Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 7 Articles
Traditionally, circadian clocks have been thought of as a neurobiological phenomenon. This view changed somewhat over\r\nrecent years with the discovery of peripheral tissue circadian oscillators. In mammals, however, the suprachiasmatic nucleus\r\n(SCN) in the hypothalamus still retains the critical role of a central synchronizer of biological timing. Zebrafish, in contrast,\r\nhave always reflected a more highly decentralized level of clock organization, as individual cells and tissues contain directly\r\nlight responsive circadian pacemakers. As a consequence, clock function in the zebrafish brain has remained largely\r\nunexplored, and the precise organization of rhythmic and light-sensitive neurons within the brain is unknown. To address\r\nthis issue, we used the period3 (per3)-luciferase transgenic zebrafish to confirm that multiple brain regions contain\r\nendogenous circadian oscillators that are directly light responsive. In addition, in situ hybridization revealed localised neural\r\nexpression of several rhythmic and light responsive clock genes, including per3, cryptochrome1a (cry1a) and per2. Adult\r\nbrain nuclei showing significant clock gene expression include the teleost equivalent of the SCN, as well as numerous\r\nhypothalamic nuclei, the periventricular grey zone (PGZ) of the optic tectum, and granular cells of the rhombencephalon. To\r\nfurther investigate the light sensitive properties of neurons, expression of c-fos, a marker for neuronal activity, was\r\nexamined. c-fos mRNA was upregulated in response to changing light conditions in different nuclei within the zebrafish\r\nbrain. Furthermore, under constant dark (DD) conditions, c-fos shows a significant circadian oscillation. Taken together,\r\nthese results show that there are numerous areas of the zebrafish central nervous system, which contain deep brain\r\nphotoreceptors and directly light-entrainable circadian pacemakers. However, there are also multiple brain nuclei, which\r\npossess neither, demonstrating a degree of pacemaker complexity that was not previously appreciated....
Objective: Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that\r\nrequires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR\r\nafter HoLEP.\r\nMaterials and Methods: 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between\r\nJuly 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after\r\nsurgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal.\r\nDemographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR;\r\nn = 299) groups.\r\nResults: The mean age of patients was 68.3 (66.5) years and the mean operative time was 75.3 (637.4) min. Thirty seven\r\npatients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (61.7) days after UR.\r\nWith regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related\r\nUR respectively. Using multivariate analysis (p,0.05), we found significant differences between the UR and the non-UR\r\ngroups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498ââ?¬â??0.988) and a bleeding-related complication, such as,\r\na reoperation for bleeding (OR 0.039, 95% CI 0.004ââ?¬â??0.383) or a transfusion (OR 0.144, 95% CI 0.027ââ?¬â??0.877). Age, history of\r\ndiabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time\r\nwere not significantly associated with the UR (p.0.05).\r\nConclusions: De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age,\r\ndiabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease\r\nthe risk of UR after HoLEP....
Background: Millions of people rely on N95 filtering facepiece respirators to reduce the risk of airborne particles and\r\nprevent them from respiratory infections. However, there are no respirator fit testing and training regulations in China.\r\nMeanwhile, no study has been conducted to investigate the fit of various respirators. The objective of this study was to\r\ninvestigate whether people obtained adequate fit when wearing N95 filtering facepiece respirators (FFRs) used widely in\r\nChina.\r\nMethods: Fifty adult participants selected using the Chinese respirator fit test panel donned 10 common models of N95\r\nFFRs. Fit factors (FF) and inward leakage were measured using the TSI PortaCount Plus. Each subject was tested with three\r\nreplications for each model. A subject was considered to pass the fit test when at least two of the three FFs were greater\r\nthan 100. Two models were conducted fit tests before and after training to assess the role of training.\r\nResults: The geometric mean FFs for each model and trained subjects ranged from ,10 to 74.0. The fifth percentile FFs for\r\nonly two individual respirator models were greater than 10 which is the expected level of performance for FFRs. The passing\r\nrates for these two models of FFRs were 44.7% and 20.0%. The passing rates were less than 10.0% for the other eight\r\nmodels. There were 27 (54%) participants who passed none of the 10 FFRs. The geometric mean FFs for both models when\r\nthe subjects received training (49.7 and 74.0) were significantly larger than those when the same group of subjects did not\r\nreceive any training (29.0 and 30.9) (P,0.05).\r\nConclusions: FFRs used widely in China should be improved according to Chinese facial dimensions. Respirator users could\r\nbenefit from respirator training and fit testing before using respirators...
Background: In developing countries hip osteoarthritis constitutes a major public health issue as it is highly prevalent in all\r\nage ranges of population, including the young. It often remains untreated because of the low accessibility of total hip\r\nprostheses. Hip arthrodesis still represents a major treatment option, but, for several reasons which are discussed in this\r\npaper, is nowadays infrequently performed. By means of reporting the results of a new simple technique, using a selfdevised\r\nplate, the relevancy of hip arthrodesis in this particular environment is emphasized.\r\nMethods and Findings: Our series included 35 patients with painful hip osteoarthritis who underwent a hip fusion with the\r\nanterolateral arthrodesis plate. Two of them had a concurrent femoral osteotomy for correction of a vicious position of the\r\nlimb and another patient had a femoral diaphysis osteotomy and placement of a Wagner elongating device in order to\r\nproceed with a limb lengthening by callotasis. The follow-up period averaged 16,9 months (9 to 34). All hips, except two,\r\nachieved solid fusion between 6 and 15 months after surgery. One failure of fusion was in the oldest patient, who presented\r\na loosening of plate and screws due to an advanced degree of osteoporosis; the other was in a young patient who admitted\r\nhaving walked on his leg too soon. Patient satisfaction was high. We concluded that this technique is reliable and effective.\r\nConclusions: The results of this study should convince the hesitant surgeon and patient to consider hip arthrodesis an\r\nacceptable treatment option for disabling hip arthritis, compared to no treatment at all....
