Cross-sectional Value Research Articles

SAT0135 Modified antitnf dose patterns in clinical practice: Achieving clinical control with minimum effective dosages

BackgroundIn the management of rheumatoid arthritis (RA) patients, the election of the drug and dosage needs to be personalized considering each particular subject conditions.ObjectivesAssessclinical characteristics, disease activity and concomitant treatment...

Effect of chang run tong on the biomechanical and morphometric remodeling of colon and rectum in streptozotocin-induced diabetic rats

The present study investigates the effect of Chang Run Tong (CRT) on the biomechanical and morphometrical remodeling of colon and rectum in streptozotocin-induced diabetic rats. The colonic and rectal segments were obtained from diabetic (DM), CRT-treated diabetic (T1, high dosage: 50 g/kg/day; T2, low dosage: 25 g/kg/day) and normal (Con) rats. The experimental period was 60 d. The blood glucose level and body weight were measured. The circumferential length, wall thickness, and opening angle were measured from the segments in the no-load and zero-stress states. The residual strain was computed from the morphometry data. The step-wise distension was done on the colonic segment (from 0 to 20 cmH2O). The circumferential and longitudinal stresses and strains were computed. The blood glucose level was significantly higher and the body weight was significantly lower in the DM, T1, and T2 groups compared to those in the Con group (p ＜ 0.01, p ＜ 0.001). The glucose level did not differ among the DM, T1, and T2 groups. The wet weight per unit length to body weight ratio, wall thickness, cross-sectional wall area, opening angle, and absolute value of residual strain of colonic and rectal segments in the DM group were significantly higher than those in the Con group (p ＜ 0.05 and p ＜ 0.01), and those in the T1 group, but not those in the T2 group, were significantly lower than those in the DM group (p ＜ 0.05, p ＜ 0.01). Furthermore, the circumferential and longitudinal stiffness of the colonic wall in the DM group was higher than those in the Con group. T1, but not T2, treatment could significantly decrease the colonic wall stiffness in both directions (p ＜ 0.01). CRT (high dose) treatment could partly restore the morphometric and biomechanical remodeling of the lower gastrointestinal tract in diabetic rats.

Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

To demonstrate the potential benefits of biochemical axial T2 mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting. Ninety-three patients suffering from lumbar spine problems were examined using standard MRI protocols including an axial T2 mapping protocol. All discs were classified morphologically and grouped as "healthy" or "abnormal". Differences between groups were analysed regarding to the specific T2 pattern at different regions of interest (ROIs). Healthy intervertebral discs revealed a distinct cross-sectional T2 value profile: T2 values were significantly lower in the annulus fibrosus compared with the nucleus pulposus (P = 0.01). In abnormal IVDs, T2 values were significantly lower, especially towards the centre of the disc representing the expected decreased water content of the nucleus (P = 0.01). In herniated discs, ROIs within the nucleus pulposus and ROIs covering the annulus fibrosus showed decreased T2 values. Axial T2 mapping is effective to detect early stages of degenerative disc disease. There is a potential benefit of axial T2 mapping as a diagnostic tool, allowing the quantitative assessment of intervertebral disc degeneration.

Computational Fluid Dynamics Analysis of Pulsatile Blood Flow Behavior in Modelled Stenosed Vessels with Different Severities

This study focuses on the behavior of blood flow in the stenosed vessels. Blood is modelled as an incompressible non‐Newtonian fluid which is based on the power law viscosity model. A numerical technique based on the finite difference method is developed to simulate the blood flow taking into account the transient periodic behaviour of the blood flow in cardiac cycles. Also, pulsatile blood flow in the stenosed vessel is based on the Womersley model, and fluid flow in the lumen region is governed by the continuity equation and the Navier‐Stokes equations. In this study, the stenosis shape is cosine by using Tu and Devil model. Comparing the results obtained from three stenosed vessels with 30%, 50%, and 75% area severity, we find that higher percent‐area severity of stenosis leads to higher extrapressure jumps and higher blood speeds around the stenosis site. Also, we observe that the size of the stenosis in stenosed vessels does influence the blood flow. A little change on the cross‐sectional value makes vast change on the blood flow rate. This simulation helps the people working in the field of physiological fluid dynamics as well as the medical practitioners.

