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61.
62.
Braun Ralph P. MD Klumb Francis PhD † Bondon David PhD † Salomon Denis MD Skaria Andreas MD Adatto Maurice MD French Lars E. MD Saurat Jean-Hilaire MD Vallée Jean-Paul MD † 《Dermatologic surgery》2005,31(5):562-569
BACKGROUND: Basal cell carcinoma (BCC) is the most common type of skin cancer. One of the main problems with BCC is the risk of local recurrence of the tumor after treatment. This is mainly due to its irregular outgrowths, which cannot be detected clinically. OBJECTIVE: To better understand the tumor morphology and growth pattern of BCC, we tried to develop a method that provides a precise three-dimensional model of the tumor. METHODS: Because Mohs surgery provides the best overview of the tumor and the tumor margins (both lateral and in depth), the reconstruction was based on slides from Mohs surgery. After digitization and processing of the slides, the tumor was then surrounded by a Mohs surgeon on a computer screen. These selections (lines) were used for a three-dimensional reconstruction of the tumor using MedSurf3D software. RESULTS: This method allows three-dimensional reconstruction of any given BCC. The MedSurf3D software enables visualization of a three-dimensional model of the tissue, which is removed during the surgical procedure. CONCLUSIONS: Three-dimensional reconstruction is a fascinating tool that might improve our understanding of the behavior, growth pattern, and tumor morphology of BCCs. This technique might also be useful in other fields of cutaneous oncology, such as the calculation of the tumor volume of melanomas. 相似文献
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Tetsurou Torisu Kelun Wang Peter Svensson Antoon De Laat Hiroyuki Fujii Lars Arendt-Nielsen 《Clinical neurophysiology》2007,118(5):999-1009
OBJECTIVE: To investigate the effects of muscle fatigue induced by low-level isometric jaw-clenching and subsequent glutamate-evoked muscle pain on the exteroceptive suppression (ES) response and resting electromyographic (EMG) activities in human jaw muscles. METHODS: The resting EMG activity and the ESs were recorded before (baseline), after low-level jaw-clenching (Post1), after subsequent glutamate or isotonic saline injections into the left masseter (Post2), and 60 min after the clenching (Post3) in 23 healthy volunteers. RESULTS: The late ES (ES2) showed more inhibition at Post1 compared with baseline (P<0.05). It was less inhibited after both types of injections (Post2), and increased at Post3 again (P<0.05) with no significant difference between the glutamate and isotonic saline sessions. The resting EMG activity increased at Post1 and Post2 (P<0.05). The glutamate injection further increased the resting EMG activity in the injected muscle (P<0.01). CONCLUSIONS: Muscle fatigue influences inhibitory reflex pathways in jaw-closing muscles and subsequent acute muscle pain potentiates the local increase in the resting EMG activity of the painful muscle. SIGNIFICANCE: Muscle fatigue which can be observed in patients with oral dysfunctions may interact with nociceptive regulation and influence the clinical presentation of jaw symptoms and function. 相似文献
65.
Henrik Hein Lauridsen Jan Hartvigsen Claus Manniche Lars Korsholm Niels Grunnet-Nilsson 《European spine journal》2006,15(11):1717-1728
In studies evaluating the efficacy of clinical interventions, it is of paramount importance that the functional outcome measures are responsive to clinically relevant change. Knowledge thereof is in fact essential for the choice of instrument in clinical trials and for clinical decision-making. This article endeavours to investigate the sensitivity, specificity and clinically significant improvement (responsiveness) of the Danish version of the Oswestry disability index (ODI) in two back pain populations. Two hundred and thirty three patients with low back pain (LBP) and/or leg pain completed a questionnaire booklet at baseline and 8 weeks follow-up. Half of the patients were seen in the primary (PrS) and half in the secondary sectors (SeS) of the Danish Health Care System. The booklet contained the Danish version of the ODI, along with the Roland Morris Questionnaire, the LBP Rating Scale, the SF36 (physical function and bodily pain scales) and a global pain rating. At follow-up, a 7-point transition question (TQ) of patient perceived change and a numeric rating scale relating to the importance of the change were included. Responsiveness was operationalised using three strategies: change scores, standardised response means (SRM) and receiver operating characteristic (ROC) analyses. All methods revealed acceptable responsiveness of the ODI in the two patient populations which was comparable to the external instruments. SRM of the ODI change scores at 2 months follow-up was 1.0 for PrS patients and 0.3 for SeS (raw and percentage). A minimum clinically important change (MCID) from baseline score was established at 9 points (71%) for PrS patients and 8 points (27%) for SeS patients using ROC analyses. This was dependable on the baseline entry score with the MCID increasing with 5 points for every 10 points increase in the baseline score. We conclude that the Danish version of the ODI has comparable responsiveness to other commonly used functional status measures and is appropriate for use in low back pain patients receiving conservative care in both the primary and secondary sector. 相似文献
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67.
