Cumulative Recovery Rate Research Articles

How to Quantify and Interpret Treatment Effects in Comparative Clinical Studies of COVID-19.

Clinical trials of treatments for coronavirus disease 2019 (COVID-19) draw intense public attention. More than ever, valid, transparent, and intuitive summaries of the treatment effects, including efficacy and harm, are needed. In recently published and ongoing randomized comparative trials evaluating treatments for COVID-19, time to a positive outcome, such as recovery or improvement, has repeatedly been used as either the primary or key secondary end point. Because patients may die before recovery or improvement, data analysis of this end point faces a competing risk problem. Commonly used survival analysis techniques, such as the Kaplan-Meier method, often are not appropriate for such situations. Moreover, almost all trials have quantified treatment effects by using the hazard ratio, which is difficult to interpret for a positive event, especially in the presence of competing risks. Using 2 recent trials evaluating treatments (remdesivir and convalescent plasma) for COVID-19 as examples, a valid, well-established yet underused procedure is presented for estimating the cumulative recovery or improvement rate curve across the study period. Furthermore, an intuitive and clinically interpretable summary of treatment efficacy based on this curve is also proposed. Clinical investigators are encouraged to consider applying these methods for quantifying treatment effects in future studies of COVID-19.

Treatment of horizontal canal BPPV-a randomized sham-controlled trial comparing two therapeutic maneuvers of different speeds.

ObjectivesTo compare the effect of a high‐speed barbecue maneuver with the modified Lempert maneuver and sham in patients with benign paroxysmal positional vertigo (BPPV) of the horizontal canal.MethodsRandomized sham‐controlled, single blinded multicenter clinical trial in two university hospitals investigating consecutive patients with horizontal canal BPPV.Patients were randomly assigned to high‐speed barbecue (HSB), modified Lempert maneuver (ML), or sham maneuver (SM). All treatments were performed in a biaxial rotational chair with weekly follow‐up to a maximum of three treatment sessions. The final follow‐up was 3 months after the last treatment.ResultsPrimary outcome: 2‐week recovery rate per protocol. Secondary outcome: Cumulative recovery rate and Dizziness Handicap Inventory (DHI) scores after 3 months per protocol (HSB and ML) and intention to treat (all groups).Fifty‐four patients were analyzed after 2 weeks (HSB = 17; ML = 20; SM = 17). Two‐week recovery rate was 14/17 after HSB, 11/20 after ML, and 4/17 after SM, with significantly better recovery in HSB [OR 15.17, 95% CI (1.85, 124.63), P = .001] using sham as base level. Recovery rate after 3 months was 15/17 after HSB and 15/19 after ML. Cumulative recovery rate showed no significant differences between the two treatment groups [95% CI (0.30, 13.14), P = .46] in cure rate DHI [95% CI (−16.56, 15.02), P = .92]. No unexpected adverse events were observed.ConclusionVelocity change in horizontal canal BPPV treatment gives a faster initial recovery. Rapid recovery could reduce the disease burden.Trial Registration Clinicaltrials.gov. Identifier: NCT01905800.Level of Evidence1b

Recovery Over Time and Prognostic Factors in Treated Patients with Post-Infectious Olfactory Dysfunction: A Retrospective Study.

The aims of the present study were to clarify the time-course of olfactory recovery and the prognostic factors in PIOD patients treated with Toki-shakuyaku-san (TSS). A retrospective cohort study of patients with PIOD was conducted by reviewing patients' medical records. This study included patients who received TSS or a combination of TSS and zinc sulfate. Olfactory function was examined by T&T olfactometer at each 3-monthly follow-up visit. Patients with normal and mild olfactory dysfunction were excluded. Gender, age, treatment, duration of disease until the first visit and olfactory function scores of the T&T olfactometer at the first visit were analyzed as candidate clinical predictors of recovery. A total of 82 PIOD patients with ages ranging from 16 to 79 years were included. The mean duration of follow-up was 14.5 months (range 3-45 months). The number of patients with olfactory recovery increased for 24 months and the cumulative recovery rate was 77.3%. In about 60% of patients, olfactory recovery occurred within 6 months. Multivariate analysis showed that younger age (<65 years) and residual olfactory function were significantly associated with good olfactory recovery. We revealed recovery rates over time in patients with PIOD. The recovery of olfactory function often occurred during the early period (≤6 months). However, the number of patients with olfactory recovery increased for a long-term of 24 months after the first visit. Residual olfactory function and younger age were prognostic factors exactly. TSS may be a useful therapeutic agent for patients with PIOD. We believe that these results provide important information that is useful for counseling patients with PIOD.

