Cent Incidence Research Articles

The principles and technique of resection of soft parts for sarcoma. 1958.

The principles and technique of resection of soft parts for sarcoma. 1958.

Pre‐ and post‐expiry metal levels in canned dry milk

Levels of 12 metals (Ca, K, Na, Mg, Cu, Fe, Mn, Zn, Cd, Cr, Pb and Ni) were estimated in 19 different imported brands of unexpired and expired canned dry milk available from local markets. The HNO3/HClO4‐based wet digestion method was used for the analysis of the samples by the FAAS technique under optimum analytical conditions. Of the macronutrients, Ca showed highest at 1,144 μg/g in the dry milk from Holland. In the case of micronutrients, Fe showed the maximum level at 119.15 μg/kg in the milk from UK. Cr dominated at 23.19 μg/kg compared with other heavy toxic trace elements. The following order of decreasing concentration was observed for both unexpired and expired milk: Ca > Na > K > Mg > Fe > Zn > Cr > Pb > Cu > Ni > Cd. All the trace elements were found to have 100 per cent incidence of occurrence. The expired milk samples showed enhanced levels of Fe, Zn, Cr and Pb by a factor of 1.2‐1.6 on average. The results of the metal contents were compared with those for fresh cow milk. The data were stat...

Meta-analysis to determine the incidence of obstetric anal sphincter damage.

The reported incidence of anal sphincter injury after first (11.5-35.0 per cent) and subsequent (3.4-12.1 per cent) vaginal deliveries varies widely. In addition, the reported incidence of associated faecal incontinence ranges from zero to 68.2 per cent. The aim of this study was to perform a meta-analysis of reported incidences of postpartum anal sphincter defect diagnosed by endoanal ultrasonography (EAUS) and associated incidences of faecal incontinence. A Medline search yielded five studies with more than 100 subjects who underwent EAUS after childbirth for evaluation of anal sphincter disruption and who were questioned about symptoms of faecal incontinence, defined as any impairment in flatus and stool control but not including urgency of defaecation. A Bayesian meta-analysis was performed to produce one inference while accounting for potential heterogeneity among the five study populations. Meta-analysis of 717 vaginal deliveries revealed a 26.9 per cent incidence of anal sphincter defect in primiparous women and an 8.5 per cent incidence of new sphincter defects in multiparous women. Overall, 29.7 per cent of anal sphincter defects were symptomatic. Some 3.4 per cent of women experienced postpartum faecal incontinence without an anal sphincter defect. In a Bayesian calculation, the probability of postpartum faecal incontinence due to a sphincter defect was 76.8-82.8 per cent. : The incidence of occult anal sphincter disruption following vaginal delivery is much higher than commonly estimated. However, at least two-thirds of occult defects are asymptomatic postpartum. The probability of faecal incontinence associated with an anal sphincter defect was 76.8-82.8 per cent.

Chronic suppurative otitis media and sensorineural hearing loss: Is there a correlation?

Traditionally, it has been accepted that chronic suppurative Otitis media is associated with a breakdown in meekanical conduction of sound leading to conductive hearing loss, On;the contrary, there are two schools of thought when it come, to the issue of cpchlear involvement leading to sensorineural hearing loss (SNIIL) in chronic suppura the Otitis media. The present study was undertaken to find out whether a sensorineural component exists in hearing loss associated with chronic suppurative otitis media, A sample of 100 patients of unilateral chronic suppurative otitis media was selected for the Study and their bone conduction thresholds Mere analyzed in relation to the duration of disease using audiometric data. A 24 per cent incidence of sensoineural hearing loss was found in this series, garticularly involving the higher frequencies. Moreover, the incidence of sensorineural hearing loss progressively increased with the increase in duration of chonic suppurative Ouns meadia.