Variability in CKD stage in outpatients followed in two large renal clinics

Chronic kidney disease (CKD) is staged by glomerular filtration rate (GFR). CKD stages sometimes vary between routine office visits, and it is unknown if this impacts renal and patient survival separately from a cross-sectional CKD stage value. We quantified and categorized CKD stage variability in a large group of outpatients and correlated this with clinical and demographic features and with renal and patient survival. All estimated GFRs were staged in the first observation period. CKD stages were then categorized as static, improving, worsening, or fluctuating. Logistic regression analysis was performed to identify clinical variables associated with CKD stage variability. Death and dialysis progression rates were then collected and analyzed using Cox proportional regression. During a 1.1-year observation period, 1,262 patients (mean age 71.25 years) had a mean 5 eGFR's. CKD stages were static in 60.4%, worsened in 14.4%, improved in 7.4%, and fluctuated in 17.2% of patients. Secondary analysis revealed heavy proteinuria and East Asian ethnicity to be negatively, and diabetes mellitus and previous acute kidney injury to be positively associated with improving CKD stages. Cox proportional regression of 902 patients analyzed 2.3 years later revealed a negative association with improving CKD stage and subsequent need for dialysis. CKD stage changed in 40% of 1,262 elderly patients when determined 5 times in just over 1 year. Improving CKD stage was the only variability pattern significantly associated with any of the clinical outcomes when assessed 2.3 years later, being unlikely to be linked with subsequent need for dialysis.

Reply to Letter to the Editor: The Sensitivity and Specificity of Ultrasound for the Diagnosis of Carpal Tunnel Syndrome: A Meta-analysis

We thank Descatha et al. for their interest in our article [3] and their comments. A systematic review and meta-analysis uses a systematic approach to identify evidence from multiple studies to attain an accurate and unbiased estimate of the association between interventions or exposures and events that could be widely applicable to a larger population [4]. By combining patient data from multiple studies appropriately, meta-analyses allow for larger sample sizes and therefore statistical power to determine treatment effects [1, 4]. However, systematic reviews are not without limitations. All reviews are retrospective and observational and therefore are subject to random error and systematic bias [1]. Systematic reviews, when conducted properly, can provide a high level of evidence, improve the precision of the analysis by increasing the sample size, and help to explain differences in study results attributable to heterogeneity [2]. Ultimately, a meta-analysis depends on the quality of the primary studies included in the analysis [2]. We believe that we performed a quality meta-analysis [3], confirmed by high scores on the Oxman and Guyatt index [5], a validated scoring system for the quality of meta-analyses and systematic reviews. Drs. Descatha, Huard, and Duval suggest that by combining studies that used different cross-sectional area cutoffs for positive diagnosis of carpal tunnel syndrome, our results may artificially influence the sensitivity and specificity of the sample. All meta-analyses carry this risk, and our study is no different. We agree that obtaining the raw data from all studies included in the analysis would have yielded more accurate results. However, as obtaining the raw data from every study is not possible, including only studies for which we were able to obtain raw data would introduce substantial selection bias. They also suggested that separate analyses should have been performed at each cross-sectional area cutoff value, however, this would decrease the sample size for each value and add more confusion to an already potentially confusing analysis. We thank Drs. Descatha, Huard, and Duval for observing our failure to include the likelihood ratios in the manuscript and have included a table detailing the ratios (Table 1). Table 1 Studies included in the meta-analysis [3] and reported likelihood positive and negative ratios We respectfully disagree that the specific transducer and ultrasound equipment used in each study is an important factor in the sensitivity and specificity of ultrasound as a diagnostic tool. We found no literature to support the advantage or disadvantage of one transducer over another. We did identify substantial heterogeneity in the criteria used for electrodiagnostic testing and clinical findings in the diagnosis of carpal tunnel syndrome. This heterogeneity, however, mirrors clinical reality where different institutions and physicians use varying criteria. We sincerely thank Descatha et al. for their thoughtful comments and hope we have addressed their concerns.

Correlation of Charge Buildup and Stress-Induced Leakage Current in Cerium Oxide Films Grown on Ge (100) Substrates

High-kappa films are currently deposited on Ge substrates to compensate the mobility loss, as Ge offers higher mobility compared with that of silicon. This paper deals with the reliability characteristics of cerium oxide films grown by molecular beam deposition on n-type Ge (100) substrates. MOS capacitors with Pt gate electrodes were subjected to constant voltage stress conditions at accumulation. The correlation of the charge-trapping characteristics and the stress-induced leakage current (SILC) to the applied field is observed and analyzed. The results suggest that one major problem for the potential use of rare earth oxides in future MOS technology is the existence of relaxation effects. The cross-sectional value of the bulk oxide traps is on the order of 10-18 cm2 , thus indicating neutral defects. Direct comparison to reported results on high- kappa/Si and SiO2/Si structures shows that SILC properties are related to the quality of the dielectric layers; the semiconductor substrate is immaterial.