Glucose mobilization and utilization in the periphery and central nervous system are important during exercise and are\r\nresponsible for exercise efficacy. Magnesium (Mg) is involved in energy production and plays a role in exercise performance.\r\nThis study aimed to explore the effects of Mg on the dynamic changes in glucose and lactate levels in the muscle, blood and\r\nbrain of exercising rats using a combination of auto-blood sampling and microdialysis. Sprague-Dawley rats were pretreated\r\nwith saline or magnesium sulfate (MgSO4, 90 mg/kg, i.p.) 30 min before treadmill exercise (20 m/min for 60 min). Our\r\nresults indicated that the muscle, blood, and brain glucose levels immediately increased during exercise, and then gradually\r\ndecreased to near basal levels in the recovery periods of both groups. These glucose levels were significantly enhanced to\r\napproximately two-fold (P,0.05) in the Mg group. Lactate levels in the muscle, blood, and brain rapidly and significantly\r\nincreased in both groups during exercise, and brain lactate levels in the Mg group further elevated (P,0.05) than those in\r\nthe control group during exercise. Lactate levels significantly decreased after exercise in both groups. In conclusion, Mg\r\nenhanced glucose availability in the peripheral and central systems, and increased lactate clearance in the muscle during\r\nexercise....
Assistive devices, like exoskeletons or orthoses, often make use of physiological data that allow the detection or prediction\r\nof movement onset. Movement onset can be detected at the executing site, the skeletal muscles, as by means of\r\nelectromyography. Movement intention can be detected by the analysis of brain activity, recorded by, e.g.,\r\nelectroencephalography, or in the behavior of the subject by, e.g., eye movement analysis. These different approaches\r\ncan be used depending on the kind of neuromuscular disorder, state of therapy or assistive device. In this work we\r\nconducted experiments with healthy subjects while performing self-initiated and self-paced arm movements. While other\r\nstudies showed that multimodal signal analysis can improve the performance of predictions, we show that a sensible\r\ncombination of electroencephalographic and electromyographic data can potentially improve the adaptability of assistive\r\ntechnical devices with respect to the individual demands of, e.g., early and late stages in rehabilitation therapy. In earlier\r\nstages for patients with weak muscle or motor related brain activity it is important to achieve high positive detection rates\r\nto support self-initiated movements. To detect most movement intentions from electroencephalographic or\r\nelectromyographic data motivates a patient and can enhance her/his progress in rehabilitation. In a later stage for\r\npatients with stronger muscle or brain activity, reliable movement prediction is more important to encourage patients to\r\nbehave more accurately and to invest more effort in the task. Further, the false detection rate needs to be reduced. We\r\npropose that both types of physiological data can be used in an and combination, where both signals must be detected to\r\ndrive a movement. By this approach the behavior of the patient during later therapy can be controlled better and false\r\npositive detections, which can be very annoying for patients who are further advanced in rehabilitation, can be avoided....
Background: Confirmation of diabetic sensorimotor polyneuropathy (DSP) relies on standard nerve conduction studies\r\n(NCS) performed in specialized clinics. We explored the utility of a point-of-care device (POCD) for DSP detection by\r\nnontechnical personnel and a validation of diagnostic thresholds with those observed in a normative database.\r\nResearch Design and Methods: 44 subjects with type 1 and type 2 diabetes underwent standard NCS (reference method).\r\nTwo nontechnical examiners measured sural nerve amplitude potential (SNAP) and conduction velocity (SNCV) using the\r\nPOCD. Reliability was determined by intraclass correlation coefficients (ICC [2,1]). Validity was determined by Bland-Altman\r\nanalysis and receiver operating characteristic curves.\r\nResults: The 44 subjects (50% female) with mean age 56618 years had mean SNAP and SNCV of 8.068.6 mV and\r\n41.568.2 m/s using standard NCS and 8.068.2 mV and 49.9611.1 m/s using the POCD. Intrarater reproducibility ICC values\r\nwere 0.97 for SNAP and 0.94 for SNCV while interrater reproducibility values were 0.83 and 0.79, respectively. Mean bias of\r\nthe POCD was 20.163.6 mV for SNAP and +8.466.4 m/s for SNCV. A SNAP of #6 mV had 88% sensitivity and 94% specificity\r\nfor identifying age-and height-standardized reference NCS values, while a SNCV of #48 m/s had 94% specificity and 82%\r\nsensitivity. Abnormality in one or more of these thresholds was associated with 95% sensitivity and 71% specificity for\r\nidentification of DSP according to electrophysiological criteria.\r\nConclusions: The POCD demonstrated excellent reliability and acceptable accuracy. Threshold values for DSP identification\r\nvalidated those of published POCD normative values. We emphasize the presence of measurement bias ââ?¬â?? particularly for\r\nSNCV ââ?¬â?? that requires adjustment of threshold values to reflect those of standard NCS....
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