Analysis of Readers' Questions: A Case Study

Mentions the need for the analysis of the subjects of questions put by the specialist readers to document finding systems. Gives data on the facet structures of the subjects of 323 questions in the fields of High-Speed Aerodynamics and Aeronautical Engineering. On the whole, such questions appear to be fairly well confined to the core subjects. The subjects could be patterned into 34 facet structures. About 73 per cent of the subjects were based on three similar facet structures with 3, 4, and 5 facets respectively. The maximum number of Levels of [P] in anyone facet structure was 3; while that of the Levels of [IMP] in anyone facet structure was 5. The maximum number of facets in anyone subject was 12 and the minimum 2, with an average of 5·4. The maximum number of kernel ideas in anyone subject was IS and the minimum 3, with an average of S. This appears to conform to the findings of psychology of the Span of Immediate Memory and the Span of Absolute Judgment. The average frequency of incidence of (P), (M), and (E) isolates was in the ratio of 4·2: 5·6: 1. The frequency of incidence of isolates from the second and later Rounds of [P] and [M] was quite small. The number of different (lPl) isolates incident in the subjects of the questions was 48; 20 such isolates accounted for a 90-per cent incidence of (1P1) isolates. The number of different (1MP) isolates incident in the subjects was 152. 20 such isolates accounted for a 62-per cent and 50 isolates for an 80-per cent incidence of (1MP) isolates. The number of different (IE) isolates incident in the subjects was 24. They were all common isolates. A principle is mentioned as an aid in differentiating whether an idea is to be deemed a manifestation of Matter (Property) or of Energy, when the idea is associa!ed with an action. A total of 178 qualifiers occuring 266 times qualified 80 ideas in [1P1].A total of 274 qualifers occurring 577 times qualified 98 ideas in [1MP]. 22·5 per cent of the isolates in [1P1] and 88 per cent of the isolates in [1MP] did not have qualifiers. There were 76 Complex Subjects in the subjects of the questions. The influence Phase Relation had the highest incidence (68 %) among the Complex Subjects. Concludes mentioning a few subjects for further investigation.

Enteric colonisation following natural exposure to Campylobacter in pigs

A survey was conducted to establish the prevalence of Campylobacter in pigs from an integrated commercial hog farm. This study was carried out in four different groups of pigs: 1) adult gilts (50); 2) pregnant sows (9); 3) piglets at day-of-birth (73); 4) weaned piglets (20). Rectal and/or caecal samples were collected from each pig.Campylobacter was cultured and enumerated from such samples using Bolton enrichment broth and Campy-Cephex agar plates. Both biochemical and serological tests were used to determine Campylobacter species. Gilts had a 76 per cent incidence ofCampylobacter with a mean of 76·3 per cent for C. jejuni, 21 per cent for C. coli and 2·6 per cent for C. lari. Pregnant sows had a 100 per cent incidence of Campylobacter with a mean of 87 per cent forC. jejuni and 13 per cent for C. coli. Newborn piglets had a 57·8 per cent incidence ofCampylobacter , rising to 100 per cent by the time of weaning. Thus it appears that pigs, from the day of birth, are highly susceptible to colonisation by Campylobacter.

Intraoperative Angiography

Intraoperative angiograms were performed on 131 patients. There were 23 aortoiliac procedures (Group I); 20 aortofemoral procedures (Group II); 25 femoral artery reconstructionellaneous operative angiograms (Group V) were included; examples of this group were renal artery and brachial artery reconstructions. Ten intraoperative carotid angiograms comprised Group VI. Twenty-three patients (17.5%) showed abnormalities which required correction. These were the presence of thrombus in 11 (47.8%) and anastomotic stricture in nine (39.1%); the remaining 13.1 per cent consisted of one kinked graft, one vessel disruption, following embolectomy, and one false aneurysm. The incidence of defects was 4.3 per cent in Group I; 15 per cent in Group II; 16 per cent in Group III; 21.6 percent in Group IV, and 25 per cent in Group V. A 30 per cent incidence was found in Group VI. Technical defects in vascular reconstructions are revealed by intraoperative angiography in a significant number of cases and their incidence is directly related to the size of the vessel being operated on. Recognition and repair of these defects should result in a reduction in the rate of early occlusion.

'Revertant' DCIS in human axillary breast carcinoma metastases.