Increased platelet activation markers in rheumatoid arthritis: Are they related with subclinical atherosclerosis?

Atherosclerotic cardiovascular mortality is increased in rheumatoid arthritis (RA) patients. We evaluated the association of inflammatory response with platelet, endothelial, coagulation activation parameters; and subclinical atherosclerosis in RA patients. We included 27 RA patients (21 female; six male) and 19 healthy subjects (14 female; five male). Disease activity score (DAS28) in RA patients was calculated; and patients were divided into two groups as active and inactive. Flow cytometry was used to determine platelet CD62P expression, platelet microparticles (PMP), platelet-monocyte (PMC) and platelet-neutrophil complexes (PNC). Plasma E-selectin, thrombin-antithrombin (TAT) complex, and serum sCD40L levels were determined by ELISA. The intima-media thickness (IMT) of carotid arteries was determined by B-mode ultrasonography. In RA patients, platelet CD62P expression (p < 0.001), PMC (p = 0.037) and sCD40L (p < 0.001) levels were increased when compared to the control group. PNC (p = 0.07) and TAT levels (p = 0.1) were non-significantly higher, and PMP level (p = 0.075) was nonsignificantly lower in RA patients. Soluble E-selectin level was significantly higher in the active RA group than in the inactive RA group (p = 0.009). There was no correlation between carotid IMT and activity markers, the evaluated parameters (p > 0.05).The increase in markers of active platelets, CD62P and sCD40L, and PMC levels might be associated with the increased cardiovascular mortality in RA. Nevertheless, none of these parameters were associated with carotid IMT: this suggests that one cross-sectional value might not be a good marker for atherosclerosis.

Effective properties of a nonuniform beam under torsion

Effective characteristics are considered in the pure torsion problem for a nonuniform beam. The Saint-Venant semi-inverse method is used. A torsion stress function is introduced; this function can be found by solving a cross-sectional boundary value problem for a partial differential equation with variable coefficients. Two special boundary value problems are formulated for such an equation; after solving these problems, some effective characteristics are calculated in the case of torsion. It is shown that these effective characteristics satisfy the conditions of symmetry and positive definiteness. The case of an infinite in-plane layer of nonuniform thickness is discussed.

Free-convective heat transfer in fluids with non-uniform volumetric heat generation

The characteristics of natural convection of a heat-generating fluid with non-uniform distribution of volumetric heat release have been studied theoretically. The analysis was based on analytical estimates method and numerical simulation. It has been found that under particular conditions the details of volumetric heat release distribution over horizontal cross-sections of the liquid pool do not affect the convectional heat transfer characteristics. The vertical distribution of the horizontal cross-sectional mean value of volumetric heat generation completely determines the distribution of temperature in the bulk as well as the heat flux to the cooled boundary.

BOT3P—Bologna Transport Analysis Pre-Post-Processors Version 3.0

BOT3P is a set of standard FORTRAN 77 language programs developed at the ENEA-Bologna Nuclear Data Centre. BOT3P Version 1.0 was originally conceived to give the users of the DORT and TORT deterministic transport codes some useful diagnostic tools to prepare and to check their input data files. BOT3P Version 3.0 contains some important additions in the input geometrical model description, such as “rod” and “hexagonal” geometrical objects, respecting the exact cross-sectional area value and very suitable to describe a reactor lattice in detail. Moreover, it has extended the possibility to produce the geometrical, material distribution, and fixed neutron source data for the deterministic transport codes TWODANT and THREEDANT of the DANTSYS system and for the PARTISN code too, starting from the same input to BOT3P. When users require X-Y-Z TORT/THREEDANT/PARTISN mesh grids to be generated, BOT3P Version 3.0 produces a geometrical input for the MCNP Monte Carlo transport code also, where the MCNP cells correspond to the X-Y-Z bodies created for TORT.BOT3P Version 3.0 lets users specify areas/volumes of the model where the zone/material distribution can be defined not only by a combinatorial geometry but also by an external source, such as one originated from computerized tomography scan data (only for three-dimensional applications) and from one or more external DORT/TORT input files. BOT3P was developed on a DIGITAL UNIX ALPHA 500/333 workstation and successfully used in some complex neutron shielding and criticality benchmarks. It was also tested on Red Hat Linux 7.1 and is designed to run on most UNIX platforms. All BOT3P versions are publicly available from the Organisation for Economic Co-operation and Development/Nuclear Energy Agency Data Bank (NEA-1627, NEA-1678).

