2011-05-31

354

Defective Endochondral Ossification-Derived Matrix and Bone Cells Alter the Lymphopoietic Niche in Collagen X Mouse Models  

PubMed Central

Despite the appreciated interdependence of skeletal and hematopoietic development, the cell and matrix components of the hematopoietic niche remain to be fully defined. Utilizing mice with disrupted function of collagen X (ColX), a major hypertrophic cartilage matrix protein associated with endochondral ossification, our data identified a cytokine defect in trabecular bone cells at the chondro-osseous hematopoietic niche as a cause for aberrant B lymphopoiesis in these mice. Specifically, analysis of ColX transgenic and null mouse chondro-osseous regions via micro-computed tomography revealed an altered trabecular bone environment. Additionally, cocultures with hematopoietic and chondro-osseous cell types highlighted impaired hematopoietic support by ColX transgenic and null mouse derived trabecular bone cells. Further, cytokine arrays with conditioned media from the trabecular osteoblast cocultures suggested an aberrant hematopoietic cytokine milieu within the chondro-osseous niche of the ColX deficient mice. Accordingly, B lymphopoiesis was rescued in the ColX mouse derived trabecular osteoblast cocultures with interlukin-7, stem cell factor, and stromal derived factor-1 supplementation. Moreover, B cell development was restored in vivo after injections of interlukin-7. These data support our hypothesis that endrochondrally-derived trabecular bone cells and matrix constituents provide cytokine-rich niches for hematopoiesis. Furthermore, this study contributes to the emerging concept that niche defects may underlie certain immuno-osseous and hematopoietic disorders.

Sweeney, Elizabeth; Roberts, Douglas; Lin, Angela; Guldberg, Robert

2013-01-01

355

Cancer Centers Program - Cancer Centers List  

Cancer.gov

Cancer Centers Program - Cancer Centers List Map of Cancer Centers Data Tables Benchmark Home > Cancer Centers > Region Map Cancer Centers List View By: Name | State | State Map | Region Map Click on geographical region

356

Senior Centers  

MedlinePLUS Videos and Cool Tools

... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ... chi, tap dancing, ballroom dancing, square dancing, chair exercise, arthritis classes, yoga, and lots of dancing. [Narrator] ...

357

A new haplotype in BMP4 implicated in ossification of the posterior longitudinal ligament (OPLL) in a Chinese population.  

PubMed

Previous genome-wide microarray analysis of candidate genes involved in the ossification of the posterior longitudinal ligament (OPLL) of the spine resulted in the identification of a novel, clinically relevant gene encoding bone morphogenetic protein 4 (BMP4) but was defined only by its expression patterns. The complete genomic BMP4 coding DNA from 450 patients with OPLL and 550 matched controls were sequenced and compared. We identified 18 SNPs, among which the minor alleles of SNP8 (C>T; p?T; p?T; p?

Ren, Yuan; Feng, Jie; Liu, Zhi-zhong; Wan, Hong; Li, Jun-hua; Lin, Xin

2011-11-02

358

Conservatively treated ossification of the posterior longitudinal ligament increases the risk of spinal cord injury: a nationwide cohort study.  

PubMed

The optimal treatment strategy for ossification of the posterior longitudinal ligament (OPLL) depends on symptoms and is uncertain. Whether the risk of spinal cord injury (SCI) is increased in patients with cervical spinal stenosis or myelopathy caused by OPLL remains unclear. This study aimed to evaluate the risk of SCI in patients with OPLL of the cervical spine when managed with conservative treatment (no surgery). Study subjects were identified from a nationwide cohort of 26,544,883 people from 1998 to 2005 and were divided into the OPLL group (n=265), who were hospitalized for OPLL but had conservative treatment (no surgery), and the comparison group (n=5339), composed of age- and sex-matched people. Until the end of 2008, a total of 5604 subjects were followed-up for 34,723.5 person-years. The propensity score method was used to adjust for covariates. Kaplan-Meier and Cox regression analyses were performed. The incidence rate of cervical SCI in the OPLL group was found to be significantly higher than in the comparison group (4.81 versus 0.18 per 1000 person-years; p<0.001). Cervical SCI was more likely to happen in the OPLL group than in the comparison group (crude hazard ratio [HR] 25.64; p<0.001). After adjustments, the OPLL group had a 32.16-fold (p<0.001) higher risk for cervical SCI. Disability caused by SCI had an even higher risk (HR=110.72, adjusted HR=104.78; p<0.001) for the OPLL group. Therefore, cervical SCI and related disabilities are more likely to happen in OPLL patients, who should be cautioned for subsequent SCI if treated conservatively. PMID:21992063

Wu, Jau-Ching; Chen, Yu-Chun; Liu, Laura; Huang, Wen-Cheng; Chen, Tzeng-Ji; Lo, Su-Shun; Thien, Peck-Foong; Cheng, Henrich

2011-12-05

359

A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification  

SciTech Connect

Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT (p < 0.0001). Chi-square test and multiple logistic regression analysis showed no significant association between all other factors and the risk of HO (race, gender, cause and type of fracture, surgical approach, or the use of indomethacin). Conclusions: Our data suggest that there is higher incidence and risk of HO if prophylactic RT is significantly delayed after a displaced acetabular fracture. Thus, RT should be administered as early as clinically possible after the trauma. Patients undergoing RT >3 weeks from their displaced acetabular fracture should be informed of the higher risk (>90%) of developing HO despite prophylaxis.

Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel); Packianathan, Satyaseelan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Shourbaji, Rania A. [Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States); Zhang Zhen; Graves, Mathew [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Khan, Majid A. [Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States); Baird, Michael C. [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Russell, George [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)

2012-03-01

360

Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up  

PubMed Central

Cervical total disc replacement (CTDR) aims to decrease the incidence of adjacent segment disease through motion preservation in the operated disc space. Ongoing data collection and increasing number of studies describing heterotopic ossification (HO) resulting in decreased mobility of implants, forced us to carefully evaluate our long-term clinical and morphological results of patients with CTDR. We present the first 54 consecutive patients treated with 65 ProdiscC™ prostheses during a 12-month period (2/2004–3/2005). All patients signed an informed consent and were included in prospective long-term study approved by hospital ethical committee. The 1- and 2-year follow-up analysis were available for all patients included and 4-year results for 50 patients (60 implants). Clinical (neck disability index-NDI, visual analog scale-VAS) and radiological follow-up was conducted at 1-, 2- and 4-years after the procedure. The Mehren/Suchomel modification of McAfee scale was used to classify the appearance of HO. Mean preoperative NDI was 34.5%, VAS for neck pain intensity 4.6 and VAS for arm pain intensity 5.0. At 1-, 2- and 4-year follow-up, the mean NDI was 30.7, 27.2, and 30.4, mean VAS for neck pain intensity 2.5, 2.1 and 2.9 and mean VAS for arm pain intensity pain 2.2, 1.9 and 2.3, respectively. Significant HO (grade III) was present in 45% of implants and segmental ankylosis (grade IV) in another 18% 4 years after intervention. This finding had no clinical consequences and 92% of patients would undergo the same surgery again. Our clinical results (NDI, VAS) are comparable with fusion techniques. Although, advanced non-fusion technology is used, a significant frequency of HO formation and spontaneous fusion in cervical disc replacement surgery must be anticipated during long-term follow-up.

Suchomel, Petr; Jurak, Lubomir; Brabec, Radim; Bradac, Ondrej; Elgawhary, Shamel

2009-01-01

361

Breast Centers in Austria  

PubMed Central

Summary Breast centers (BRCs) in Austria are currently managed and will be managed in the future as interdisciplinary and largely virtual, well-structured entities. The goals of the initiative to set up these centers are convergence of care, enhancement of the quality of care delivered to women diagnosed with breast cancer, and a significant actual benefit for the affected women. Given the geographical and infrastructural circumstances and partly already existing diagnostic and therapeutic facilities, a collaborating center model seems to be the target-oriented solution to employ the already existing resources. Evaluation and optimization of outcome quality (i.e. overall survival rate, disease-free survival, breast conservation rate, etc.) necessitate the implementation of treatment pathways with data collection and recording in a central registry. The aim should be to create an independent ‘neutral’ certification commission (a standard setter) in order to adapt the requirements of BRCs to Austrian circumstances. An appointed certification agency reviews compliance with the specifications of the certification commission. The European Society of Mastology (EUSOMA) specifications, as laid down in the European Parliament, serve as guidelines. These specifications were compiled by the brain trust of the Austrian Federal Institute of Health (ÖBIG) in Chapter 3.6.11 ‘Breast Health Centers’ for implementation in the Austrian Health Care Structure Plan (ÖSG). BRCs in Austria should demonstrate a minimum caseload of 100 primary diagnoses per year. The collaborating partners – the affiliated centers – may, however, join a BRC with a demonstrated minimum caseload of 30 per year. In this model, the outcome quality should be achieved even with a smaller caseload with structure quality assurance. It is planned that, by the end of 2016, breast health centers will take over the comprehensive care of breast cancer patients nationwide. Center certification is viewed as quality enhancement since care is provided to all patients on a verifiable high quality level, subject to constant improvements.

Postlberger, Sabine

2009-01-01

362

Association of bone morphogenetic protein-2 gene polymorphisms with susceptibility to ossification of the posterior longitudinal ligament of the spine and its severity in Chinese patients  

Microsoft Academic Search

A case–control study was conducted to examine the association between two single nucleotide polymorphisms (SNPs) in exon 2\\u000a of the bone morphogenetic protein-2 gene (BMP-2) and ossification of the posterior longitudinal ligament (OPLL), and to investigate\\u000a whether SNPs of the Ser37Ala (T\\/G) and the Ser87Ser (A\\/G) in the BMP-2 gene are associated with genetic susceptibility to\\u000a OPLL and its severity

Hao Wang; Dongmei Liu; Zhaohui Yang; Baopeng Tian; Jie Li; Xianglong Meng; Zhentian Wang; Hui Yang; Xin Lin

2008-01-01

363

Personal Technique for Primary Repair of Alveolar Clefts  

PubMed Central

From 1969, the senior author (H.B.) has developed a technique for the repair of alveolar clefts during primary cheiloplasty at patient age of 3 months. The operation used palatally hinged mucoperiosteal flaps from the edges of the cleft to reconstruct the posterior and inferior walls of the alveolar box. The roof was reconstructed by repairing the nasal floor, and the anterior wall was reconstructed using a buccal mucosal flap from the undersurface of the lateral lip segment. Fourteen operated patients were selected to scientifically follow the long-term results of the technique. The results indicated restoration of the arch form, varying degrees of ossification in the repaired alveolar box, and eruption of canines through the repaired alveolus. One case of anterior cross-bite was observed in these selected cases. However, a limited cross-bite was present at the site of the repaired cleft in many cases.

Badran, Hassan A.; Ali, Hazem M.; Elbarbary, Amir S.

2011-01-01

364

Challenger Center  

NSDL National Science Digital Library

"Challenger Center uses students' natural enthusiasm for space to create innovative learning experiences for imaginative young minds." After learning about the Challenger 51-L crew, users can find information about visits to the Challenger Learning Center Networks' forty six sites located across the Unites States, Canada, and the United Kingdom. Within the Teacher and Community Resources link, users can find student activities, professional development opportunities, community programs, and special events. Teachers can learn about Space Day 2004 on May 6th, where young students can take a journey to uncharted galaxies.

2008-05-05

365

Nanobiotechnology Center  

NSDL National Science Digital Library

Established in January 2000, the Nanobiotechnology Center (NBTC) is a consortium of several major universities that is headed by Cornell University. Despite being so new, the NBTC has already made many important advances in this area of research. This brochure starts with a good introduction to the principles and uses of nanobiotechnology, and then gives a brief synopsis of the center's work. Some of the research programs described in this document are Selective Molecular Filtration, Bioselective Surfaces, and Molecular Motors. The NBTC Web site has even more information, including research papers and educational materials. Lesson plans for grade school teachers are also provided to let students learn about this exciting science.

