Applicability of ELISA detection of statherin for forensic identification of saliva

Statherin is a low molecular-weight phosphoprotein secreted from the parotid gland. Statherin mRNA was previously reported to be a useful marker for mRNA-based saliva identification. In this study, applicability of ELISA detection of statherin for forensic identification of saliva was investigated. The specificity and sensitivity of ELISA for detection of statherin were compared with those of ELISA for α-amylase and the Phadebas® amylase test. Statherin was specifically detected in saliva but not in other body fluids. In addition, statherin was successfully detected in aged saliva stains, mixed body fluids–saliva stains, and simulated casework samples. On the other hand, although ELISA for α-amylase showed higher sensitivity than ELISA for statherin, it was not specific enough to identify saliva. The Phadebas® amylase test also showed positive results in other body fluids that are known to have α-amylase activity; however, it is easy to use for screening forensic casework samples. In conclusion, ELISA for detection of statherin developed in this study could be an effective tool for the forensic identification of saliva because of its specificity for saliva among other body fluids. Forensic casework samples should be tested by ELISA detection or mRNA-based analysis for statherin, depending on the condition of the sample, to supplement presumptive tests for α-amylase, such as the Phadebas® amylase test.     

犬的动脉导管未闭模型建立失败总结

目的 为了更好地开展动脉导管未闭动物模型建立工作，对实验中失败的11条模型犬进行总结分析。方法 回顾性总结实验总例数40条模型犬中11条模型失败的原因。结果 11条模型犬中麻醉失败3条，手术失败5条，围手术期处理不当失败2条，原因不明死亡1条。结论 动物模型建立与人的手术操作一样，随着操作的熟练和程序化，动脉导管未闭的犬模型建立的成功率也将随之提高。     

Results of medical selection of drivers and candidates for drivers of motor vehicles

The aim of this study is the analysis of medical selection of drivers and candidates for car drivers. The examination included 41,561 drivers (36,008 candidates for car drivers sent to preliminary medical examination, 5,175 professional drivers sent to periodic medical examination and 378 drivers sent to special medical examination). At the preliminary medical examination, 1.5% of candidates for car drivers were declared to be incapable of driving and 8.4% of candidates had a limited driving ability. At the periodic medical examination, 8.2% of drivers were declared to be incapable to driving and 26% of drivers had a limited driving ability. At the special medical examination, 34.9% of drivers were declared to be incapable for driving and 54.3% of drivers had a limited driving ability. The reasons for driving incapability and for limited driving ability were the disturbances of psychologic-psychiatric and neurologic state, cardiovascular diseases, endocrine diseases and sight disturbances. In our opinion, medical selection of drivers and candidates for car drivers is a significant preventive measure of traffic trauma. New, more subtle methods for determination of the latent disturbances must be developed. Periodic medical examination for amateurs in the period between the preliminary medical examination and 65 years of age must biobligatory.     

Literature review of the subject of a research project

It can be very complicated to obtain relevant information through searching the medical literature if you do not know how it is organized and indexed or if you do not know how to use the specialized databases. For a successful review of the literature, you need to know what you are looking for and the key words for an effective search of the specialized databases and libraries and especially of the internet. It is essential to critically evaluate the information selected. Finally, using a reference manager can facilitate the gathering, organization, systematization, and integration of the bibliographic references in the documents generated in the study. This article aims to provide guidelines for efficient searching for information and for accurate, critical use of the literature. It makes recommendations about strategies for managing references to help to ensure the success of a research project.     