Quality of life associated with visual loss: A time tradeoff utility analysis comparison with medical health states

Purpose To assess the visual utility values of patients with ocular disease and to compare these values with those of patients with systemic health states Design Cross-sectional utility value assessment. Methods Consecutive patients with ophthalmic diseases were interviewed in a one-on-one fashion using a standardized time tradeoff utility value assessment form. These values were compared with utility values for systemic health states present in the literature. Intervention None. Main outcome measure Time tradeoff utility value on a scale ranging from 1.0 (perfect visual health) to 0.0 (death). The ophthalmic patient groups were stratified into 4 visual groups dependent on the visual acuity in the better-seeing eye. The groups were as follows: group 1, 20/20 to 20/25; group 2, 20/30 to 20/50; group 3, 20/60 to 20/100; group 4, 20/200 to no light perception. Results A total of 500 subjects were enrolled in the study. The mean utility values for the visually stratified groups were: group 1, 0.88; group 2, 0.81; group 3, 0.72; group 4, 0.61. Comparable respective systemic health state utility values for each of the ophthalmic groups were: diabetes mellitus, status after kidney transplantation, moderate stroke, and moderately severe stroke. Conclusions Visual loss is associated with a substantial and measurable diminution in quality of life. This diminution in quality of life can be directly compared with that induced by systemic health states.

Effect of perineural anesthesia on the ultrasonographic appearance of equine palmar metacarpal structures.

The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% mepivacaine hydrochloride solution. Ultrasonographic examinations similar to the initial examination then were performed immediately, 1 h and 24 h postinjection. Cross-sectional area and mean pixel value were determined for the superficial and deep digital flexor tendons, the accessory ligament of the deep digital flexor tendon, the suspensory ligament, and the suspensory branches at each level and time period. Subjective ultrasonographic changes also were noted. No significant difference was noted in the cross-sectional area or mean pixel value of any structure at any level or time period compared to baseline. Subjective changes in the tendons and ligaments were not noted. There was mild hypoechoic swelling of the surrounding soft tissues and gas in the region of the injections. Gas could interfere with the evaluation of the origin of the suspensory ligament and the proximal portion of the accessory ligament of the deep digital flexor tendon within the first hour but was not detectable ultrasonographically at 24 h. Based on these findings, if gas interferes with an ultrasonographic examination performed temporally close to perineural anesthesia, a repeat examination at 24 h is recommended.

Leg Length Increase/Decrease in Japanese in the Latter Half of the 20th Century.

In order to determine whether the legs of the Japanese have continued to lengthen, two nation-wide anthropometric data sets from the MITI and Ministry of Education were referred to. Based on the cross-sectional and longitudinally-followed mean value observations, we can conclude that until the 1970s the Japanese had become taller due to increasing leg length. Since the 1980s, however, increase in leg length (crotch height and estimated leg length) has declined relative to height increase, especially in young males, whereas in young females relative leg length to height continues to increase if only a little. The main cause of the absolute and relative shortening of the legs in young males can be attributed to the greater increase of weight and trunk circumferences resulting from subcutaneous fat accumulation. Thus we can conclude that the Japanese have become taller and bigger while retaining their original linear body proportion. These proportions will remain unchanged so long as the gene pool remains unchanged.

Loss, humiliation and entrapment as appraisals of schizophrenic illness: a prospective study of depressed and non-depressed patients.

Life-events that precede the onset of unipolar depression usually involve an appraisal of loss; recent research has shown that where these events are also appraised as humiliating or involving entrapment and defeat (the absence of a way forward or failure to reaffirm an identity) they are especially potent in triggering depression. Depression in schizophrenia has not been studied from the cognitive or psychosocial perspectives, probably because of its confused nosological status. In a previous study we showed that patients' perceived loss of control and entrapment by psychotic illness (e.g. by recurring relapse) was strongly linked to depression. In this study we follow up the original sample of 49 patients 2.5 years later to examine the hypotheses using more powerful prospective methodology. Two of the sample had died of natural causes and the remaining 47 agreed to be reinterviewed. We used the same measures of patients' appraisal of their illness and symptoms in terms of the extent to which they perceive it as embodying loss, humiliation and entrapment. It was found using multivariate analysis that perceived loss of autonomy and social role, particularly employment, were correlated with depression. The appraisal of entrapment in psychotic illness was found to have high cross-sectional and prospective predictive value independent of illness, symptom and treatment variables and was shown to be influenced by certain aspects of psychiatric treatment, particularly compulsory detention. We propose that episodes of depression in schizophrenia are triggered by psychosis-related events (relapse, compulsory admission, residual voices, loss of job, etc.) that signify the inability to overcome the loss of a cherished personal goal or social role and thereby to affirm an identity. Implications for psychological therapy are discussed.