2000-01-01

366

[Coaching for primary care].  

PubMed

Patient-centered approach is critical in current team-medication, and the importance of the approach is broadly accepted among the medical workers including pharmacists. Nevertheless, based on the experience as a communication trainer for medical workers and a faculty at the pharmacy school, many of pharmacists and/or pharmacy students have certain mental model for the pharmacist-patient relationship similar to the paternalism. Active concern to the decision-making and the health behavior for the patients' own medication is the key for patient-centered approach. Heron's six categories of intervention model show the need for caregivers to support their clients' autonomy with facilitative approach. Coaching, client-centered, behavior-focus support communication method would be useful for the pharmacists to implement the facilitative approach in medical context, especially on the primary care. PMID:21139386

Norose, Takahiko

2010-12-01

367

Primary amyloidosis  

MedlinePLUS

... This reduces their ability to work correctly. Primary amyloidosis can lead to conditions that include: Carpal tunnel syndrome Heart muscle damage ( cardiomyopathy ) leading to congestive heart failure ...

368

Ossification centre of the hyoid bone in complete transposition of great vessels, Ivemark asplenia syndrome, and Down's syndrome with congenital heart disease: correlation with the humeral capital epiphysis.  

PubMed

The incidence of radiographic visibility of the ossification centres of the body of the hyoid bone and of the humeral capital epiphysis in antero-posterior or lateral chest radiographs taken during the first month of life of 63 autopsied infants were analysed. The group comprised patients with Down's syndrome (DS) with congenital heart disease, 15; complete transposition of the great vessels (TGV), 10; Ivemark asplenia syndrome (IS), 17; and a control group of infants with congenital heart disease (CHD) who had none of the above conditions, nor tetralogy of Fallot, interrupted aortic arch, DiGeorge syndrome or hypoplastic left-heart complex, 31. The incidence of radiographically visible hyoid ossification centre (HOC) in the control group was 71% and of humeral capital epiphysis (HE), 16.1%. Autopsied infants with TGV, IS or DS with CHD showed increased visibility of HOC (100%); the incidence of visible HE was increased in neonates with IS (71.4%) and with TGV (50%). The differences in the incidence of radiographic visibility of HOC and HE in neonates with CHD, in this study and in others in the literature, appear to have diagnostic value. PMID:2947657

Wells, T R; Landing, B H; Senac, M O; Gilsanz, V

1986-11-01

369

Mackinac Center  

NSDL National Science Digital Library

Based in Midland, Michigan, the Mackinac Center for Public Policy is a "nonpartisan research and educational institute dedicated to improving the quality of life for all Michigan citizens by promoting sound solutions to state and local policy questions." Visitors to their website can read their blog, check out some of their publications, and also learn about some of their key topical interests. Most of their work focuses on economic policy matters, and visitors can get a sense of their viewpoints by clicking on the "Periodicals & Projects" area. The "In the Spotlight" area includes recent items of note, and recently they have featured pieces on charter schools, tax credits, and distance learning. Visitors are also encouraged to sign up to receive the Center's email updates and other materials.

370

Primary anetoderma.  

PubMed

The authors report a case of primary anetoderma in a 27-year-old black woman. Primary anetoderma is characterized by circumscribed oval plaques with overlying loose, wrinkled skin appearing as a depression or pouch-like protrusion of the skin. PMID:10795075

Benest, L; Kwark, E; Goldwasser, J; Dantzig, P; Weinberg, J M; Davis, I

2000-04-01

371

Primary Partition \\  

Microsoft Academic Search

. The paper considers the problem of implementing "VirtuallySynchronous Communication" in the primary partition of an asynchronoussystem. Virtually Synchronous Communication was first introducedby the Isis system as a powerful mechanism for building faulttolerantprocesses that mask failures by replication: it can be understoodas a rule for ordering message deliveries (reliable multicasts) with respectto view changes, defined by a membership service. Primary

André Schiper; Alain Sandoz

1994-01-01

372

Identification and location of bone-forming cells within cartilage canals on their course into the secondary ossification centre  

PubMed Central

Osteoblasts and osteocytes derive from the same precursors, and osteocytes are terminally differentiated osteoblasts. These two cell types are distinguishable by their morphology, localization and levels of expression of various bone cell-specific markers. In the present study on the chicken femur we investigated the properties of the mesenchymal cells within cartilage canals on their course into the secondary ossification centre (SOC). We examined several developmental stages after hatching by means of light microscopy, electron microscopy, immunohistochemistry and in situ hybridization. Cartilage canals appeared as extensions of the perichondrium into the developing distal epiphysis and they were arranged in a complex network. Within the epiphysis an SOC was formed and cartilage canals penetrated into it. In addition, they were successively incorporated into the SOC during its growth in the radial direction. Thus, the canals provided this centre with mesenchymal cells and vessels. It should be emphasized that regression of cartilage canals could never be observed in the growing bone. Outside the SOC the mesenchymal cells of the canals expressed type I collagen and periostin and thus these cells had the characteristics of preosteoblasts. Periostin was also expressed by numerous chondrocytes. Within the SOC the synthesis of periostin was down-regulated and the majority of osteoblasts were periostin negative. Furthermore, osteocytes did not secret this protein. Tissue-non-specific alkaline phosphatase (TNAP) staining was only detectable where matrix vesicles were present. These vesicles were found around the blind end of cartilage canals within the SOC where newly formed osteoid started to mineralize. The vesicles originated from osteoblasts as well as from late osteoblasts/preosteocytes and thus TNAP was only expressed by these cells. Our results provide evidence that the mesenchymal cells of cartilage canals express various bone cell-specific markers depending on their position. We suggest that these cells differentiate from preosteoblasts into osteocytes on their course into the SOC and consider that cartilage canals are essential for normal bone development within the epiphysis. Furthermore, we propose that the expression of periostin by preosteoblasts and several chondrocytes is required for adhesion of these cells to the extracellular matrix.

