Frequency Of Different Patterns Research Articles

Scalable Methods for Multiple Time Series Comparison in Second Order Dynamics

Statistical comparison of multiple time series in their underlying frequency patterns has many real applications. However, existing methods are only applicable to a small number of mutually independent time series, and empirical results for dependent time series are only limited to comparing two time series. We propose scalable methods based on a new algorithm that enables us to compare the spectral density of a large number of time series. The new algorithm helps us efficiently obtain all pairwise feature differences in frequency patterns between M time series, which plays an essential role in our methods. When all M time series are independent of each other, we derive the joint asymptotic distribution of their pairwise feature differences. The asymptotic dependence structure between the feature differences motivates our proposed test for multiple mutually independent time series. We then adapt this test to the case of multiple dependent time series by partially accounting for the underlying dependence structure. Additionally, we introduce a global test to further enhance the approach. To examine the finite sample performance of our proposed methods, we conduct simulation studies. The new approaches demonstrate the ability to compare a large number of time series, whether independent or dependent, while exhibiting competitive power. Finally, we apply our methods to compare multiple mechanical vibrational time series.

Advancing non-invasive fetal health monitoring: A time–frequency approach to extracting fetal electrocardiogram signals

The fetal electrocardiogram (FECG) provides an important way for clinicians to assess fetal health and to monitor pregnancy conditions. Although FECG can be captured through abdominal electrocardiogram (AECG) recordings from pregnant women, it often receives interference from maternal cardiac activity and other external sources. Particularly, as the high-amplitude maternal electrocardiogram (MECG) typically obscures the waveform of the FECG, isolating FECG from the AECG signals is challenging. Nevertheless, the differences in frequency patterns between MECG and FECG suggest a potential way for reconstructing FECG by combining the frequency and amplitude information. To this end, we proposed a novel method for separating FECG signals from the AECG via the time–frequency representation. We designed an encoder–decoder architecture based hierarchical multiscale-aware network to capture features embedded in both the time and frequency domains. Equipped with a holistic attention-aware module (HAA), the model extracts and consolidates fetal heart activity-related features in the time–frequency domain. Further introducingan attention gate module (AG) to emphasize key features during encoder-to-decoder transmission, the model enhances the quality and efficiency of FECG extraction without any redundancy in high-quality feature mapping. The model was trained using a hybrid time-domain and frequency-domain loss function and validated on two public databases. Excellent performances, such as an average Pearson correlation coefficient of 0.85 for estimating the quality of FECG signals, were observed demonstrating its excellent performance and providing a promising non-invasive method for monitoring fetal health. These findings indicate that the proposed method effectively captures the amplitude differences between fetal and maternal heartbeats across various frequency components within the AECG, leading to the extraction of high-quality FECG signals.

Assessment of the Frequency of Different Patterns of Clinical Presentation of Children Presenting with Congenital Adrenal Hyperplasia

Background: Congenital suprarenal hyperplasia is an autosomal recessive condition that is characterized by defects in some of the 5-enzymes required for cortisol synthesis. Literature indicates a high incidence of salt depletion and genital virilization in children with congenitally adrenal hyperplasia. The purpose of this study was to examine the prevalence of clinical patterns in children with congenital adrenal hyperplasia. Material and methods Study design: Cross sectional study Setting: Department of Pediatric, Fatima Memorial Hospital, Lahore. Duration: 6 months i.e. 19-12-2019 to 18-06-2020 Data collection: 92 infants who met the inclusion criteria were included in the study. Blood sample was obtained, if serum sodium was <135mEq/L, salt depletion was labeled. Then, genital examination for assessment of genital virilization was done. All data was entered in specially designed Performa and analyzed in SPSS. Results: The mean age of patients was 6.52±3.56 months. There were 49 (53.26%) male while 43 (46.74%) female infants. The mean weight of patients was 5.59±1.44 kg. There were 21 (22.83%) cases of consanguineous marriage while 71 (77.17%) were others. 63 (68.48%) had salt depletion while 29 (31.52%) did not had salt depletion. 39 (42.39%) patients had genital virilization while 53 (57.61%) did not have genital virilization. Conclusion: The frequency of patterns (salt depletion and genital virilization) of Congenital adrenal hyperplasia are high in local population. Keywords: Patterns, salt depletion, genital virilization, congenital adrenal hyperplasia, infants, consanguineous marriage

Electroencephalography Patterns of Subacute Sclerosing Panencephalitis.