Influencing factors and application prospects of CO2 flooding in heterogeneous glutenite reservoirs

In recent years, large amounts of CO2 emissions have led to many environmental problems. Developing a reasonable approach to carbon dioxide emissions is one of the most important issues for the sustainable development of human civilization. Compared with CO2 geological storage, CO2 flooding has greater advantages and a higher utilization efficiency. CO2 flooding technology has been successfully applied to many types of reservoirs, such as conventional sandstone reservoirs, low-permeability reservoirs, and carbonates. In this paper, the feasibility of CO2 flooding in glutenite reservoirs is studied. First, the glutenite reservoir is divided into fine stages, and reasonable vertical development units are determined. On this basis, the distribution scale, genetic environment and formation mode of the glutenite reservoir are characterized in detail and their spatial distribution rules are depicted in three dimensions. Then, the influencing factors of CO2 flooding in the glutenite reservoir are analysed via reservoir numerical simulation technology. The effects of reservoir thickness, reservoir heterogeneity, macropores, dominant channels and fracturing on CO2 flooding efficiency are evaluated individually, and a set of reasonable parameters constituting an evaluation system for CO2 flooding in the glutenite reservoir is established. Finally, based on parameter optimization, the disadvantaged conditions of CO2 flooding in glutenite reservoirs are optimized, and their effects are gradually eliminated. In view of the characteristics of glutenite reservoirs, a unique three-dimensional well pattern arrangement is designed, different injection modes are optimized, and suitable injection agents are tested. These methods are conducive to improving the effect of reservoir parameters on CO2 flooding efficiency, allowing these reservoirs to be used for CO2 flooding. Based on these new methods, the displacement effect of the Yanjia-Yongan glutenite reservoir is predicted. Our results show that the reservoir has been developed efficiently and achieved a high recovery rate, the displacement front of the CO2 has become more uniform, and the sweep range has become wider. After extending the successful application of CO2 flooding in this reservoir to all of the glutenite reservoirs in the entirety of the Bohaiwan Basin, we predict that the oil recovery rate may reach 40%, with a cumulative oil recovery rate of approximately 3.04 × 108 t and a total CO2 consumption of 1.672 × 108 t. Thus, the proposed approach not only can improve the atmospheric environment but can also greatly improve the efficiency of oil displacement.

End-to-side versus side-to-side anastomosis after laparoscopic right hemicolectomy for colon cancer: Short-term outcomes of a randomized controlled trial.