Blumer, Michael J F; Schwarzer, Christoph; Perez, Maria Teresa; Konakci, Kadriye Zeynep; Fritsch, Helga

2006-01-01

373

Maternal body weight and feed allowance of breeders affect performance of dwarf broiler breeders and tibial ossification of their progeny.  

PubMed

Four hundred and eight dwarf broiler breeder hens were raised collectively in a floor pen to 21 wk of age. At this age they were classified into four groups with reference to their individual BW as heavy (1.95 +/- .1 kg), medium (1.80 +/- .1 kg), light (1.69 +/- .1 kg), and ultralight (1.57 +/- .1 kg). All groups were individually caged at 23 wk of age. During the reproductive period, each group was divided into three subgroups fed on liberal, intermediate, or severe feed restriction (reaching up to 135, 125, and 115 g of daily feed allowance at 29 wk of age, respectively). Intergroup differences in BW were maintained throughout the experiment (21 to 61 wk) but tended to decrease with age. Hen-day egg production was depressed by the lower feed allowance. Fertility and hatchability were impaired when hens received the largest quantities of food. Hen size influenced female breeder performance only slightly. Shell quality and albumen quality were affected by the level of feed consumption. Egg weights as well as BW of the progeny at hatching were enhanced by increased maternal BW and feed allowance. This positive maternal effect was still present at 40 days of age. Despite better overall BW performances of the male versus female broilers, the abdominal fat pad of female broilers was heavier than that of males and tended to increase with breeder size and breeder feed allowance. Accordingly, tibial breaking strength and percentage ash of the progeny at hatching were markedly improved in proportion to the breeders' BW and to their feed allowance. The effect of breeder size on broiler tibial quality was maintained up to 40 days of age but the effect of breeder feed intake tended to disappear with increasing age of the broilers. Tibial strength and mineralization were higher in male than in female broilers at 40 days of age. Dyschondroplasia was higher in broilers hatched from heavier breeder hens, but was not influenced by breeder feed intake. The incidence of varus and valgus in progeny was similar whatever the breeders' treatment. It is concluded that performance of dwarf breeders in a given flock depends mainly upon breeder feed allowance but that broiler performance and, especially, tibial ossification of broilers is greatly influenced by maternal size and, to a lesser extent, by maternal feed intake. PMID:1546035

Triyuwanta; Leterrier, C; Brillard, J P; Nys, Y

1992-02-01

374

[Primary megaureter].  

PubMed

A primary megaureter is an anomaly with a prevesical or overall dilated ureter of more than 6 mm in diameter. It is important to distinguish between cases of primary non-refluxing and primary obstructive-refluxing megaureters, as the treatment of both is completely different. The basic diagnostic work-up includes ultrasonography and voiding cystourethrography. Diuretic renography is used to detect split renal function and the degree of upper urinary tract obstruction. In most cases of primary non-refluxing megaureter surgical treatment is unnecessary due to the high remission rate, whereas obstructive refluxing megaureters commonly only need to be corrected. Antibiotic prophylaxis may be indicated in infants with a primary obstructive megaureter during the first 6 months of life due to a higher risk of complications due to pyelonephritis especially in this age group. PMID:23340725

Anheuser, P; Kranz, J; Steffens, J; Beetz, R

2013-01-01

375

Salvadori Center  

NSDL National Science Digital Library

The Salvadori Center was established in New York City in 1976, when Professor Salvadori of Columbia University was challenged by the New York Academy of Sciences to improve the teaching of math and science in middle schools. Visitors can read the about the vision and values of the Salvadori Center in the "About Us" link, which explains that "[u]sing the urban landscape of buildings, tunnels, and bridges,...[it] introduces teachers to the wonder, beauty, and logic of architecture and engineering, who then share it with their students." The "Resource Center" tab near the top of the page has a link to the "Salvadori Curriculum," which has been created for Science, Social Studies, Language Arts, Art, and Math. Visitors will note that the inclusion of non-STEM subjects offers a well-rounded approach to learning that still addresses the STEM subjects. Examples of some of the lessons that are taught in the Language Arts curriculum include asking students to legally protect their new ergonomic chair design, invent or improve upon a product they currently use, and produce a radio program telling the story of a school building, from the building's point of view.

2012-01-13

376

[Primary hyperparathyroidism].  

PubMed

For the past 40 years, primary hyperparathyroidism has been recognized as a common endocrine disease which is, most often, "non-symptomatic", without the occurrence of nephrolithiasis or osteitis fibrosa cystica. Our knowledge in the pathophysiology has increased largely and diagnosis of primary hyperparathyroidism is usually easy. The only radical treatment is surgery and the surgical indications have been codified by several consensus conferences. For patients who do not undergo surgery, prolonged medical monitoring is needed. PMID:23195909

Maruani, G; Cornière, N; Nicolet, L; Baron, S; Courbebaisse, M; Renaud, S; Houillier, P

2012-11-26

377

Primary Hyperparathyroidism  

Microsoft Academic Search

\\u000a This chapter describes the diagnosis, clinical features, and principles of management of primary hyperparathyroidism. The\\u000a chapter focuses primarily on current management recommendations for patients with primary hyperparathyroidism, particularly\\u000a for those with “asymptomatic” or mild disease. We also discuss the risks and benefits of parathyroidectomy for hyperparathyroidism\\u000a and the various preoperative and intraoperative localization techniques currently in use to enable minimally

Kaitlyn J. Kelly; Herbert Chen; Rebecca S. Sippel

378

[Primary malignant bone tumors].  