Recent experimental evidence obtained in Scid mice has suggested that the metastatic process is in large part epigenetically regulated and undergoes partial reversion once the metastatic process is completed: the metastatic colonies become more engaged in the process of growing in situ than actively metastasizing. Based on this experimental evidence, examples were sought of metastatic human cancers where similar reversion to an in situ growth state was occurring. Review of 200 cases of metastatic human breast cancer revealed a 21 per cent incidence of reversion to a ductal carcinoma in situ (DCIS) growth pattern within axillary nodal metastases. The revertant DCIS areas were characterized by an intact and circumferential basement membrane, as demonstrated by extracellular laminin and type IV collagen immunoreactivity. These revertant DCIS areas could be distinguished from primary DCIS, however, by the absence of surrounding myoepithelial cells in the former, identified in the latter by their positive maspin, S-100, and smooth muscle actin immunoreactivity. The pattern of revertant DCIS, poorly differentiated (comedo) (13 per cent), intermediate (non-comedo) (6 per cent), or well-differentiated (non-comedo) (2%), exhibited complete 100 per cent concordance with the primary DCIS pattern. The concordance of histological patterns held true for even the subtypes of DCIS determined by architectural pattern, such as the micropapillary or cribriform subtypes. Nuclear size by digital image analysis and Her-2/neu, p53, and Ki-67 status in the revertant DCIS also exhibited complete concordance with the primary DCIS counterparts. Cases exhibiting a revertant DCIS pattern tended to be ER-negative/EGFR-positive and exhibited significant nodal involvement (mean number, 9; mean area, 90 per cent) compared with cases lacking a revertant pattern (mean number, 4; mean area, 15 per cent) (P < 0.01) These findings suggest that reversion of the metastatic phenotype may also be occurring within autochthonous human metastasis.

Distant metastases in terminal head and neck cancer patients.

With improved control of cancer above the clavicles, distant metastases (DM) are frequently more seen and are becoming a more common cause of morbidity and mortality. The present study defined the incidence of distant metastases in a cohort of terminal head and neck cancer patients (HNCP) and compared it to current reported data. The incidence of distant metastases in relation to the primary tumour was evaluated and their impact on survival was assessed. A retrospective survey of patient charts was made, based on the hospice database and original referring hospital charts. Data of 59 patients admitted to the hospice were evaluated. The incidence and location of locoregional and distant disease were studied and effects on survival analyzed. The overall survival from diagnosis to demise was 42.7 months. Thyroid cancer was seen in 20.3 per cent of cases and squamous cell cancer was seen in 59.3 per cent. Distant metastases were found in 83 per cent and 48.6 per cent of patients respectively. Laryngeal cancer patients had a 54.5 per cent incidence of distant metastases. Locoregional disease was seen in 47 per cent of cases and 35.7 per cent of them had distant metastases while a 64.3 per cent incidence of distant metastases was found in cases without locoregional disease. Mean survival was 47.3 months with distant metastases vs 36.5 months without metastases. The difference was not statistically significant. The incidence of distant metastases in squamous cell cancer in terminal HNCP was 48.6 per cent. This is the highest reported incidence of metastases in a clinical series. Patients without locoregional disease had almost a two-fold incidence of metastases. Survival was not affected by metastases in this series.

Surveillance of sorghum armyworm Mythimna separata (Walker) and its natural enemies in transitional region of Dharwad.

Surveillance studies conducted on the sorghum armyworm Mythimna separata (Walker) and its natural enemies revealed that the pest actively was from June to December during 1992 and up to October during 1993. The activity attained peak during September with 59.42 and 34.25 per cent incidence during 1992 and 1993, respectively. Nine parasitoids were recorded parasitizing 18.16 and 17.55 per cent larvae during 1992 and 1993, respectively. The parasitoids Pseudogonia sp ., Compsiiura sp . and Goryphus sp . were active in the early part of the season which were followed by C otesia ruficrus and Exorista xanthaspis in the middle of the season (September-October). Correlation studies on parasitism indicated significant positi ve correlation with maximum temperature (r=0.645) and significant negati ve correlation with minimum relative humidity (r=-0.693) during 1992 and non significant correlation with abiotic factors during 1993.

