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61.
Human brain tumor stem cells have been enriched using antibodies against the surface protein CD133. An antibody recognizing CD133 also served to isolate normal neural stem cells from fetal human brain, suggesting a possible lineage relationship between normal neural and brain tumor stem cells. Whether CD133-positive brain tumor stem cells can be derived from CD133-positive neural stem or progenitor cells still requires direct experimental evidence, and an important step toward such investigations is the identification and characterization of normal CD133-presenting cells in neurogenic regions of the embryonic and adult brain. Here, we present evidence that CD133 is a marker for embryonic neural stem cells, an intermediate radial glial/ependymal cell type in the early postnatal stage, and for ependymal cells in the adult brain, but not for neurogenic astrocytes in the adult subventricular zone. Our findings suggest two principal possibilities for the origin of brain tumor stem cells: a derivation from CD133-expressing cells, which are normally not present in the adult brain (embryonic neural stem cells and an early postnatal intermediate radial glial/ependymal cell type), or from CD133-positive ependymal cells in the adult brain, which are, however, generally regarded as postmitotic. Alternatively, brain tumor stem cells could be derived from proliferative but CD133-negative neurogenic astrocytes in the adult brain. In the latter case, brain tumor development would involve the production of CD133.  相似文献   
62.
Aim and background:  Family-centred care, which acknowledges parents as partners in care, is a desirable and essential part of neonatal nursing. There has been extensive research on parents' experiences of parenting in neonatal intensive care units (NICU), but there is little research on nurses' experiences of being in these enduring close relationships. The aim of this paper is to explore parents' and nurses' experiences of the close parent–nurse relationship when a premature child is hospitalized.
Method:  The design was exploratory with a hermeneutic approach. The methods used were participant observation and in-depth interviews with six mothers, six fathers and six nurses in a Norwegian 13-bed NICU. Eighteen individual interviews and 160 hours of observations were conducted over 27 weeks from 2003 to 2004. This study complies with the principles of the Declaration of Helsinki. The Regional Committee for Medical Research Ethics, the Ombudsman for Privacy in Research at the Norwegian Social Science Data Services and the hospital's research department approved the study protocol.
Results:  The NICU context is a technological environment where human interaction is a crucial issue. The character of the context and the ongoing interactions drive parents and nurses into close relationships. Closeness increases the emotional involvement and the boundary between the professional and the personal approach is threatened. The commitment of being close, combined with the emotional involvement, can be an emotional burden to both parents and nurses.
Conclusion:  Parent–nurse closeness in NICU is desirable; however, the emotional burden of this closeness seems to be seldom problematized. Awareness about the need to strike a balance between closeness and distance can positively influence parents' independence and nurses' ability to maintain professional relationships with their primary care parents.  相似文献   
63.
Host tissue response and heterotopic osteoinduction by composites of demineralized bone matrix and three different substances used as bioresorbable carriers implanted in the abdominal muscles were evaluated by strontium 85 uptake and histology 4 weeks postoperatively in 60 male Wistar rats. Both fibrin-collagen paste and fibrin sealant inhibited bone induction and produced a chronic inflammation; part of the fibrin-collagen paste was still present at 4 weeks. Polyorthoester with gentamicin was almost completely absorbed, induced minimal tissue reaction, and did not inhibit osteoinduction.  相似文献   
64.
A data set concerning cardiac arrests treated by the Emergency Medical Service in Trondheim during a nine year period is analysed. The relationship between the occurrence of cardiac arrest and covariates related to weather and season is examined. The covariate order method is used in the analysis of the data. It is explained how this method can be extended to recurrent event data, and the practical usefulness and flexibility of the method is demonstrated in these analyses. In the analyses a significant relationship between outdoor air temperature, or factors closely related to outdoor air temperature, and the occurrence of cardiac arrest is found. The incidence of cardiac arrest decreases with increasing temperature. Further a significant effect of snowfall is also found, with increased intensity of cardiac arrest on days with snowfall. A more borderline significant effect of precipitation is also identified.  相似文献   
65.

Objective

To identify determinants of older patients’ perceptions of involvement in decision-making on colorectal (CRC) or pancreatic cancer (PC) treatment, and to compare these with determinants of observers' perceptions.

Methods

Patients’ perceptions of involvement were constructed by the 9-item SDM questionnaire (SDM-Q-9) and a Visual Analogue Scale for Involvement (VAS-I). Observers’ perceptions were constructed by the OPTION5, OPTION12, and MAPPIN’SDM. Convergent validities were calculated between the patient-sided and observer instruments using Spearman’s correlation coefficient. Linear regression was used to identify determinants per criterion.

Results

58 CRC and 22 PC patients were included (mean age: 71.8?±?5.2 years, 45.0% female). No significant correlations were found between the patient-sided and observer instruments. Patients’ impression of involvement was influenced by patient characteristics such as quality of life and satisfaction, while observers’ perceptions mainly referred to encounter characteristics such as the mean duration of consultations and general communication skills.

Conclusion

Due to evident differences in determinants, older CRC/PC patients’ and observers’ perceptions of involvement should both be collected in evaluating the quality of medical decision-making.

Practice Implications

General communication skills should be integrated in SDM training interventions. New SDM measurement tools for patients are needed to sufficiently discriminate between the constructs of involvement and satisfaction.  相似文献   
66.
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68.

Background

Ligament balancing is considered a prerequisite for good function and survival in total knee arthroplasty (TKA). However, there is no consensus on how to measure ligament balance intra-operatively and the degree of stability obtained after different balancing techniques is not clarified.

Purpose

This study presents a new method to measure ligament balancing in TKA and reports on the results of a try-out of this method and its inter-observer reliability.

Methods

After the implantation of the prosthesis, spatulas of different thickness were used to measure medial and lateral condylar lift-off in flexion and extension in 70 ligament-balanced knees and in 30 knees were ligament balancing was considered unnecessary. Inter-observer reliability for the new method was estimated and the degree of medial–lateral symmetry in extension and in flexion, and the equality of the extension gaps and flexion gaps were calculated.

Results

The method was feasible in all operated knees, and found to be very reliable (intraclass correlation coefficient?=?0.88). We found no statistically significant difference in condylar lift-off between the ligament-balanced and the non ligament-balanced group, however, there was a tendency to more outliers in flexion in the ligament-balanced group.

Conclusions

Our method for measuring ligament balance is reliable and provides valuable information in assessing laxity intra-operatively. This method may be a useful tool in further research on the relationship between ligament balance, function and survival of TKA.  相似文献   
69.
Functional Benefits of Dysphagia Therapy Using Adjunctive sEMG Biofeedback   总被引:10,自引:0,他引:10  
This article describes a retrospective analysis of functional outcome, time in therapy, and cost per unit of functional change in patients who received therapy for pharyngeal dysphagia. Twenty-five patients presenting dysphagia following stroke and 20 patients with dysphagia following treatment for head/neck cancer completed a systematic therapy program supplemented with surface electromyographic (sEMG) biofeedback. Eighty-seven percent (39/45) of all patients increased their functional oral intake of food/liquid including 92% of stroke patients and 80% of head/neck cancer patients. Patients with dysphagia following stroke demonstrated greater improvement than those in the head/neck cancer group. Patients in the stroke group completed more therapy sessions thus increasing the total cost of therapy, but they made more functional progress resulting in lower costs per unit of functional change than patients in the head/neck cancer group. Limitations of this study are described in reference to implications for future clinical research on the efficacy of this therapy approach.  相似文献   
70.
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