PubMed

Among human neoplasms, primary malignant bone tumors are fairly rare. They present an incidence rate of roughly 10 cases per 1 million inhabitants per year. During childhood (<15 years), the percentage of malignant bone tumors amounts to 6% of all infantile malignancies. Only leukemia and lymphoma show a higher incidence in adolescence. Of all primary malignant bone tumors, 60% affect patients younger than 45 years and the peak incidence of all bone tumors occurs between 15 and 19 years. The most common primary malignant bone tumors are osteosarcoma (35%), chondrosarcoma (25%), and Ewing's sarcoma (16%). Less frequently (??5%) occurring tumors are chordoma, malignant fibrous histiocytoma of bone, and fibrosarcoma of bone. Vascular primary malignant tumors of bone and adamantinoma are very rare. Staging of the lesion is essential for systemic therapeutic decision-making and includes complete imaging and histo-pathological confirmation of the suspected entity. In most cases, this is established by open- or image-guided biopsy. Based on this information, an interdisciplinary tumor board will determine the individual therapeutic approach. Endoprosthetic or biological reconstruction following wide tumor resection is the most common surgical therapy for primary malignant bone tumors. There is vital importance in a thorough postoperative follow-up and continous after-care by a competent tumor center which is permanentely in charge of therapy. PMID:22130624

von Eisenhart-Rothe, R; Toepfer, A; Salzmann, M; Schauwecker, J; Gollwitzer, H; Rechl, H

2011-12-01

379

[Primary hyperparathyroidism].  

PubMed

Primary hyperparathyroidism is frequently an incidental finding in asymptomatic patients. Often the diagnosis of primary hyperparathyroidism is made in evaluation for osteoporosis, rarely in the context of hypercalcemic crisis, myopathy, kidney stones, nephrocalcinosis, and osteitis fibrosa. The most frequent cause for primary hyperparathyroidism is benign parathyroid adenoma, reminders have hyperplasia. Primary hyperparathyroidism is defined as hypercalcemia with inappropriately high parathyroid hormone levels. Surgery is the definitive treatment for patients with symptomatic primary hyperparathyroidism and asymptomatic patients, who meet one of the following criteria: serum calcium>0.25 mmol/L (1.0 mg/dl) above the accepted normal reference range, renal failure (GFR<60 ml/min) and presence of osteoporosis (T-score<-2.5 or fracture). Parathyroidectomy should be performed by an experienced surgeon. As an alternative in inoperable patients or preoperatively in severe hypercalcemia cinacalcet successfully reduces calcium levels. In asymptomatic patients not meeting the above mentioned criteria serum calcium and creatinin levels should be measured once a year and DXA every two years, since 30% of the patients with asymptomatic primary hyperparathyroidism are progressive. PMID:21656491

Suter-Widmer, Isabelle; Kraenzlin, Marius E; Meier, Christian

2011-06-01

380

Waisman Center.  

PubMed

The Waisman Center MRDDRC supports behavioral, social, and biomedical research on human development, developmental disabilities, and neurodegenerative diseases. Examples of research conducted in each of the four MRDDRC units include: abnormalities in gene expression in human neuronal stem cells and progenitor cells from Down syndrome tissue (from the Molecular and Genetic Sciences Unit), language disorders in adolescents with Down syndrome and Fragile X syndrome (from the Communication Processes Unit); the development of selective visual attention during the first 6 months of life (from the Sensory and Cognitive Processes Unit); and the long-range effects of early intervention on special education placement, delinquency, and high school graduation rates (from the Social and Affective Processes Unit). PMID:12175890

Seltzer, Marsha Mailick

381

Midwives as primary care providers.  

PubMed

Historically, primary health care services for women have been vastly inadequate. It was not until 1990, when the National Institutes of Health established the Office of Research on Women's Health, that the United States began to acknowledge the importance of providing primary care services to women. Even today, women continue to be a greatly underserved population when it comes to primary health care services. Midwives are ideal providers of health promotion services for women because their entire philosophy of care centers on the promotion of women's health throughout the lifecycle. PMID:10772740

DeSandre, C A

382

Matrix GLA protein is a developmental regulator of chondrocyte mineralization and, when constitutively expressed, blocks endochondral and intramembranous ossification in the limb.  

PubMed

Matrix GLA protein (MGP), a gamma-carboxyglutamic acid (GLA)-rich, vitamin K-dependent and apatite-binding protein, is a regulator of hypertrophic cartilage mineralization during development. However, MGP is produced by both hypertrophic and immature chondrocytes, suggesting that MGP's role in mineralization is cell stage-dependent, and that MGP may have other roles in immature cells. It is also unclear whether MGP regulates the quantity of mineral or mineral nature and quality as well. To address these issues, we determined the effects of manipulations of MGP synthesis and expression in (a) immature and hypertrophic chondrocyte cultures and (b) the chick limb bud in vivo. The two chondrocyte cultures displayed comparable levels of MGP gene expression. Yet, treatment with warfarin, a gamma-carboxylase inhibitor and vitamin K antagonist, triggered mineralization in hypertrophic but not immature cultures. Warfarin effects on mineralization were highly selective, were accompanied by no appreciable changes in MGP expression, alkaline phosphatase activity, or cell number, and were counteracted by vitamin K cotreatment. Scanning electron microscopy, x-ray microanalysis, and Fourier-transform infrared spectroscopy revealed that mineral forming in control and warfarin-treated hypertrophic cell cultures was similar and represented stoichiometric apatite. Virally driven MGP overexpression in cultured chondrocytes greatly decreased mineralization. Surprisingly, MGP overexpression in the developing limb not only inhibited cartilage mineralization, but also delayed chondrocyte maturation and blocked endochondral ossification and formation of a diaphyseal intramembranous bone collar. The results show that MGP is a powerful but developmentally regulated inhibitor of cartilage mineralization, controls mineral quantity but not type, and appears to have a previously unsuspected role in regulating chondrocyte maturation and ossification processes. PMID:10579728

Yagami, K; Suh, J Y; Enomoto-Iwamoto, M; Koyama, E; Abrams, W R; Shapiro, I M; Pacifici, M; Iwamoto, M

1999-11-29

383

Association Study of Fibroblast Growth Factor 2 and Fibroblast Growth Factor Receptors Gene Polymorphism in Korean Ossification of the Posterior Longitudinal Ligament Patients  