27 Background: A standard anastomotic configuration after right hemicolectomy is not well established, although short-term benefits of end-to-side anastomosis have been reported. This study was designed to assess the superiority of end-to-side anastomosis compared to side-to-side anastomosis after laparoscopic right hemicolectomy for colon cancer under an enhanced recovery program. Methods: Between September 2016 and August 2019, 130 patients (18–80 years) scheduled for laparoscopic right hemicolectomy were randomly assigned (1:1) to undergo end-to-side ( n = 65) or side-to-side ( n = 65) anastomosis. All patients underwent an enhanced recovery program with early diet and mobilization. The primary outcome was the cumulative recovery rate 7 days after surgery, defined as the percentage of patients who met all of the following recovery criteria: tolerated diet for 24h, analgesic-free, safe ambulation, and afebrile status without major complications. Results: The cumulative recovery rate did not differ between end-to-side (92.3%, 60/65) and side-to-side anastomosis (92.3%, 60/65) ( P = 1.000). Both approaches had similar cumulative recovery rates at 4, 5, and 6 days (end-to-side vs. side-to-side: 41.5% vs. 35.4%, P = 0.589; 73.8% vs. 63.1%, P = 0.257; 86.2% vs. 81.5%, P = 0.634; respectively) The median recovery time [interquartile range (IQR)] in the end-to-side and side-to-side groups was 105 [90-124] hours and 113 [84-139] hours, respectively ( P = 0.474), showing no significant difference. Length of stay [IQR] was similar in the end-to-side and side-to-side groups (5 [5–7] vs. 6 [5–7] days; P = 0.376). The 30-day complication rate (16.9% vs. 12.3%, P = 0.620), enhanced recovery program failure rate (10.8% vs. 7.7%, P = 0.763), and 30-day readmission rate (4.6% vs. 3.1%; P = 1.000) were not significantly different between the groups. Conclusions: This is the first randomized controlled trial showing that end-to-side anastomosis is not superior to side-to-side anastomosis in terms of short-term outcomes after laparoscopic right hemicolectomy. Clinical trial information: NCT02897531.

Follicular flushing increases the number of oocytes retrieved in poor ovarian responders undergoing in vitro fertilization: a retrospective cohort study

BackgroundTo investigate the impact of follicular flushing on the number of oocytes retrieved and embryo quality and to determine the optimal number of flushings for poor ovarian responders (PORs) undergoing in vitro fertilization (IVF).MethodsThis retrospective study included 291 IVF cycles in 224 patients who were PORs and had no more than three dominant follicles on retrieval day. During oocyte retrieval, follicular fluid was aspirated and examined for an oocyte. If no oocyte was identified, follicular flushing was repeated until an oocyte was retrieved or up to a maximum of nine times.ResultsThe mean number of oocytes retrieved by aspiration and subsequent flushes was significantly higher than the number retrieved from the initial aspirate (1.73 ± 0.96 VS. 1.23 ± 1.00, P = 0.000). The total recovery rate was 83.7% (503/601), which was significantly higher than the 59.6% recovery rate for direct aspiration (P = 0.000). Before the 4th follicular flushing, the cumulative recovery rate increased significantly as flushing was repeated, but after the 4th flushing, the ascending trend was mitigated; and the risk ratio of recovering fewer oocytes after 4 flushes compared with after 9 flushes was 0.765 (95%CI, 0.570–1.026, P = 0.074). Significant differences were not observed in maturation rate, fertilization rate, cleavage rate or high-quality embryo rate (P > 0.05).ConclusionsFollicular flushing may increase the number of oocytes retrieved and does not have adverse effects on oocyte or embryo quality in PORs undergoing IVF. Four times may be an optimal number of follicular flushings.

Introducing a novel model and tool for design and performance forecasting of waterflood projects

Although the waterflood process as an improved oil recovery method for increasing production and pressure maintanence has been around and widely used for more than six decades, it still holds a significant portion of world oil production. In some giant international companies, e.x. BP, about half of their production is by waterflooding. On the other hand, forecasting the performance of waterflooding projects plays an important role in successful study, design and selection of the best candidates from company reservoir asset. A model which is fast, robus, easy to use and reasonably accurate with a few input data required is of great desire. In this paper we address this deficiency by presenting a novel analytical-base forecasting model/tool that does not rely on conventional numerical simulation.Using the concepts of material balance, momentum balance, segregated flow and fractional flux (F-C or F-Phi) we achieve an analytical approach for modeling waterflooding behavior in reservoir. We used a Koval flow-storage capacity (F-C) model in the current research because of its strength and wide applicability for both homogenous and heterogeneous permeable media. The validity of the forecasting model was investigated by matching numerous actual field, single well and also simulation results.History matching showed good agreement between field data and forecasting results. The forecasting model demonstrates a strong ability to forecast the oil saturation, recovery efficiency, cumulative oil recovery, oil cut and oil rate changes with time. In addition, predicting the recovery efficiency enables us to generate the volumetric efficiency change with time which is of great importance for studying and evaluating waterflood process. These valuable results are produced using a few input data required.

Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy

To assess the results of following up patients with chronic myeloid leukemia (CML) and a deep molecular response (MR) without tyrosine kinase inhibitor (TKI) therapy. The reasons for TKI discontinuation in 70 patients with CML and a deep MR of more than 1 year's duration were adverse events, pregnancy, and patients' decision. Information was collected retrospectively and prospectively in 2008-2016. The median follow-up after TKI therapy discontinuation was 23 months (2 to 100 months). At 6, 12 and 24 months after TKI therapy discontinuation, the cumulative incidence of major MR (MMR) loss was 28, 41 and 48%, respectively; the survival rates without TKI therapy were 69, 50, and 39%, respectively. MMR loss was noted in 28 (88%) patients at 12 months; it was not seen without TKI therapy at 2-year follow-up. Deaths due to CML progression were absent. The Sokal risk group was a reliable factor influencing MMR loss (p ≤ 0.05). The cumulative recovery rate for deep MR after resumption of TKI use was 73 and 100% at 12 and 24 months, respectively, with a median follow-up of 24 months (1 to 116 months). Deep MR recovered at a later time when the therapy was resumed more than 30 days after MMR loss. Safe follow-up is possible in about 50% of the patients with CML and stable deep MRs without TKI therapy. The introduction of this approach into clinical practice requires regular molecular genetic monitoring and organizational activities. Biological factors in maintaining remission after TKI discontinuation need to be separately studied.

Hypophosphatemia predicts a failure to recover from adefovir-related renal injury after dose reduction in lamivudine-resistant hepatitis B patients.

In chronic hepatitis B patients receiving 10mg adefovir, dose reduction is recommended when renal injury appears. However, recovery is not always achieved and markers that recommend switching to another antiviral agent are unknown. We investigated adefovir-related renal injury, recovery after dose reduction, and their predictors. The renal injury in 77 chronic hepatitis B patients receiving 10mg adefovir and recovery after dose reduction to alternate day administration in those with adefovir-related renal injury were assessed. The predictors for >20% estimated glomerular filtration rate (eGFR) decline following treatment with 10mg adefovir and for >20% eGFR recovery after dose reduction were investigated. The adefovir dose was reduced in 26 patients (34%) at 59 ± 30 (mean ± standard deviation) months of 10mg adefovir treatment because of decreases in eGFR (cumulative incidence 27%), serum phosphorus (9%), and uric acid (16%) levels, and increases in alkaline phosphatase (20%), bone type alkaline phosphatase (18%), urinary α1-microglobulin (18%), and urinary N-acetyl-β-D-glucosaminidase (18%) levels. The only significant predictor for >20% eGFR decline was age ≥50years at the start of 10mg adefovir treatment. The cumulative eGFR recovery rate was 42% at 42 ± 27months after dose reduction, and ≥2.5mg/dL serum phosphorus level at dose reduction was the only significant predictor for >20% eGFR recovery after dose reduction. Patients aged ≥50years are predisposed to adefovir-related renal injury and switching to another antiviral agent rather than adefovir dose reduction is recommended when hypophosphatemia is observed.

Excretion rates of indigestible plastic balls of different specific gravities and diameters in dairy cattle.