Conformation radiotherapy of carcinoma of the prostate]

During the period from 1975 to 1989, 84 patients with carcinoma of the prostate were treated with conformation radiotherapy at Tokyo Metropolitan Komagome Hospital. The radiation field encompassed only the area of the prostate gland; it did not include the pelvic lymph nodes. The clinical stage of the 84 tumors was 22 in Stage A, 31 in Stage B, 15 in Stage C and 16 in Stage D. The average age of patients was 73.4 years, with range of 54 to 88 years. The average dose to the tumor was 65.7 Gy, with range of 60 Gy to 70 Gy. Hormone therapy was applied to 42 cases. The 5- and 10-year cumulative survival rates were 90.7% and 70.5% for Stage A, 41.7% and 26.7% for Stage B, 48.9% and 48.9% for Stage C, and 32.6% and 0% for Stage D, respectively. The 5-year cause-specific cumulative survival rates were 100% for Stage A, 92.3% for Stage B, 65.0% for Stage C and 40.3% for Stage D, respectively. Patients with poorly differentiated adenocarcinomas or undifferentiated carcinomas showed poorer survival than those with well-differentiated carcinoma. Only 7 cases suffered in-field recurrence, and 2 cases suffered recurrence at pelvic lymph nodes. Acute reactions were noted in 13 cases. Late complications following treatment were acceptable. Mild to moderate complications were recognized in 2 cases, but neither patient required surgery. In conclusion, our data suggest the advantage of the conformation technique applied to radiation therapy for carcinoma of the prostate.     

Use of radiographic projections of knee

A study of determine the routine radiography practice for the investigation of acute trauma cases and those with suspected arthritis of the knee was carried out by questionnaires sent to radiologists in 41 countries. The role of radiology in the investigation of chondromalacia patellae was also ascertained. Some of the reasons for the diversities of practice are discussed.The necessity for further views of the knee to supplement the two standard projections was assessed for various diagnostic entities. It became clear that if occult fractures were not to be missed, patients with knee effusions following acute trauma required additional views if a lesion was not shown by the anteroposterior (AP) and lateral views. In contrast, two views of the knee sufficed for examination of most entities affecting the knee.     

Implications of a new case law on the Deprivation of Liberty Safeguards

The Deprivation of Liberty Safeguards (DOLS), introduced into the Mental Capacity Act 2005 (MCA), were implemented in April 2009. Recent case law established several principles: the Mental Health Act (MHA) has primacy over the MCA and it is not appropriate for professionals to pick and choose which Act to use; the eligibility assessors for DOLS need to consider whether a hospital would detain the patient under the MHA. The eligibility assessors for DOLS need to apply a 'but for' test, whereby consideration would need to be given to the need for detention in hospital if it were not for the physical illness, and if the only reason for detention in hospital was the need for treatment of the physical disorder then detention under DOLS would be appropriate. This judgement clarifies that individuals with mental disorders who only require treatment in hospital for physical disorders should be detained under DOLS. The implications of this judgement are discussed in this paper.     

Accuracy of stable xenon/CT measurements of regional cerebral blood flow: effect of extrapolated estimates of brain-blood partition coefficients

Stable xenon/computed tomographic (Xe/CT) measurements of regional brain-blood partition coefficients for xenon (lambda) and of regional cerebral blood flow (rCBF) have been reported for animal models of stroke and for patients with a variety of neurological diseases. We estimated the uncertainty in reported measurements of lambda and rCBF using computer simulations based on Kety's blood flow equation. Anesthetized baboons were scanned repeatedly for 30-60 min while inhaling an 80:20% xenon-oxygen mixture, and the resulting CT enhancement values for user-defined regions of interest were used to define a mathematical function with which to fit simulated CT enhancement data. In computer simulation studies, extrapolated and fit values of lambda for the same dataset were used to calculate rCBF, and the calculated flow values were compared. Computer simulations for heterogeneous (gray-white matter) regions indicate that better estimates of flow are obtained by fitting lambda than by using extrapolated values of lambda to calculate flow, although, paradoxically, better estimates of lambda are obtained by extrapolation than by fitting lambda.     