PubMed Central

Objective The aim of this study was to determine whether single nucleotide polymorphisms (SNPs) of fibroblast growth factor (FGF) 2 gene and fibroblast growth factor receptor (FGFR) genes are associated with ossification of the posterior longitudinal ligament (OPLL). Methods A total of 157 patients with OPLL and 222 controls were recruited for a case control association study investigating the relationship between SNPs of FGF2, FGFR1, FGFR2 and OPLL. To identify the association among polymorphisms of FGF2 gene, FGFR1, FGFR2 genes and OPLL, the authors genotyped 9 SNPs of the genes (FGF2 : rs1476217, rs308395, rs308397, and rs3747676; FGFR1 : rs13317 and rs2467531; FGFR2 : rs755793, rs1047100, and rs3135831) using direct sequencing method. SNPs data were analyzed using the SNPStats, SNPAnalyzer, Haploview, and Helixtree programs. Results Of the SNPs, a SNP (rs13317) in FGFR1 was significantly associated with the susceptibility of OPLL in the codominant (odds ratio=1.35, 95% confidence interval=1.01-1.81, p=0.048) and recessive model (odds ratio=2.00, 95% confidence interval=1.11-3.59, p=0.020). The analysis adjusted for associated condition showed that the SNP of rs1476217 (p=0.03), rs3747676 (p=0.01) polymorphisms in the FGF2 were associated with diffuse idiopathic skeletal hyperostosis (DISH) and rs1476217 (p=0.01) in the FGF2 was associated with ossification of the ligament flavum (OLF). Conclusion The results of the present study revealed that an FGFR1 SNP was significantly associated with OPLL and that a SNP in FGF2 was associated with conditions that were comorbid with OPLL (DISH and OLF).

Jun, Jae-Kyun

2012-01-01

384

Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level.  

PubMed

Our objective was to evaluate the clinical efficacy and feasibility of posterior decompression with transforaminal thoracic interbody fusion (PTTIF) for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) and ossification of the posterior longitudinal ligament (OPLL) at the same level. Between March 2004 and December 2008, 13 patients (five men and eight women, average age: 56years, range: 39-72years) who underwent PTTIF for concurrent OLF and OPLL were studied retrospectively. The clinical efficacy, operative time, blood loss, sagittal alignment and complications were investigated. Cerebrospinal fluid leakage occurred in three patients, all of whom healed well after repair. One patient developed a urinary tract infection and one developed a wound infection, but both were cured with appropriate antibiotic therapy. Neurological symptom deterioration occurred in one patient, but she returned to her preoperative baseline after completing methylprednisolone therapy. After an average 36.8months follow up, the mean Japanese Orthopaedic Association (JOA) score significantly increased from 4.3±1.3 preoperatively to 7.2±1.8 at 3months after the operation and 8.5±1.7 at the final follow-up (P<0.01), with an overall recovery rate of 63.2±21.8%. Postoperative imaging demonstrated an improvement in the local kyphosis (P<0.01), and as of the final follow up no cases of spinal instability or instrument loosening had occurred. We conclude that PTTIF provides satisfactory neurological recovery and stabilises the thoracic fusion through a single posterior approach. However, this procedure is not complication free and demands advanced technical expertise on the part of practitioners, particularly to avoid catastrophic spinal cord injuries. PMID:23313526

Liu, Fa-Jing; Chai, Yi; Shen, Yong; Xu, Jia-Xin; Du, Wei; Zhang, Peng

2013-01-11

385

Functional impact of human collagen alpha2(XI) gene polymorphism in pathogenesis of ossification of the posterior longitudinal ligament of the spine.  

PubMed

Ossification of the posterior longitudinal ligament (OPLL) of the spine is the leading cause of myelopathy in Japan. In earlier studies, we provided genetic linkage and allelic association evidence of distinct differences in the human collagen alpha2(XI) gene (COL11A2) that might constitute inherited predisposition to OPLL. In the present study, a strong allelic association with non-OPLL (p = 0.0003) was observed with an intron 6 polymorphism [intron 6 (-4A)], in which the intron 6 (-4A) allele is more frequently observed in non-OPLL subjects than in OPLL patients. In addition, a newly identified polymorphism in exon 6 [exon 6 (+28A)] was in linkage disequilibrium with the intron 6 (-4A). The functional impact of the polymorphisms was analyzed by comparing the differences in messenger RNA (mRNA) splicing by reverse-transcription polymerase chain reaction (RT-PCR) analysis in cultured cells from the interspinous ligament and an in vitro exon trapping study. The intron 6 (-4A) allele resulted in skipping exon 6 and retaining exon 7, while the exon 6 (+28A) allele was not associated with alteration in mRNA splicing. Similar mRNA species were observed in undifferentiated osteoblast (Ob) cells and in cells from posterior longitudinal ligament of non-OPLL subjects. The region containing exons 6-8 is an acidic subdomain presumably exposed to the surface that could interact with molecules of the extracellular matrix. Accordingly, retaining exon 7 together with removal of exon 6 observed in intron 6 (-4A) could play a protective role in the ectopic ossification process because the same pattern was observed in undifferentiated Ob cells and nonossified posterior longitudinal ligament cells. PMID:11341341

Maeda, S; Ishidou, Y; Koga, H; Taketomi, E; Ikari, K; Komiya, S; Takeda, J; Sakou, T; Inoue, I

2001-05-01

386

Solid Medical Waste Management in Healthcare Centers in Palestine  

Microsoft Academic Search

\\u000a This chapter discusses the current situation of solid waste management in healthcare centers in Palestine. The monthly estimated\\u000a quantity of solid waste produced by the healthcare centers in Palestine was 472.9 tons. There is very little separation of\\u000a solid waste in primary healthcare centers (38.1%) as compared to secondary healthcare centers (71%). Only 17.3% of the healthcare\\u000a centers in Palestine

Issam A. Al-Khatib; Mohamed Abu-Dayah; Hussein Hajjeh; Tayseer Al-Shanbleh

387

76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative  

Federal Register 2010, 2011, 2012, 2013

...Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare...notice announces a solicitation for health care payer organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer...

2011-10-03

388

Choosing a Transplant Center  

MedlinePLUS

... Email this page Print this page Choosing a transplant center Tweet A transplant center is a hospital ... transplant center has treated. Questions to ask the transplant center Our patient services coordinators can answer your ...