SEED MYCOFLORA OF GREEN GRAM

The per cent incidence of seed mycoflora and seed germination of two varieties of green gram or mungbean (Vigna radiata L. var. Pant-2 and Type-44) were studied in freshly collected, six months stored and one year stored seeds. In all, 25, 23 and 25 fungal species were isolated from the seeds of var. Pant-2 collected from godown, shopkeepers and crop filed respectively and 22 fungal species were isolated from var. T 44 collected from godown using agar plate and blotter techniques. Seed mycoflora superficially associated with the freshly collected seeds of both the varieties predominantly consisted of fungi belonging to genera Alternariu, Cladosporium and Curvularia. Dominant fungal species of Alternaria, Aspergillus, Penicillium, Cladosporium and Curvularia were found to be associated with stored seeds. Aspergillus flavus, A. niger, A. fumigatus and A. luchuensis were found to be dominant on one year stored seeds. Deuteromycetes ranked first in number followed by phycomycetes. The number of fungal species was found more by the blotter technique in comparison to the agar-plate technique. The fungal population increased with increasing storage periods.

Evaluation of Insecticides and Agril Polyester Cover against Whitefly (Bemisia Tabaci Gennadius) in Tomato Crops

Field experiments were conducted on tomato crops over a two year period to evaluate the efficacy of six insecticides, viz., triazophos, phosphamidon, dimethoate, buprofezin and Aflix (endosulfan + dimethoate) each at 0.05% and Repelin (plant insecticide) at 1% concentration along With a cultural treatment by covering the plants with Agril (a polyester material ) for the control of whitefly, Bemisia tabaci. The insecticides were applied eight times at weekly interval immediately after transplantation. The whitefly eggs, nymphal population counts and the per cent incidence of tomato leaf curl virus (TLCV) were recorded every week for eight weeks in all the treatments including untreated control. The incidence of whitefly was more severe in the second year (i.e, 1992-93) as compared to the previous season. Among the various treatments, the Agril cover, a newly introduced cultural practice, recorded the least incidence of whitefly and of TLCV. The average of counts of eggs were 0.0 and 5.47 and of nymphs 0.54 and 0.58 per 10 leaflets and TLCV were 4.32% and 4.76% in Agril cover treatment during the first and second year, respectively. Among the insecticides tested only Aflix recorded less incidence of the pest, being 3.46 and 30.4 eggs per 10 leaflets and 0.94 and 5.34 nymphs per 10 leaflets during the two years of study, respectively. The other treatments were less effective in reducing pest and disease incidence. The crop under Agril-cover recorded the maximum yield of 34.57 and 26.15 t/ha of tomatoes as compared to 16.48 and 10.82 t/ha in control during the first and second year, respectively.

An increased incidence of haemangiomas in infants born following chorionic villus sampling (CVS)

The incidence of haemangiomas was ascertained by questionnaire in infants born to 578 consecutive CVS patients and 445 consecutive mid-trimester amniocentesis patients seen at a single institution between 1 January 1989 and 31 May 1991. The incidence of 7.4 per cent reported in the amniocentesis group was comparable to previous estimates of the incidence of haemangiomas in the general population. In contrast, a 21.1 per cent incidence, three-fold higher than that observed in the amniocentesis group, was observed among CVS-exposed infants (P < 0.001). This increased incidence was largely confined to patients undergoing a transcervical procedure. No correlation was observed between the incidence of haemangiomas and gestational age at sampling, sample size, number of sampling attempts, or a history of bleeding following the procedure.

Late haemorrhage from the subclavian vein due to a fracture of the first rib

Lesions of the subclavian vessels due to closed chest injury are rare. Berga et all, reported during a five year period a 0.2 per cent incidence of lesions of the subclavian artery, in patients with closed chest injury. Pain and swelling were consistent findings in patients with traumatic lesions of the subclavian artery. Absence of peripheral pulsations or murmurs were occasionally found. In spite of severe damage of the subclavian arteryz, peripheral pulsations can be present because of extensive collateral circulafion of the upper extremity. Fractures of the clavicle, first rib or second rib, were found in all patients with lesions of the subclavian artery. A correlation between either the localisation of the rib fracture, or the degree of dislocation of the fragments and the occurrence of a lesion of the subclavian artery, has not been found3.