Effect of field of view on MR diagnosis of rotator cuff tears

Purpose. To determine the effect of decreasing the field of view (FOV) on the accuracy of MR for diagnosing rotator cuff tears. Material and methods. One hundred shoulder MR scans with surgical correlation were evaluated for the presence or absence of a cuff tear. The sensitivity and specificity of MR relative to the surgical results were determined for the 59 patients scanned with a 24-cm FOV, and the 41 patients scanned with an 18-cm FOV. All other imaging parameters including acquisition time were identical. The sensitivity and specificity of the two groups were compared using a t-test. Results. The specificity of MR for diagnosing a rotator cuff tear improved from 0.65 for the 24-cm FOV group to 0.89 for the 18-cm FOV group (P = 0.04). The sensitivity changed from 0.91 to 0.96 (P = 0.25). Conclusion. Reducing the FOV from 24 cm to 18 cm results in a statistically significant improvement in specificity of MR for diagnosing rotator cuff tears.     

Validation of the Children's OMNI-Resistance Exercise Scale of perceived exertion

PURPOSE: This investigation examined concurrent validity of the Children's OMNI-Resistance Exercise Scale (OMNI-RES) of perceived exertion for 10- to 14-yr-old females (N = 25) and males (N = 25) performing unilateral biceps curl (BC) and knee extension (KE) isotonic exercises. METHODS: The criterion variable was total weight lifted (Wt(tot)), determined separately for females and males during BC and KE. Subjects performed three separate sets of 6, 10, and 14 repetitions for BC and KE at 50% 1-RM. Ratings of perceived exertion for the active muscles (RPE-AM) and overall body (RPE-Overall) were measured during the final repetition. RESULTS: For both female and male groups across the three sets: (a) RPE-AM ranged from 2.9 to 8.3 for BC and 4.5 to 9.6 for KE, and (b) RPE-O ranged from 1.9 to 7.0 for BC and 3.6 to 7.7 for KE. Positive linear regression coefficients ranged from r = 0.72 to 0.88 (P < 0.01) between Wt(tot) and RPE-AM and RPE-Overall for BC and KE in both gender groupings. RPE did not differ between females and males at any measurement point within each set for BC and KE. RPE-AM was greater (P < 0.01) than RPE-Overall in the three sets of BC and KE. CONCLUSION: Findings provided concurrent validation of the Children's OMNI-RES to measure RPE for the active muscle and overall body in 10- to 14-yr-old females and males performing upper and lower body resistance exercise.     

Effects of storage conditions of human whole blood on the viability of lymphocytes

PURPOSE: To investigate the optimal storage conditions of human whole blood to retain viability of lymphocytes. MATERIAL AND METHODS: Phytohaemagglutinin (PHA) stimulated and unstimulated human whole blood samples were stored for 48-96 h up to one week at 4 degrees C, 20 degrees C and 37 degrees C and were analysed for apoptosis. After 96 h and one week of storage unstimulated cultures were stimulated to proliferate. These cultures and samples stimulated immediately before storing were incubated at 37 degrees C for 56 h and analysed for mitotic index (MI). RESULTS: Lymphocytes undergo apoptosis during storage and this loss of viability is accelerated by increasing both temperature and storage time. In the presence of PHA, incubation at both 4 degrees C and 20 degrees C for 48 h resulted in low percentages of apoptotic cells and after incubation at 4 degrees C for 96 h the cultures grown for 56 h at 37 degrees C revealed the highest percentage of MI. CONCLUSIONS: The storage conditions affect lymphocytes in terms of both cell viability and proliferation. Storage at 4 degrees C for 96 h in presence of PHA was found optimal.     

Reliability of center of pressure measures for assessing the development of sitting postural control through the stages of sitting

Cerebral palsy (CP) impairs an individual’s ability to move and control one’s posture. Unfortunately, the signs and symptoms of CP may not be apparent before age two. Evaluating sitting posture is a potential way to assess the developing mechanisms that contribute to CP. The purpose of this project was to determine the reliability of linear and nonlinear measures, including inter- and intrastage reliability, when used to analyze the center of pressure (COP) time series during the stages of sitting development in children with typical development (TD) and with/at-risk for cerebral palsy (CP). We hypothesized that nonlinear tools would be more reliable than linear tools in assessing childrens’ sitting development, and reliability would increase with development. COP data was recorded for three trials at eight sessions. Linear parameters used were root mean square, range of sway for the anterior-posterior (AP) and medial-lateral (ML) directions, and sway path. Nonlinear parameters used were Approximate Entropy, the largest Lyapunov Exponent, and Correlation Dimension for the AP and ML direction. Participants consisted of 33 children with TD and 26 children with/at-risk for CP. Our results determined that COP is a moderately reliable method for assessing the development of sitting postural control in stages in both groups. Thus, clinicians may be able to use measures from COP data across stages to assess the efficacy of therapeutic interventions that are intended to improve sitting postural abilities in children with/at-risk for CP.     