We used plastic balls to investigate how their specific gravity and diameter affect excretion rate and rumination in dairy cattle, to develop a capsule that can be used for reaching the lower gastrointestinal tract without physical breakdown and/or degradation in the rumen. Twelve types of indigestible plastic balls composed of a combination of four specific gravities (0.95, 1.19, 1.41, or 2.20) and three diameters (3.97, 6.35, or 7.94 mm) were orally administered to lactating dairy cows, and the balls were collected from feces, after 120 h post-administration, to evaluate the recovery rate. Recovery rate of the balls with specific gravity 1.19 or 1.41 and diameter 6.35 or 7.94 mm was higher than those with specific gravity 0.95 or 2.20 and diameter 3.97 mm. The cumulative recovery rate at 24 and 48 h post-administration was higher for balls with specific gravity 1.19 than that for balls with other specific gravities. These results suggest that specific gravity 1.19 or 1.41 and diameters 6.35-7.94 mm are optimal for use in bypass capsules for administration to cattle. In addition, the passage time of capsules differed between specific gravities 1.19 and 1.41.

Analysis of Purified Oligomeric Proanthocyanidins from Larix gmelinii Bark and the Study of Physiological Activity of the Purified Product

A simple and efficient method for the purification of oligomeric proanthocyanidins (LOPC) from degreased Larix gmelinii bark was developed. The purity of LOPC was increased from 51.7% to 92.2%, and the cumulative recovery rate was 97.0%. The reversed phase high performance liquid chromatography-mass spectrum (RHPLC-MS) analysis indicated that the percentage contents of catechin (CA), epicatechin (EC), and procyanidin B1 (PB1) in purified LOPC (P-LOPC) were 5.05%, 2.02%, and 0.71%, respectively. The percentage contents of catechin and procyanidin B1 were noticeably higher than those obtained from grape seed extract (2.77% and 0.61%). The average degree of polymerization of P-LOPC was found to be 2.66. The matrix-assisted laser desorption ionization-time of flight/mass spectrum (MALDI-TOF/MS) analysis demonstrated that the dimer was the major component of purified LOPC and the distribution range was from dimer (m/z 713) to decamer (m/z 3016.6). The IC50 values of P-LOPC against DPPH• (1,1-diphenyl-2-picryl-hydrazyl), OH• (hydroxy radical), and ABTS+ (2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid diammonium salt) were 76.4±3.82, 7.92±0.40, and 2.4±0.12. Purified LOPC exhibited more excellent physiological activity than VC (vitamin C), TBHQ (tert-butyl hydroquinone), and pine bark extract.

(13)C-tryptophan breath test detects increased catabolic turnover of tryptophan along the kynurenine pathway in patients with major depressive disorder.

Altered tryptophan–kynurenine (KYN) metabolism has been implicated in major depressive disorder (MDD). The l-[1-13C]tryptophan breath test (13C-TBT) is a noninvasive, stable-isotope tracer method in which exhaled 13CO2 is attributable to tryptophan catabolism via the KYN pathway. We included 18 patients with MDD (DSM-IV) and 24 age- and sex-matched controls. 13C-tryptophan (150 mg) was orally administered and the 13CO2/12CO2 ratio in the breath was monitored for 180 min. The cumulative recovery rate during the 180-min test (CRR0–180; %), area under the Δ13CO2-time curve (AUC; %*min), and the maximal Δ13CO2 (Cmax; %) were significantly higher in patients with MDD than in the controls (p = 0.004, p = 0.008, and p = 0.002, respectively). Plasma tryptophan concentrations correlated negatively with Cmax in both the patients and controls (p = 0.020 and p = 0.034, respectively). Our results suggest that the 13C-TBT could be a novel biomarker for detecting a subgroup of MDD with increased tryptophan–KYN metabolism.

Risk Factors and Clinical Outcomes of Recurrent Laryngeal Nerve Paralysis After Esophagectomy for Thoracic Esophageal Carcinoma.