Neural classifier construction using regularization, pruning and test error estimation 总被引:1,自引:0,他引:1
Mads Hintz-Madsen Lars Kai Hansen Jan Larsen Morten With Pedersen Michael Larsen 《Neural networks》1998,11(9):1659-1670
In this paper we propose a method for construction of feed-forward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme, we derive a modified form of the entropic error measure and an algebraic estimate of the test error. In conjunction with optimal brain damage pruning, a test error estimate is used to select the network architecture. The scheme is evaluated on four classification problems. 相似文献
68.
Viktoria Werkström Lars Ny Katarina Persson K.-E. Andersson 《Naunyn-Schmiedeberg's archives of pharmacology》1997,356(2):151-158
Neuronal regulation of smooth muscle tone in the female pig urethra has mainly been studied in vitro using electrical field
stimulation (EFS) of nerves. Excitatory control is considered to be exerted by released noradrenaline, whereas inhibitory
control is non-adrenergic non-cholinergic (NANC), and mediated by nitric oxide (NO), and an as yet unidentified agent. We
investigated the functional and morphological effects of α-latrotoxin (αLTX), a spider neurotoxin believed to cause massive
release of vesicle-stored neurotransmitters, on spontaneously developed urethral smooth muscle tone. The effects were compared
to those of EFS and high potassium. In the presence of the NO-synthesis inhibitor Nω-nitro-L-arginine (L-NOARG: 0.3 mM) both αLTX and EFS evoked contractions. After treatment with scopolamine and phentolamine,
no contraction was observed, and under these conditions αLTX and EFS induced relaxation. At low frequencies (<12 Hz), the
EFS-induced relaxations were rapid, whereas at higher frequencies (>12 Hz), they were biphasic, consisting of a rapid first
phase followed by a more long-lasting second phase. L-NOARG abolished the relaxations at low frequencies, as well as the first
phase of the biphasic relaxation. The second phase was not affected by treatment with L-NOARG, but 0.1 μM ω-conotoxin GVIA,
blocker of N-type voltage-operated calcium- channels (VOCCs), markedly reduced or abolished the response. In the presence
of L-NOARG or ω-conotoxin GVIA, the αLTX-induced relaxation was significantly decreased, and the combination of L-NOARG and
ω-conotoxin GVIA further reduced or abolished the relaxation. In preparationstreated with tetrodotoxin or scorpion venom,
believed to inactivate nerves by acting on sodium channels, αLTX and EFS had no effects. αLTX-induced relaxation was not associated
with changes in cyclic GMP or cyclic AMP content. High (80 mM) potassium solution induced a triphasic response of the preparation.
A transient relaxation was followed by a restoration of tone, and then by a persistent relaxation. The persistent relaxation
was slightly reduced by scorpion venom or L-NOARG, but reduced by 50% by a combination of L-NOARG and ω-conotoxin GVIA. Ultrastructural
analysis of the urethral circular smooth muscle layer revealed a moderate amount of nerve profiles supplying the smooth muscle.
In control preparations, the nerve profiles contained both small synaptic vesicles and large dense core vesicles. αLTX caused
a major loss of both types of vesicle. The present data suggest that αLTX has the ability to release not only adrenergic and
cholinergic transmitters, but also NANC mediators of relaxation, including NO, from nerve terminals in the urethra.
Received: 13 January 1997 / Accepted: 17 April 1997 相似文献
69.
Successful internal arterial embolization with steel coils in life-threatening bleeding after femoral fracture is described in an older patient. 相似文献
70.