180例外伤患者对瘢痕担忧及早期美容缝合的满意度调查

目的通过调查统计患者外伤后来本科室就诊的主要原因及对伤后瘢痕发生的担忧情况,了解患者对瘢痕的重视程度,对瘢痕防治方法的了解程度,以及对早期美容缝合的满意度。方法对180例因皮肤外伤而进行早期缝合的患者,采用问卷调查的形式对其入院缝合的主要原因及疗效满意度进行调查。结果 180例患者对瘢痕形成的重视度达85.0%以上:对瘢痕防治方法的了解程度达95.0%,对早期美容缝合的满意度达94.2%。结论外伤患者对创面愈合后的美观要求较高,因此早期美容缝合对外伤患者的意义重大,可明显减少瘢痕,提高患者满意度。     

Measurements of clinically significant doses of ionizing radiation using non-invasive in vivo EPR spectroscopy of teeth in situ.

There are plausible circumstances in which populations potentially have been exposed to doses of ionizing radiation that could cause direct clinical effects within days or weeks, but there is no clear knowledge as to the magnitude of the exposure to individuals. In vivo EPR is a method, perhaps the only such method that can differentiate among doses sufficiently to classify individuals into categories for treatment with sufficient accuracy to facilitate decisions on medical treatment. Individuals with significant risk then can have appropriate procedures initiated immediately, while those without a significant probability of acute effects could be reassured and removed from the need for further medical treatment. In its current state, the in vivo EPR dosimeter can provide estimates of absorbed dose of +/-25 cGy in the range of 100-->1000 cGy. This is expected to improve, with improvements in the resonator, the algorithm for calculating dose, and the uniformity of the magnetic field. In its current state of development, it probably is sufficient for most applications related to terrorism or nuclear warfare, for decision-making for action for individuals in regard to acute effects from exposure to ionizing radiation.     

Hygiene of daily meals of pilots

The hygienic approaches to daily meals for the flying personnel while on the ground are discussed from the historical point of view. It is indicated that the hygienic requirements for the chemical composition of the daily diet are related to the physiological norms accepted by the nutritional science in the USSR and other countries at various stages of its development. It is shown that the present-day diets for the flying personnel are of high caloric value. The basic physiological and hygienic requirements for the daily diets are given.     

An analysis of the geometry of saccular intracranial aneurysms.

BACKGROUND AND PURPOSE: Our goal was to characterize the geometry of simple-lobed cerebral aneurysms and to find the absolute size of these lesions from angiographic tracings. METHODS: Measurements of angiographic neck width (N), dome height (H), dome diameter (D), and semi-axis height (S) were obtained from tracings of 87 simple-lobed lesions located at the basilar bifurcation (BB), middle cerebral (MCA), anterior communicating (AcomA), posterior communicating (PcomA), superior cerebellar (SCA), and posterior cerebral (PCA) arteries. The following ratios were analyzed as subgroups according to location and as a collective sample: dome diameter/dome height (D/H), dome height/neck width (H/N), dome diameter/neck width (D/N), and dome height/semi-axis height (H/S). Using the parent artery as a reference, aneurysm dimensions were normalized to absolute in vivo size. Estimations were validated using angiographic markers. RESULTS: For the entire sample, mean ratios were D/H = 1.11, D/N = 1.91, and H/N = 1.86. For the H/S ratio, the value was 1.98 for BB, MCA, and PcomA lesions and significantly smaller for the AcomA subgroup, at 1.52. The average sizes (in mm) for these dimensions were N = 3.4 for MCA, 3.0 for AcomA, 3.1 for PcomA, and 6.5 for BB; D = 6.1 for MCA, 5.9 for AcomA, 5.3 for PcomA, and 11.7 for BB; H = 5.6 for MCA, 5.0 for AcomA, 5.3 for PcomA, and 11.3 for BB. On average, BB aneurysms were twice as large as aneurysms at other locations. Good correlations were found between the scaled values for D and N, H and N, and H and D. CONCLUSION: These results have been used to characterize the typical simple-lobed aneurysm geometry and to provide a framework for the development of a method of assessment of treatment choice and outcome on the basis of lesion geometry.     

