A planimetric study of therapy-dependent development of temporal bone pneumatization in secretory otitis media

The present study is based on the results of a planimetric investigation of temporal bone pneumatization in 43 children. Radiological and clinical follow-up studies 10 years after therapy for secretory otitis media indicate an adaptation in the size of pneumatization to an almost normal area. The increase shows that a myringotomy is sufficient in cases of serous effusion, whereas a mucous fluid requires long-term middle ear ventilation. Received: 5 August 1999 / Accepted: 3 December 1999     

Cadmium in kidneys in Swedes measured in vivo using X-ray fluorescence analysis

An X-ray fluorescence (XRF) technique using plane polarized X-rays for excitation was used for in vivo measurements of cadmium in the kidney cortex among non-occupationally exposed members of the general population in southern Sweden. The measured concentrations of cadmium in the kidney cortex of smokers (median 28 g/g, n = 10) were significantly higher (P = 0.0036) as compared to those in non-smokers (median 8 g/g, n = 10), and so were the cadmium concentrations in blood and urine. The results show that smoking considerably increases the cadmium concentration in the kidney cortex and that smoking is a major source of cadmium exposure in the general population of Sweden. Except in the presence of very deeply situated kidneys, where the minimum detectable concentration is high, non-invasive in vivo XRF analysis of kidney cadmium should be a useful tool for evaluating the effects of long-term low-level exposure to cadmium and the risk of kidney damage.     

Doppler flow velocity measurements in patients with intracranial hypertension

Summary In patients with severe brain lesions monitoring of the intracranial pressure as well as monitoring of cerebral blood flow can be of clinical value. While at the moment there is no atraumatic method for measuring cerebral blood flow in man, it is recommended to measure blood flow velocity with the ultrasound Doppler technic in the common carotid artery. On theoretical grounds a positive correlation between cerebral blood flow and blood flow velocity can be expected and the observations presented show that such a correlation exists in normal controls and in neurological patients. In many neurological patients the flow velocity in the common carotid artery decreases with increasing intracranial pressure. This suggests that the autoregulation is disturbed. The demonstration of such a disturbance can have clinical implications.

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Zusammenfassung Bei Patienten mit ernsten Läsionen im Gehirn kann Monitoring von sowohl intercraniellem Druck als auch der zerebralen Blutdurchströmung für die Klinik von Bedeutung sein. Da im Moment keine atraumatische Methode für die Messung der zerebralen Blutdurchströmung besteht, wird anempfohlen, die Durchströmungsgeschwindigkeit mit der Ultraschall-Doppler-Technik in der Arteria carotis communis zu messen. Theoretisch kann eine positive Korrelation zwischen der zerebralen Blutdurchströmung und der Strömungsgeschwindigkeit erwartet werden.Die beschriebenen Ergebnisse zeigen, daß tatsächlich ein solcher Zusammenhang besteht, sowohl bei gesunden Versuchspersonen als auch bei neurologischen Patienten.Bei vielen dieser Patienten nimmt die Durchströmungsgeschwindigkeit in der Arteria carotis communis ab bei einer Zunahme des intracraniellen Druckes. Dies suggeriert eine gestörte Autoregulation. Das Aufzeigen einer solchen Störung kann klinische Bedeutung haben.

     

Cyclical Etidronate Therapy for Prevention of Postmenopausal Bone Loss: A 1-Year Open-Label Follow-Up Study

The objective of this study was to evaluate whether the pharmacological activity of cyclical etidronate therapy is sustained beyond the dosing period. A group of 121 postmenopausal women who had completed a 2-year, double-blind, placebo-controlled parallel study with etidronate or placebo (400 mg/day for 14 days every 3 months) and calcium agreed to participate in a 1-year open-label follow-up study to evaluate the effect of discontinuing etidronate treatment. Fifty-nine subjects in the former etidronate group and 62 in the placebo group received 500 mg/day of elemental calcium; 54/59 and 58/62 subjects, respectively, completed the study. Outcomes of the study were bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DXA), and biochemical markers of bone turnover (urinary deoxypyridinoline/creatinine and serum osteocalcin). To determine whether there was a residual effect of previous therapy we compared mean percentage changes from baseline (year 0) to year 3 for both spinal and femoral neck BMD and markers of bone turnover in the former cyclical etidronate and placebo groups. To evaluate the carryover effect of treatment we compared the percent change from year 2 to year 3 for the same variables. Mean percentage change (SEM) from year 2 to year 3 for spinal BMD in the former cyclical etidronate group was −2.87% (0.48%) versus −0.99% (0.36%) in the placebo group (P= 0.0022). In the femoral neck, the BMD changes were −0.86% (0.42%) versus −1.01% (0.41%) (NS). Biochemical markers increased within 6 months toward baseline levels. Mean percentage changes from baseline (year 0) in both spinal and femoral neck BMD were significantly different between groups 1 year after treatment discontinuation. No differences between groups were maintained in deoxypyridinoline and osteocalcin. It is concluded that following withdrawal of cyclical etidronate therapy bone loss resumes at a normal and moderately accelerated rate in the proximal femur and lumbar spine, respectively. A positive effect on BMD at both cortical and trabecular sites is maintained for 1 year after treatment withdrawal. Received: 8 May 1999 / Accepted: 10 December 1999     