The objectives of this study were to assess the incidence of recurrent laryngeal nerve paralysis (RLNP) using laryngoscopy after esophagectomy for thoracic esophageal carcinoma and to clarify the risk factors influencing postoperative RLNP. A total of 299 patients who underwent laryngoscopic examination after esophagectomy were retrospectively reviewed. Patients who were found to have postoperative RLNP were followed up every 1–3 months, with a median follow-up period of 3 months. Recovery from paralysis was also evaluated on the basis of each affected nerve. Multivariate analyses using logistic regression were used to identify independent risk factors for RLNP. Cumulative recovery rate was calculated using Kaplan–Meier method. A total of 178 (59.5%) patients were diagnosed with RLNP by first laryngoscopy [bilateral in 59 (33.1%) patients, right in 15 (8.4%), and left in 104 (58.4%)]. In 206 patients who underwent transthoracic and thoracoscopic esophagectomy, independent risk factors for RLNP were lymph node dissection along the right RLN (odds ratio [OR] 3.01, 95% confidence interval [CI] 1.06–8.54, P = 0.04) and cervical anastomosis (OR 5.94, 95% CI 1.78–19.80, P < 0.01). Cumulative recovery rate from RLNP was 61.7% at 12 months after esophagectomy with 91 nerves eventually recovering from paralysis. Median recovery time was 6 months. RLNP developed in 60 % of patients after esophagectomy and may be associated with lymphadenectomy around the right RLN and cervical esophageal mobilization. Although 62% of affected nerves recovered within 12 months, great attention should be given when performing these procedures.

Intratympanic steroid injection for Bell's palsy: preliminary randomized controlled study.

To investigate adjuvant effect and safety of intratympanic steroid for the treatment of Bell's palsy. Prospective, investigator blinded, randomized study. Tertiary referral center. Patients who received treatment for Bell's palsy from December 2007 to March 2011 were randomly divided into two groups. The control group (n = 17) was treated with systemic steroid plus antiviral agent, and intratympanic steroid injection group (IT group, n = 14) received intratympanic steroid injection combined with medications. Facial functions were evaluated on a regular basis up to 6 months. Intratympanic steroid injection. Facial nerve functions of initial presentation and follow-up were evaluated with House-Brackmann (H-B) system. Primary outcome was complete recovery rate of 6 months. Secondary outcomes included improvement of H-B grade within 3 weeks, time of first improvement in facial function, and cumulative recovery rate. In addition, subgroup analysis of H-B grade over than IV was performed. Complete recovery rate was not different between groups. Time of first improvement was shorter in IT group (p = 0.043). And IT group had a better cumulative recovery rate (p = 0.041) and showed the significant improvement in H-B grade within 3 weeks compared with control group (p = 0.045). In severe facial palsy, complete recovery rate of IT group and control group were 80% and 50% (p = 0.16), and IT groups showed the significant facial improvement within 3 weeks (p = 0.025). And there were no major adverse effects of intratympanic injection. Intratympanic steroid injection might be a safe and useful adjuvant treatment modality for Bell's palsy.

Clinical study of unrelated umbilical cord blood transplantation for 25 patients with hematological diseases

This study was purposed to investigate the engraftment, graft-versus-host disease (GVHD), transplantation related mortality (TRM), relapse and survival in hematologic patients received unrelated umbilical cord blood transplantation (UCBT). A total of 25 patients with hematological disease underwent UCBT, including 8 pediatric and 17 young adult patients. Among them 3 cases received single unit of UCBT and 22 cases received double units of UCBT. For donor/recipients human leukocyte antigen (HLA) matching: HLA 6/6 loci matched in 9 cases, HLA 4-5/6 loci matched in 16 cases. There were 19 patients with hematologic malignancies, including 3 cases in the period of disease progression and 6 cases of non-hematologic malignancies. Conditioning regimens were TBI/Cy ± Flu ± ATG or BuCy ± Flu ± ATG for 21 patients and Cy+Flu+ATG for 4 patients. For prophylaxis of acute graft-versus-host disease (aGVHD) the regimen of cyclosporine (CsA) as dominant drug was used. The results showed that among 16 patients (80.0%) achieved engraftment, 20 patients survived for more than 42 d after transplantation. The cumulative neutrophil recovery rate on day 42 after transplant was 64.0%, with a median time of 17.0 d;the cumulative platelet recovery rate on day 100 after transplant was 60.0 %, with a median time of 35.0 d. The cumulative rate of grade II-IV and III-IV aGVHD after transplantation 100 d was 44.0% and 30.7%, respectively. Until the end of the follow-up, the cumulative rate of TRM was 54.3%. For all the patients, overall survival rate was 42.7%. Out of 17 evaluable patients with hematologic malignancies 7 cases (41.2%) survived to date, and only 1 case relapsed, so event-free survival rate was 35.3%. Out of 5 evaluable patients with non-hematologic malignancies, 4 patients survived and 2 patients were in stable engraftment state, 2 cases with autologous hematopoietic recovery. Among 3 cases of hematologic malignancies at advanced stage, only 1 case survived to date. It is concluded that HLA-4-6/6 loci matched UCBT is an effective option to treat hematological diseases. Double cord blood transplantation (dUCBT) can overcome the disadvantage of insufficient cells of single cord blood UCBT to treat overweight children and adult.