A study of the application of paediatric reference levels

Radiation exposure of paediatrics is of particular concern because of the greater health detriment. In this study, the application of patient dose reference levels to paediatric radiographic examinations has been investigated. The relationships between entrance surface dose and patient age and size parameters have been studied in three hospitals. The data have been used to derive conversion factors to describe relationships between doses for children of different ages. The usefulness of equivalent patient diameter, weight and age as variables relating to doses has been examined. Simple conversion factors in look-up tables have been derived that link doses for patients of a variety of ages and sizes for particular examinations. It is proposed that factors of this type could be applied to data for individual patients to allow a wider range of ages to be included in any group. This would enable sufficient dose data to be collected from non-specialist hospitals for comparison with reference levels. It would facilitate identification of hospitals where doses are higher so that changes could be made to radiographic practice.     

Validity and generalizability of findings of randomized controlled trials on arthroscopic partial meniscectomy of the knee

The validity and generalizability of evidence from trials on arthroscopic partial meniscectomy (APM ) for a ruptured meniscus of the knee has been debated in scientific journals. The aim of this paper was to assess the validity and generalizability of evidence for trials on effectiveness of APM by a novel Benchmarking method; to compare this assessment with established assessment methods; and to make an overall assessment of the current evidence on validity and generalizability of findings. Literature search was undertaken to find all randomized controlled trials. The benchmarking method, the Cochrane method for the assessment of validity of RCT s, and CONSORT method for the assessment of generalizability of findings were used. The data were extracted and checked for accuracy twice. Seven RCT s were found, of which 2 were double blinded. The benchmarking method indicated that only one trial, assessing real‐world effectiveness, had recruited patients comprehensively from the catchment area and showed clinically important effectiveness for APM . All trials had deficiencies in reporting of baseline characteristics and adherence to interventions. In 5 trials, the crossover to surgery from conservative treatment arm was between 19 and 36 percent. The benchmarking method indicates that APM may be an effective treatment for meticulously selected patients, or when APM is targeted to those patients who do not respond to the conservative treatment. There is a need for more sham‐controlled and real‐world effectiveness trials reporting comprehensively patient characteristics and adherence to interventions, preferably in a representative sample of patients living in the recruitment area.     

磷霉素钠172例临床应用分析

目的 了解我院注射用磷霉素钠的临床使用情况,为合理使用该药提供依据。方法 回顾分析我院2007年1￣11月172份住院患者使用磷霉素钠的临床资料,根据磷霉素钠的用法、用量、适应性、联合用药等分析该药使用是否正确。结果 172份病历中,磷霉素钠单一用药占50.00%,二联用药占45.34%,三联用药占4.65%;与注射用磷霉素钠联合用药的抗菌药物构成比为,青霉素类占25.28%,喹诺酮类占23.26%,头孢类占20.93%,β-酶抑制剂类占16.28%,氨基糖苷类占13.95%;用药时间构成比为,1-3天占40.70%,4-6天占32.60%,7-9天占12.79%,9天以上占13.95%;临床应用构成比为,治疗用药110例,占64%,预防用药62例,占36%。结论 各科室对磷霉素钠的使用基本正确,但存在用药起点过高,使用时间过长,不必要的联合用药,不作病原学检查等问题。