389

NCI Community Cancer Centers Program - Pilot Site Profile - St. Joseph Medical Center, Towson, Maryland  

Cancer.gov

More than 40% of the medical center's patients come from outside the primary service area, defined as a 12-mile radius of the hospital. 78% of the Cancer Institute's patients are adults over 55, and 12% are African American.

390

CHOP followed by involved field radiotherapy for localized primary gastric diffuse large B-cell lymphoma: results of a multi center phase II study and quality of life evaluation.  

PubMed

We aimed to define the role of cyclophosphamide, vincristine, doxorubicin, prednisone (CHOP) followed by involved field radiotherapy (IFRT) for treating localized primary gastric diffuse large B-cell lymphoma (DLBCL). Newly diagnosed patients with localized primary gastric DLBCL were to receive four cycles of CHOP followed by IFRT of 40.0 Gy. At 1 year after the completion of treatment, patients filled out the EORTC Quality of Life Questionnaire specified for stomach cancer (QLQ-C30-STO22). Fifty evaluable patients (25 men, 25 women) were included. The median age was 54.5 years (range, 21 - 73 years. The overall response rate to the CHOP was 94% (95% confidence interval [CI], 87 - 100) in the intent-to-treat population. Forty-one of the 50 patients (82%; 95% CI, 71 - 93) achieved complete remission (CR). After the completion of radiotherapy, five patients who were in PR following chemotherapy eventually attained CR. The overall complete response rate was thus 92% (95% confidence interval, 84 - 99). With a median follow-up period of 30 months, the 2-year progression-free and overall survival rate was 92% and 92%, respectively. The gastric function was well preserved with negligible stomach-related symptoms at 1 year after the completion of treatment. This organ-preserving combined treatment is highly effective and well tolerated for the patients with localized gastric DLBCL. PMID:16923554

Park, Yeon Hee; Lee, Se-Hoon; Kim, Won Seog; Bang, Soo-Mee; Ryoo, Baek-Yeol; Yang, Sung Hyun; Lee, Seung-Sook; Kim, Mi Sook; Kim, Kihyun; Park, Keon Woo; Im, Do Hyoung; Kang, Jung Hun; Lee, Jeeyun; Ko, Young H; Ahn, Yong Chan; Lim, Do Hoon; Park, Keunchil

2006-07-01

391

Primary aldosteronism  

Microsoft Academic Search

Primary aldosteronism (PA) is the most common cause of secondary hypertension, accounting for 10% of all hypertension. Far\\u000a from being benign, hypertension due to PA is associated with high cardiovascular morbidity and mortality. However, PA is still\\u000a underdiagnosed in general practice. Recent reports strongly recommend that identifying patients with PA is cost-beneficial\\u000a based on improved cardiovascular outcomes afforded by specific

Fumitoshi Satoh; Ryo Morimoto; Yoshitsugu Iwakura; Yoshikiyo Ono; Masataka Kudo; Kei Takase; Sadayoshi Ito

2011-01-01

392

[Primary hyperparathyroidism].  

PubMed

Primary hyperparathyroidism is a common endocrine disease. Since introduction of automated routine measurement of serum calcium the detection of primary hyperparathyroidism has increased significantly. The classical symptoms such as kidney stones, gastrointestinal and bone manifestation are rarely seen nowadays. For this reason, an elevated parathyroid hormone level in a patient with hypercalcemia confirms primary hyperparathyroidism in 95?% of cases. Currently 80?% of these patients are asymptomatic, and therefore criteria for diagnosis and treatment have been discussed on several consensus conferences. After biochemical confirmation has been obtained further diagnostic test aim at locating the tumor should be by ultrasound and 99m TC-sestamibi scintigraphy. The improved diagnostic work-up had led to a better surgical approach with minimally invasive and endoscopic techniques. In addition, quick intraoperative parathyroid hormone measurements confirm immediately the success of surgical treatment. Non-surgical treatment in asymptomatic and elderly patients may be justified. Bisphosphonates are the first choice for medical treatment in patients with bone manifestation and cinacalcet may be given to patients to lower calcium and parathyroid hormone levels. PMID:20925010

Ventz, Marcus; Quinkler, M

2010-10-05

393

Mid-America Earthquake Center  

NSDL National Science Digital Library

Understanding earthquakes is a complex process, and the Mid-Americ Earthquake Center is one of three national earthquake engineering research centers set up to work on a variety of approaches to a broad set of related scientific concerns. Based at the University of Illinois at Urbana-Champaign, the Center consists of a consortium of nine core institutions and is funded by the National Science Foundation. The Center's primary work is within four areas, including information technology and consequence-based risk management frameworks. Recognizing that they serve a broad range of visitors to their website, the Center has established a number of informative introductions on their homepage for the general public, potential industry partners, members of the press, and K-12 educators. While a number of visitors may be interested in their technical reports and software packages, most visitors will want to look over the graduate and undergraduate teaching modules, which will be of great use to educators in the engineering and geophysical sciences and their students. Additionally, the Center's site provides access to a number of informative webcasts, including presentations on seismic performances of bridges.

394

Mechanisms of organogenesis of primary lymphoid follicles  

Microsoft Academic Search

Primary lymphoid follicles in secondary lymphoid tissue of mammals are the backbone for the formation of follicular dendritic cell networks. These are important for germinal center reactions. In the context of organogenesis molecular requirements for the formation of follicles have been identified. The present study complements this work with a simulation of the dynamics of the primary lymphoid follicle formation.

Tilo Beyer; Michael Meyer-Hermann

2006-01-01

395

Primary Vesicoureteral Reflux in Iranian Children  

Microsoft Academic Search

Background: Experience with vesicoureteral reflux (VUR) differs in different centers and there are plenty of controversies. Objective: The aim of this study was to evaluate the outcome of primary VUR complications and the rate of recurrence of UTI. Methods: The medical charts of all infants and children with primary VUR who were followed up by two nephrologist were reviewed. During

Fateme Ghane Sharbaf; Mohamad Hosein Fallahzadeh; Ali Reza Modarresi; Mohamad Esmaeili

396

Higher Education Center for Alcohol and Other Drug Prevention.  