Study on Antioxidant Activity of Catalyzed Hydrogen Degradation Product of Polymeric Proanthocyanidins (LPPC) from Larix gmelinii Bark

A grading countercurrent extraction method was used to separate polymeric proanthocyanidins (LPPC) from degreased Larix gmelinii bark, and the purification of LPPC was performed using HP-2MGL resin. The purity of LPPC was 26.37%. The cumulative recovery rate of purified product (LPPC-1) was 98.54% by the adsorption method of HP-2MGL resin. The purity of LPPC-1 was 99.79%. Catalytic hydrogenolysis tests of LPPC-1 were performed by means of a palladium carbon catalyst. The degradation rate was 67.5%, and the residual rate was 72.1%. The results of antioxidant ability showed that the degradation product (LHOPC) had more excellent antioxidant ability compared with LPPC-1, VC, TBHQ, grape seed extract, and pine bark extract. The results, through the analysis of the linear model of MALDI-TOF/TOF MS, revealed that LHOPC was oligomeric with the tetramer as the major component and the distribution ranging from the trimer to eleven units.

1219 – Phenylalanine kinetics in schizophrenia patients detected by 13C-phenylalanine breath test

Introduction Altered levels of phenylalanine and its metabolites in blood and cerebrospinal fluid have previously been reported in schizophrenia. This study attempted to examine whether phenylalanine kinetics is altered in schizophrenia using the 13 C-phenylalanine breath test ( 13 C-PBT). Methods Subjects were 20 patients with schizophrenia and the same number of controls. 13 C-phenylalanine was administered and then 13 CO 2 concentration in breath was monitored for 120 minutes. The Δ 13 CO 2 at each collecting time, the maximal Δ 13 CO 2 (C max ), the time to reach C max (T max ), the area under the curve of time course of Δ 13 CO 2 (AUC), the cumulative recovery rate (CRR) at each collecting time of the 13 C-PBT were calculated for each subject. Results Body weight (BW) and diagnostic status were significant predictors for C max . BW, age and diagnostic status were significant predictors for AUC and CRR at 120 minutes (CRR 0-120 ). A repeated measures ANCOVA controlling for age and BW revealed a different pattern of change in CRR over time between the patients and controls and that Δ 13 CO 2 in schizophrenia were lower than that in healthy control at all sampling point during 120 min, with an overall significant differences between healthy control and schizophrenia. The ANCOVA controlling for age and BW, showed that C max , AUC and CRR 0-120 were significantly lower in schizophrenics than in controls. Conclusions Our data indicate the different change of Δ 13 CO 2 and CRR over time and the decreased C max , AUC and CRR 0-120 of 13 C-PBT in schizophrenia patients compared to healthy controls, suggesting the altered phenylalanine kinetics in schizophrenia.