Cross-Sectional Area of the Stenotic Lumbar Dural Tube Measured from the Transverse Views of Magnetic Resonance Imaging

The cross-sectional area of the lumbar dural tube was calculated from transverse-slice lumbosacral magnetic resonance images (MRI) using the simple geometric formulas and computerized digitizer in 51 patients with low-back pain only, 79 with mainly radicular symptoms, and 53 with intermittent claudication, and in 39 controls with confirmed symptomatic lesions at a nonlumbar level or of a nonspinal organ. Findings suggesting developmental narrowing of the spinal canal were found not only in the intermittent claudication group, but also in the radicular pain group. Cross-sectional area of < 100 mm2 at more than two of three (L2/3, L3/4, and L4/5) intervertebral levels was highly associated with the presence of intermittent claudication. The cross-sectional area value obtained with the simplified geometric formulas was highly correlated with that calculated with the digitizer, indicating that this simple method can be used with MRI in outpatient clinics for the rapid determination of the most stenotic portion of the dural tube.

Some connections between velocity-related and pressure-related quantities in axisymmetric fluid flow

In the context of axisymmetric flow of a fluid of constant density, a quantity is defined which is tantamount to the cross-sectional mean-square value of the axial velocity. An upper estimate is obtained for this quantity in terms of its value at two values of the axial coordinate and in terms of the pressure. The upper estimate coincides with the quantity in some circumstances. Other estimates of a similar nature are also discussed.

Texture Evaluation of Dehulled Whole Soybean Extrudate Treated with a Twin-screw Extruder.

Extrusion cooking of dehulled whole soybean, containing ca. 20% oil, was done through a twin-screw extruder equipped with a cooling nozzle. The effect of various parameters as barrel temperature, feed rate and screw speed on the textural quality of the extrudate was investigated and evaluated using the values of shearing force measured with the shear cell and physical structure index which was a modified version of Integrity Index of the FNS test. The concept of index or the ratio of parallel to cross-sectional value of blade shear force was introduced, expressing the fiber orientation of extrudate which was strongly affected by the feed rate. The main factor affecting texturization of dehulled whole soybean was found to be barrel temperature, optimum at 160°C.

頚椎疾患のＣＴ所見からみた手術前後における頚筋

Twenty-one cases of cervical disorders (CSM, 9 cases; CSR, 3 Cases; OPLL, 9 cases) were analysed for their neck muscles on CT. The neck muscles were devided into three groups at C5 level; sternocleidomastoideus (Scm), superficial dorsal group (SDG) and deep dorsal group (DDG). Cross-sectional area and mean CT value of each muscle group were measured.The results obtained were as follows;1) Male patients have larger size of the neck and higher ratio of muscle transectional area to whole area than female patients.2) CT view at an average of 8 weeks postoperatively showed enlarged intermuscular low density areas of superficial dorsal muscles and decreased mean density of deep dorsal muscles in the group of posterior approach, which suggested the state of edema in the former and the degenerative changes in the latter.

Filtered bessel functions in computerized tomography

Computer Aided Tomography (CAT) is widely used in the medical imaging area for the detection of cancerous tissues. It has also proved to be a good technique for measuring point-density (void-fraction) in two-phase flow systems. The present day CAT-scanners employ alogorithms which are essentially a discrete implementation of the Radon Inversion Formulae. These methods of reconstructing density distributions are fast and easy to implement. The present work is an attempt to simplify (and consequently to speed-up) the existing algorithms for the cases of radially symmetric density distribution. The method uses Radon Inversion Formulae and involves Bessel's Function of Fourier frequency. The algorithm was tested on some known distributions and the reconstruction is excellent. Data for bubbly-flow was also processed to obtain a point density distribution. The range of investigation was 0.6 ≤ 〈ϱ〉 ≤ 0.9 g/cm 3 , where “〈 〉” denotes average cross-sectional value. The values of 〈ϱ CT 〉 are within ±0.03 g/cm 3 of the true values, 〈ϱ〉, for the data sets considered. The results are comparable with another simple method involving radial polynominals. It is observed that the simplified Radon Inversion Formulae for the radially symmetric case gives good results and can be implemented with ease.