ERIC Educational Resources Information Center

This brochure describes the mission, approach, and services of the Higher Education Center for Alcohol and Other Drug Prevention. The Center is the nation's primary resource center for assisting higher education institutions in the development, implementation, and evaluation of alcohol and drug violence prevention policies and programs that…

Higher Education Center for Alcohol and Other Drug Prevention, Newton, MA.

397

Primary processes and structure of the photosystem II reaction center. 5. Modeling of the fluorescence kinetics of the D{sub 1}-D{sub 2}-cyt-b{sub 559} complex at 77 K  

SciTech Connect

The fluorescence kinetics of the photosystem II reaction center (D{sub 1}-D{sub 2}-cyt-b{sub 559} complex, PSII-RC) at a temperature of 77 K has been analyzed. A kinetic model is presented that takes into account the inhomogeneous broadening of the pigment spectra and the heterogeneity in the pigment composition of the sample. This work is based on the spectral analysis that was presented in a recent study to describe the absorption properties of the PSII-RC. For the kinetic model, the Foerster theory was applied to calculated the rate constants for pairwise energy transfer. Due to the inhomogeneous broadening of the spectra the energy transfer rates show a pronounced dispersion which has severe consequences for the excited state kinetics. We tested different models for radical pair formation and recombination to describe the data. Only with a model that includes several sequential radical pairs we could obtain acceptable agreement with the experimental fluorescence kinetics. A model with a static Gaussian distribution for the free energy difference of charge separation did not fit the data. The occurrence of sequential radical pair states is interpreted as a dynamic relaxation process of the protein surrounding triggered by the sudden creation of a pair of ions. The temperature dependence of the stationary fluorescence quantum yield and the temperature dependence of the stationary spectrum, as well as other experimental data predicted by the kinetic model, is in good agreement with experimental results. 73 refs., 11 figs., 3 tabs.

Konermann, L.; Gatzen, G.; Holzwarth, A.R. [Max-Planck-Institut fuer Strahlenchemie, Ruhr (Germany)

1997-04-10

398

Protein-Cofactor Interactions in Bacterial Reaction Centers from Rhodobacter sphaeroides R-26: I. Identification of the ENDOR Lines Associated with the Hydrogen Bonds to the Primary Quinone QA??  

PubMed Central

Hydrogen bonds are important in determining the structure and function of biomolecules. Of particular interest are hydrogen bonds to quinones, which play an important role in the bioenergetics of respiration and photosynthesis. In this work we investigated the hydrogen bonds to the two carbonyl oxygens of the semiquinone \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{Q}}_{{\\mathrm{A}}}^{{\\cdot}-}\\end{equation*}\\end{document} in the well-characterized reaction center from the photosynthetic bacterium Rhodobacter sphaeroides R-26. We used electron paramagnetic resonance and electron nuclear double resonance techniques at 35 GHz at a temperature of 80 K. The goal of this study was to identify and assign sets of 1H-ENDOR lines to protons hydrogen bonded to each of the two oxygens. This was accomplished by preferentially exchanging the hydrogen bond on one of the oxygens with deuterium while concomitantly monitoring the changes in the amplitudes of the 1H-ENDOR lines. The preferential deuteration of one of the oxygens was made possible by the different 1H ? 2H exchange times of the protons bonded to the two oxygens. The assignment of the 1H-ENDOR lines sets the stage for the determination of the geometries of the H-bonds by a detailed field selection ENDOR study to be presented in a future article.

Flores, M.; Isaacson, R.; Abresch, E.; Calvo, R.; Lubitz, W.; Feher, G.

2006-01-01

399

Primary, secondary, and emotional control across adulthood  

Microsoft Academic Search

Schulz and Heckhausen (1996) have recently formulated a theory of successful aging that centers on perceptions of control\\u000a as a major theme in the developmental process. They suggest primary control is a universal phenomenon and that people will\\u000a strive for primary control over secondary control. Secondary control mechanisms, on the other hand, may serve to mediate losses\\u000a in primary control.

Jasmin Tahmaseb McConatha; Haley M. Huba

1999-01-01

400

Hyperthyroidism (primary)  

PubMed Central

Introduction Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for primary hyperthyroidism? What are the effects of surgical treatments for primary hyperthyroidism? What are the effects of treatments for subclinical hyperthyroidism? We searched: Medline, Embase, The Cochrane Library and other important databases up to June 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 14 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding thyroxine to antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), radioactive iodine, and thyroidectomy.

2008-01-01

401

Hyperthyroidism (primary)  

PubMed Central

Introduction Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for primary hyperthyroidism? What are the effects of surgical treatments for primary hyperthyroidism? What are the effects of treatments for subclinical hyperthyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 15 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding thyroxine to antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), radioactive iodine, and thyroidectomy.

2010-01-01

402

Goddard Space Flight Center- Visitor Center  

NSDL National Science Digital Library

The homepage of the Visitor Center at Goddard Space Flight Center provides access to a variety of information about the history, missions, and upcoming events at the center. Users can find information on public exhibits, educational resources, and programs on space and Earth science and technology.

403

Center for International Development at Harvard University  

NSDL National Science Digital Library

Established in 1998 by the Harvard Institute for International Development and the Kennedy School of Government, the Center for International Development (CID) is Harvard's primary center for research on sustainable international development. The CID is currently headed by Professor Dani Rodrik, who provides oversight and direction for the Center. On the site, visitors can learn about upcoming international development conferences sponsored by the Center, read about the various persons working at the Center, learn about various research programs, along with reading various reports associated with each area of inquiry. The site also contains a host of links to online research data sets for persons working in the field of international development, and to the Center's working papers and special reports. Some of the more compelling working papers address the situation of sustainable development in sub-Saharan Africa and the rise and fall of the Indonesian economy.

404

Georgia's Residential Restitution Centers.  

National Technical Information Service (NTIS)

The experience and potential of Georgia's program of residential restitution centers is reviewed. The Georgia centers are offender-focused rather than victim-focused, thus differing from state victim compensation programs. Ten centers serve designated jud...