13C-phenylalanine breath test detects altered phenylalanine kinetics in schizophrenia patients

Phenylalanine is an essential amino acid required for the synthesis of catecholamines including dopamine. Altered levels of phenylalanine and its metabolites in blood and cerebrospinal fluid have been reported in schizophrenia patients. This study attempted to examine for the first time whether phenylalanine kinetics is altered in schizophrenia using L-[1-13C]phenylalanine breath test (13C-PBT). The subjects were 20 chronically medicated schizophrenia patients (DSM-IV) and the same number of age- and sex-matched controls. 13C-phenylalanine (99 atom% 13C; 100 mg) was administered orally and the breath 13CO2 /12CO2 ratio was monitored for 120 min. The possible effect of antipsychotic medication (risperidone (RPD) or haloperidol (HPD) treatment for 21 days) on 13C-PBT was examined in rats. Body weight (BW), age and diagnostic status were significant predictors of the area under the curve of the time course of Δ13CO2 (‰) and the cumulative recovery rate (CRR) at 120 min. A repeated measures analysis of covariance controlled for age and BW revealed that the patterns of CRR change over time differed between the patients and controls and that Δ13CO2 was lower in the patients than in the controls at all sampling time points during the 120 min test, with an overall significant difference between the two groups. Chronic administration of RPD or HPD had no significant effect on 13C-PBT indices in rats. Our results suggest that 13C-PBT is a novel laboratory test that can detect altered phenylalanine kinetics in chronic schizophrenia patients. Animal experiments suggest that the observed changes are unlikely to be attributable to antipsychotic medication.

Prognostic Factors of Peripheral Facial Palsy

To search for prognostic predictors and reexamine the usefulness of electroneurography (ENoG) in predicting the prognosis of peripheral facial palsy using statistical methods. Prospective study. Tertiary referral center. Consecutive 142 patients with Bell's palsy and 26 with Ramsay Hunt syndrome treated with steroid plus antiviral agents. Multivariate analysis was used to identify which factors, including Yanagihara grading score and ENoG, predict better recovery. Receiver operating characteristic (ROC) curves were constructed for ENoG and grading score. The cumulative recovery rate by ENoG was calculated using Kaplan-Meier analysis. Recovery was defined as the improvement of grading score to 36 points or more (full score, 40) without synkinesis. Multivariate analysis revealed that Ramsay Hunt syndrome, the worst grading score and ENoG were the significant prognostic predictors. The area under the ROC curve for ENoG was broader than those for grading score, indicating that ENoG was superior to grading score in terms of accuracy for prognosis prediction. The ROC curve revealed that more than 85% degeneration on ENoG had the best specificity (77.8%) and sensitivity (71.4%) to predict nonrecovery. When ENoG was subjected to the analysis of cumulative recovery rate using Kaplan-Meier plots, patients with more than 85% degeneration on ENoG had significantly poorer prognosis. ENoG was the most effective factor for prediction of the prognosis of peripheral facial palsy, and more than 85% degeneration had the best specificity and sensitivity to predict nonrecovery.

Meiotic spindle recovery is faster in vitrification of human oocytes compared to slow freezing

To investigate spindle behavior during and after slow freezing at room temperature (RT) and vitrification at different temperatures. Randomized, comparative study. University hospital. Patients undergoing IVF treatment volunteered for the study and donated part of their supernumerary oocytes. Metaphase II oocytes were divided into group A: slow freezing RT /thawing RT; group B: vitrification RT/warming RT; group C: vitrification RT/warming 37 degrees C; and group D: vitrification 37 degrees C/warming 37 degrees C. Spindle presence was evaluated at each step of the four procedures and in culture. Cumulative spindle recovery rate comparing warming phase of the three vitrification groups and culture phase among the four groups. During warming, the three vitrification groups showed a significantly fast spindle recovery rate compared to the thawing of the slow freezing group. A progressively significant fast cumulative recovery rate was observed in the three vitrification groups by increasing the number of phases at physiological temperature (hazard rate = 2.68; 95% confidence interval 1.71-4.02). The present study demonstrates that spindle recovery is faster in vitrification than in slow freezing. These data support a possible protective effect of vitrification/warming at 37 degrees C on the meiotic spindle structure and, therefore, on the subsequent clinical outcome of the procedure, although comparative clinical studies are needed.