肺癌合并中重度COPD的外科治疗

为探讨肺癌合并中 -重度COPD手术前后肺功能的变化与处理措施。 14例患者 ,经综合治疗肺功能改善后行肺叶切除术 6例 ,肺段切除术 5例 ,肺楔形切除加肺减容术 3例。术后 9例给予机械辅助通气 ,15d后定期复查肺功能 ,围手术期针对性给予抗感染、化痰、解痉、平喘、吸氧及呼吸物理学治疗。结果 :术前肺功能经治疗MVV(L)由3 6 18± 3 74增至 40 76± 4 67,FEV1 0 (L)由 0 89± 0 11增至 1 0 4± 0 13 ,P均 <0 0 1,FVC(L)由 1 44± 0 2 1增至 1 65± 0 2 8,P <0 0 5。术后 1例死亡 ,手术成活率为 92 86% ( 13 /14 )。术后 15d肺功能复查 ,MVV下降至 3 5 3 4± 3 98,FEV1 0 降至 0 82± 0 10 ,P均 <0 0 1;FVC降至 1 3 9± 0 2 0 ,P <0 0 5。 3 0d时MVV为 3 7 0 1± 4 2 4、FEV1 0 为 0 93±0 13、FVC为 1 43± 0 2 2 ,P均 <0 0 5 ;均低于术前水平。恢复至 3个月时 3项指标分别为 42 0 8± 3 62、1 12± 0 13和1 63± 0 2 7,P均 >0 0 5 ;均已达术前水平。 6个月后MVV和FEV1 0 各为 5 90± 4 12和 1 2 1± 0 19,P <0 0 5 ;较术前有所改善 ,而FVC为 1 76± 0 2 8,较术前差异无统计学意义 ,P >0 0 5。     

Performance of Hearing Aids with an Induction Loop Amplification System: Laboratory Versus Classroom Setting

This study was designed to investigate the acoustic response of ten body-type hearing aids when used with an induction loop amplification (ILA) system in the laboratory and in the actual classroom setting. Undesirable frequency response characteristics were discovered in the classroom ILA system used in this study. These consist of a slightly poorer low-frequency response and a deep notch at about 2 500 Hz. Had the frequency response of the classroom ILA system been flat, differences between laboratory and classroom measures would have been minimized. Findings of this study support the practicality of measurement in the classroom of the operating characteristics of ILA systems     

Comparison of numerical calculations with phantom experiments and clinical measurements

Three-dimensional models, while fundamentally desirable in hyperthermia treatment simulation, are only beginning to emerge and may take a number of years to perfect for routine clinical use. Two dimensional calculations, on the other hand, can be efficiently performed on today's inexpensive computer workstations; however, the accuracy of two-dimensional models in the pretreatment planning context is questionable. This paper investigates the ability of a general two-dimensional finite element model to predict power deposition patterns in phantoms and temperature distributions during actual clinical treatments. The experiments and simulations have been performed for an annular phased array (APA) operating at 70 MHz. Comparisons between model predictions and measurements show that quantitative agreement occurs in phantoms containing moderate complexities in heterogeneity, but that only qualitative agreement appears possible in clinical treatments. However, the results suggest that the lack of blood flow information may contribute as much, if not more, to the uncertainties in the clinical predictions than the two-dimensional nature of the model itself.     

Bayesian Biostatistics,by Emmanuel Lesaffre and Andrew B. Lawson,John Wiley & Sons, 2012

In nondesigned longitudinal observational studies, irregularly spaced measurements are commonly present over a period of follow-up time. We propose a smoothing dynamic model, based on the idea of varying coefficients, to analyze this highly unbalanced longitudinal data. The estimate of model parameters can be obtained by implementing a well-developed B-splines technique. Our method is illustrated with data from a primary care based longitudinal cohort of rheumatoid arthritis patients. The results show that the effects of some risk factors might be underestimated by an intention-to-treat analysis using a last-value-carried-forward method.     

Associations between Poor Sleep Quality,Obesity, and the Anthropometric Measurements of Women in Turkey

Recent studies have shown that poor sleep quality is significantly associated with obesity. The aim of this study is to examine the association of sleep quality with obesity and specific anthropometric measurements. A total of 105 women aged 20–55 years with no chronic diseases participated in this study. They filled out the Pittsburgh Sleep Quality Index (PSQI), their anthropometric measurements were taken, and their dietary data were collected with a food frequency questionnaire (FFQ). There was no significant relationship between sleep quality and BMI, waist circumference, triceps skinfold thicknesses, body fat ratio (%), and body fat mass (p > .05), but high bread consumption was significantly associated with poor sleep quality (p < .05). The women with poor sleep quality consumed significantly more bread, but not other foods, than the women with good sleep quality. Sleep quality can thus be related to eating habits.