Bilateral Duane syndrome and bilateral aniridia.

Duane retraction syndrome has been reported in association with structural abnormalities of the eye, including epibulbar dermoid, keratoconus, iris dysplasia, heterochromia iridis, persistent fetal vasculature, cataract, choroidal coloboma, microphthalmia, and optic nerve dysplasia. A novel association, that of bilateral Duane syndrome with bilateral aniridia, is the subject of this report.     

Recombinant activated factor VII for intractable bleeding post splenectomy in a patient with myeloproliferative disorder.

Recombinant activated factor VII has been Food and Drug Administration approved to treat hemorrhages in hemophiliac patients with inhibitors and in acquired hemophilia patients. Recombinant activated factor VII use has also been considered for the management of uncontrolled bleeding in a number of congenital and acquired hemostatic abnormalities. The myeloproliferative disorders are a group of clonal hematologic diseases where, frequently, abnormal platelet function is considered a hallmark. This is the first case report addressing the clinical benefit of off-label use of recombinant activated factor VII in an attempt to control intractable bleeding in a patient with a myeloproliferative disorder after splenectomy.     

Low back pain education and short term quality of life: a randomized trial

Background  

Different interventions can reduce the burden of the chronic low back pain. One example is the use of a 'Back School Programme'. This is a brief therapy that uses a health education method to empower participants through a procedure of assessment, education and skill development. This study aimed to evaluate to what extent the programme could improve quality of life in those who suffer from the condition.     

Long-term Outcomes of Patients Undergoing War-related Amputations of the Foot and Ankle

Long-term clinical and functional outcomes for patients undergoing foot and ankle amputations are not well documented. We attempted to document long-term outcomes for patients who required lower extremity amputations as a result of wounds suffered during wartime. For this study, 27 Iranian soldiers who had wounds requiring amputation of the foot and ankle were selected for follow-up. The participants' wartime medical records were reviewed, a clinical examination was performed, and each participant completed a questionnaire. Postamputation follow-up averaged 17.5 years. The most prevalent (66.6%) cause of injury was a land mine. The prevalences of different clinical symptoms reported by the amputees at the time of the last follow-up were as follows: 11 (40.7%) with phantom sensation, 6 (22.2%) with phantom pain, 12 (44.4%) with stump pain, 12 (44.4%) with back pain, 9 (33.3%) with contralateral knee pain, and 4 (14.8%) with ipsilateral knee pain; 20 (74%) reported treatment for psychological conditions. In regard to social conditions, 13 (48.1) were currently employed, or had been employed, for a number of years after the amputation; 26 (96%) had children, and all of the patients were married. The results of this observational study indicate that individuals have significant long-term pain and discomfort after war-related lower extremity amputation. Although all 27 (100%) of the amputees were able to maintain satisfactory family functioning, only 13 (48.1%) of the study participants were able to remain productively employed after undergoing amputation, and 20 (74%) reported long-term psychological problems in addition to their physical pain.     

Evaluation of pH and calcium ion release of Acroseal sealer in comparison with Apexit and Sealapex sealers.

OBJECTIVE: This is an in vitro assessment of pH level and calcium ion release exhibited by 3 calcium hydroxide-based root canal sealers-Sealapex, Apexit, and Acroseal. STUDY DESIGN: The materials were prepared according to the manufacturers' instructions and placed in 1 cm long and 4 mm diameter tubes. The tubes were then immersed in a glass flask containing 10 mL bidistilled water (n = 15), which was sealed and stored at 37 degrees C before the materials had set. The control group contained bidistilled water with empty tubes (n = 12). At predetermined time intervals (24 h, 96 h, and 7, 15, and 28 days) the pH of the bidistilled water was tested with a pH meter and for released calcium by using spectrophotometry. The data were statistically analyzed using 1-way analysis of variance for the comparison of the materials at each time point. If the difference was significant, individual comparisons were performed by Tukey multiple comparisons test (alpha = .05). RESULTS: Sealapex produced higher pH and released significantly higher calcium amounts than the other 2 sealers at all periods (P < .05). Apexit showed higher calcium release than Acroseal at the end of 15 days (P < .05). There was no significant difference in the pH between Apexit and Acroseal (P > .05). CONCLUSION: The new Acroseal sealer presented the least calcium ion release and pH than Sealapex and less calcium ion release than Apexit sealer.     

The program for phenotyping of genetically modified animals at AstraZeneca

Genetically modified mice offer a wide range of possibilities in preclinical drug discovery, e.g. for use in target identification, target validation and disease model generation. However, genomic modification and alteration in gene expression may cause unpredicted phenotypic alterations in the organism other than the intended ones. The aim of this study was to determine the importance of establishing the phenotype of transgenic and knockout mice models for use in pharmaceutical research.

A total number of 51 mouse models (transgenic and knockout) produced at AstraZeneca during a 4 year period were subjected to a thorough phenotyping package covering clinical as well as morphological aspects. Phenotype abnormalities were recorded in 36 (70.6%) of the mouse models. The majority of findings were considered to be minor in magnitude. Histopathological changes related to the genotype of the animals were observed in 33% of the mouse models, underlining the importance of pathology in the phenotyping program.     

Histopathologic changes in oral mucosa of Yemenis addicted to water-pipe and cigarette smoking in addition to takhzeen al-qat.

BACKGROUND: Because the clinicopathologic effects of takhzeen al-qat are similar to those induced by smoking, the aim of this paper was to study the oral effect of 3 bad oral habits: takhzeen al-qat and cigarette and water-pipe smoking. STUDY DESIGN: This study was done on 33 Yemeni chronic qat users grouped as heavy cigarette smokers (GI), nonsmokers (GII) and water-pipe smokers (GIII). In all cases (n = 33) 2 biopsies were taken (n = 66), one from the buccal mucosa at the chewing side and the other from a similar mucosa at the contralateral (nonexposed) side. Biopsies were prepared for routine H&E staining. RESULTS: Acanthosis appeared in 88% and 0%, abnormal rete ridges in 70% and 3%, hyperparakeratosis in 67% and 0%, and epithelial dysplasia in 30% and 0% of the chewing and nonchewing sides, respectively, in the 3 groups. Epithelial dysplasia appeared in 41% of GI and GIII (smokers) but in only 9% of GII (nonsmokers). CONCLUSIONS: Takhzeen al-qat causes distinct histopathologic changes in the oral mucosa at the side of chewing, such as acanthosis, abnormal rete ridges, and hyperparakeratosis. The association between takhzeen al-qat and cigarette or water-pipe smoking may increase the risk of epithelial dysplasia.     

Fast decomposition of water and lipid using a GRASE technique with the IDEAL algorithm.

Three-point Dixon techniques achieve good lipid-water separation by estimating the phase due to field inhomogeneities. Recently it was demonstrated that the combination of an iterative algorithm (iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL)) with a fast spin-echo (FSE) three-point Dixon method yielded robust lipid-water decomposition. As an alternative to FSE, the gradient- and spin-echo (GRASE) technique has been developed for efficient data collection. In this work we present a method for lipid-water separation by combining IDEAL with the GRASE technique. An approach to correct for errors in the lipid-water decomposition caused by phase distortions due to the switching of the readout gradient polarities inherent to GRASE is presented. The IDEAL-GRASE technique is demonstrated in phantoms and in vivo for various applications, including pelvic, musculoskeletal, and (breath-hold) cardiac imaging.