Supplementation of an elemental enteral diet with alanyl-glutamine decreases bacterial translocation in burned mice

Although there are many reports of the importance of early enteral feeding in maintaining gastrointestinal integrity and preventing bacterial translocation (BT) following burn injury, no diet has been shown clinically to protect the GI tract postburn. Several studies suggest that glutamine (GLN) may benefit gut integrity following injury, shock and other stress. Unfortunately, the free amino acid GLN is unstable in solution. Alanyl-glutamine (ALA-GLN), a soluble form of GLN, maintains long-term stability in solution and could be supplemented to conventional liquid enteral diets. We studied the effects of ALA-GLN supplementation of the elemental diet Vivonex TEN on effecting BT in mice following 32 per cent TBSA full skin thickness burs. Groups A–D were burned. Group A (30 mice) was fed standard rodent chow, which contains extremely high (clinically non-useable) levels of protein. Group B (51 mice) was fasted 24 h, then fed chow 24 h. Group C (64 mice) was fed Vivonex TEN, and Group D (65 mice) received Vivonex TEN plus ALA-GLN (GLN equivalent, 14g/l). A control group (Group E) consisted of 22 normal mice (no burn injury, chow diet). Mice were assessed for BT by sterile harvesting and plating of mesenteric lymph node tissue, 48 h postburn. Plates were considered positive if any bacterial growth was noted. Non-burned mice exhibited no BT, while burn-fasted mice showed a 64.3 per cent incidence of BT ( P = NS). Burned mice fed Vivonex TEN showed a 55.9 per cent rate of BT. Maximal protection against BT was afforded by rodent chow (31.0 per cent BT, P = 0.0081). We also found a reduced incidence of BT after supplementation of Vivonex TEN with ALA-GLN compared to burn-fasted animals (36.1 per cent vs 64.3 per cent BT, P = 0.009), or compared to mice fed Vivonex TEN without supplemental ALA-GLN (36.1 per cent vs 55.9 per cent BT, P = 0.046).

Adverse Outcome in Pregnancy Following Amniotic Fluid Isolation of Ureaplasma urealyticum

Infections in pregnancy with Ureaplasma urealyticum have been associated with a wide range of adverse outcomes, such as early abortion, stillbirth, prematurity, and neonatal morbidity and mortality. Causality has been difficult to demonstrate secondary to the high prevalence of asymptomatic lower genital tract (LGT) colonization and culture data from inaccessible or potentially contaminated sites. Between 1985 and 1989, 2461 second-trimester genetic amniocenteses were evaluated at the cytogenetics section of the Children's Hospital Medical Center of Akron. All were cultured for the genital mycoplasmas: Mycoplasma hominis and Ureaplasma urealyticum. A total of nine patients were positive, all for Ureaplasma urealyticum, with one patient excluded because of subsequent therapeutic abortion. In addition, complete follow-up data, such as indication for amniocentesis, serum alpha-fetoprotein levels, gestational age at parturition, and out- come of pregnancy, were available on 86 Ureaplasma-negative (U –) patients during an approximate 2-year span within the time-frame of the study. This was in part due to physician response to a questionnaire sent after amniocentesis. Of the eight positive cultures, 100 per cent were associated with an adverse outcome, defined as fetal loss or premature delivery. This was significant compared with the U–group (p<0.001) with a more than eight times greater risk of adverse outcome. Six (75 per cent) resulted in spontaneous miscarriage within 4 weeks of amniocentesis and at less than 21 weeks' gestation. Two (25 per cent) delivered prematurely, with one (12.5 per cent) neonatal death at 24+ weeks. Histological examination of all eight placentae and the seven fetuses revealed a 100 per cent incidence of chorioamnionitis and pneumonia, respectively. In addition, in four of the five cases (80 per cent), cultures were positive for Ureaplasma urealyticum in pure culture from either placenta, fetal lung, or both tissues. The remaining case (20 per cent) was negative for aerobes, anaerobes, and mycoplasmas. The study demonstrates a significant association and supports a causal relationship between isolation of Ureaplasma from mid-trimester amniotic fluid with fetal wastage and premature birth.

Ornipressin in cold knife cone biopsy of the cervix

SummaryCold knife cone biopsy using ornipressin and a cervical encircling suture is described. Case notes from 81 patients using this technique were studied retrospectively. The 3-7 per cent incidence of haemorrhage requiring hospital re-admission compared very favourably with other surgical techniques used.

Guillotine and dissection tonsillectomy in children.

Tonsillectomy as an outpatient or same day-stay procedure is becoming increasingly popular. A retrospective study was performed on 1,049 children who underwent tonsillectomy and adenotonsillectomy either with guillotine or dissection with snare method. The dissection method was performed both under general anaesthesia and with local anaesthesia, but the guillotine method was performed only with local anaesthesia. Generally, bleeding control required no special intervention in the guillotine method but haemostasis was achieved by ligation and electrocauterization in one-third of the patients in the dissection group operated under general anaesthesia. The greatest percentage of haemorrhage in both methods occurred within the first four post-operative hours. There was a 1.8 per cent incidence of severe reactive haemorrhage required surgical intervention in the dissection group operated under general anaesthesia, but there was no such case in the guillotine group. The results of this study show that in carefully selected children guillotine tonsillectomy with local anaesthesia is a safe, time saving and cost-effective procedure.

Incidence of HIV seroconversion in paediatric burn patients

A retrospective review of paediatric patients treated for acute burn injuries and receiving blood/blood products between 1978 and 1985, identified 52 patients at risk for HIV infection. Over 50 per cent of the identified population had received 3 or more units of blood/blood products during their acute hospital stay. A total of 214 patients (36.8 per cent) have been tested for HIV seroconversions: five tested HIV positive by ELISA and four were confirmed by Western Blot, yielding a 1.9 per cent incidence. The four confirmed patients received 2–9 total body blood volume turnovers during their postburn period in hospital. At 4 years post-exposure, two patients show active disease, one is currently asymptomatic and one has died from AIDS-related sepsis.

Adverse outcome in pregnancy following amniotic fluid isolation of Ureaplasma urealyticum.

Infections in pregnancy with Ureaplasma urealyticum have been associated with a wide range of adverse outcomes, such as early abortion, stillbirth, prematurity, and neonatal morbidity and mortality. Causality has been difficult to demonstrate secondary to the high prevalence of asymptomatic lower genital tract (LGT) colonization and culture data from inaccessible or potentially contaminated sites. Between 1985 and 1989, 2461 second-trimester genetic amniocenteses were evaluated at the cytogenetics section of the Children's Hospital Medical Center of Akron. All were cultured for the genital mycoplasmas: Mycoplasma hominis and Ureaplasma urealyticum. A total of nine patients were positive, all for Ureaplasma urealyticum, with one patient excluded because of subsequent therapeutic abortion. In addition, complete follow-up data, such as indication for amniocentesis, serum alpha-fetoprotein levels, gestational age at parturition, and outcome of pregnancy, were available on 86 Ureaplasma-negative (U-) patients during an approximate 2-year span within the time-frame of the study. This was in part due to physician response to a questionnaire sent after amniocentesis. Of the eight positive cultures, 100 per cent were associated with an adverse outcome, defined as fetal loss or premature delivery. This was significant compared with the U- group (p less than 0.001) with a more than eight times greater risk of adverse outcome. Six (75 per cent) resulted in spontaneous miscarriage within 4 weeks of amniocentesis and at less than 21 weeks' gestation. Two (25 per cent) delivered prematurely, with one (12.5 per cent) neonatal death at 24+ weeks. Histological examination of all eight placentae and the seven fetuses revealed a 100 per cent incidence of chorioamnionitis and pneumonia, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)