Introduction and background: This article explores the electroencephalography (EEG) pattern in patients of suspected subacute sclerosing panencephalitis (SSPE) visiting Lady Reading Hospital, Peshawar. Pakistan has a huge deficit of research culture, and limited studies are done on this topic. This study concluded that a typical pattern is the most common EEG pattern, although atypical and normal EEG patterns were also observed. It is worth inclusion into the existing literature and may be used for future literature review of similar studies done elsewhere in Pakistan to give a wider perspective comprised of a larger sample size - integrating all studies.Objective: To determine the frequency of different patterns of EEG (typical, atypical, and normal) in SSPE patients.Methodology: Seventy-seven patients of both male and female genders between ages one to 20 years, who were diagnosed with SSPE, were included in the study. Dyken’s criteria were used to diagnose the patients. A prior history of previous measles infection with signs and symptoms suggestive of SSPE and positive anti-measles IgG antibodies in the cerebrospinal fluid (CSF) was found in all the patients included in the study. Besides this, typical EEG patterns and raised CSF globulin levels were also used for confirmation of the diagnosis. All the patients fulfilling the above criteria and presenting to the neurology department of Lady Reading Hospital, Peshawar, from February 1, 2019, to November 30, 2019, were included in the study. All the patients underwent the EEG monitoring in the same EEG laboratory and were reported by the same consultant with careful exclusion of any artifacts during the study.Result: There were 59 (76.62%) males and 18 (23.37%) females. The mean age was 15 ± 8.6 years, and the mean duration of symptoms was 4.79 ± 1.68 months. EEG was normal in 14 (18.18%) patients, while 63 (81.81%) patients had an abnormal EEG pattern, with a majority of 53 (84.12%) patients showing periodic delta wave complexes. Only 10 (15.87%) patients showed atypical patterns.Conclusion: Almost all the patients of SSPE showed periodic high-amplitude delta waves complexes, which usually occurs in patients with a disease duration of more than four months. However, further studies with a large sample size are needed for the confirmation of this observation.

ASSESSMENT OF THE FREQUENCY OF DIFFERENT PATTERNS OF CLINICAL PRESENTATION OF CHILDREN PRESENTING WITH CONGENITAL ADRENAL HYPERPLASIA

Objective: To assess the frequency of different patterns of presentation of children presenting with congenital adrenal hyperplasia.
 Methodology:It was a cross sectional study conducted at the department of Pediatric, Fatima Memorial Hospital, Lahore, from19-12-2017 to 19-06-2018.92 infants who met the selectin criteria were recruited for the study. Then blood sample was obtained and if serum sodium <135mEq/L, then salt depletion was labeled. Then, infants underwent genital examination for assessment of genital virilization. All data is entered is specially designed Performa and analyzed in SPSS.
 Results: The mean age of patients was 6.52±3.56months. There were 49 (53.26%) male while 43 (46.74%) female infants. The mean weight of patients was 5.59±1.44kg. There were 21 (22.83%) cases of consanguineous marriage while 71 (77.17%) were other than cousin marriage. There were 63 (68.48%) had salt depletion while in 29 (31.52%) did not had salt depletion. There were 39 (42.39%) had genital virilization while in 53 (57.61%) did not had genital virilization.
 Conclusion: Thus the frequency of patterns (salt depletion and genital virilization) of Congenital adrenal hyperplasia are high in local population.

Fingers print of Libyan population in Benghazi City

This study aims to characterize finger dermatoglyphic traits and to analyze bisexual and bilateral differences in Libyan population at Benghazi city. The sample was collected from a student at university of Benghazi includes 487 males and 587 females aged between 18and 24 years old. Fingers prints were obtained by standard ink procedure. Prints were classified into digital patterns-arches, ulnar loops, radial loops, and whorls using the lens. Ulnar loops were higher (56.9 %) than whorls (37.2 %) whereas both arches and radial loops were low (3.5, 2.4 %), respectively. Order pattern frequency decreased from finger to finger in the following order III> V>I>IV>II for ulnar loops while it was IV>I>II>V>III for whorls, respectively. The highest frequency for arch found in finger II in both sex and hand. Differences in frequency patterns were found between males and females and right and lift hand . Dankmejers, Furuhata, and Pattern Intensity Indices were 9.43, 62.73 and 13.37, respectively. The frequency distribution obtained in this study is very close to those of Arabs North African and Mediterranean populations.

Morphometric analysis of the patterns of calcaneal facets for the talus in Serbian population.

Literature describes different patterns of calcaneal facets for the talus in terms of whether some calcaneal facets are connected or separated from each other or completely absent. The aim of this study was to establish the patterns of calcaneal facets for the talus, to calculate their total area, and to analyse the data with respect to gender. The study involved 59 calcanei which were photographed. The patterns of calcaneal facets noted in this study were compared with the patterns from the literature. ImageJ program was used to measure different parameters on calcanei. The pattern 1 was the most commonly found in the study sample (45.76%), then the pattern 2 (40.68%), and finally the pattern 3 (13.56%). That order of frequencies is the same in both sexes. The patterns 1 and 2 have a larger contact surface for the talus in comparison to the pattern 3. Male bones have a larger contact surface for the talus than female bones. The sum of the pattern 1 and pattern 3 frequencies was high. Knowing the frequency of different patterns of calcaneal facets for the talus in a certain population is important for orthopaedic surgeons when performing foot osteotomy.

Renal Osteodystrophy in End Stage Renal Failure Patients on Maintenance Haemodialysis Visiting at Tertiary Care Hospital, Karachi

Objective: To determine the frequency of different patterns of renal osteodystrophy in end stage renal failure patients on maintenance haemodialysis visiting at tertiary care Hospital, Karachi. Methodology: A Cross sectional study was conducted at Nephrology Department, Jinnah Postgraduate Medical Center, Karachi from April to October 2009. Fifty-six (56) patients on maintenance hemodialysis were included through non-probability purposive sampling. Various biochemical parameters of renal osteodystrophy were included in the current study. Serum corrected calcium, phosphate, and alkaline phosphatase and iPTH levels. Chi square test was used to determined frequency of renal osteodystrophy in ESRD patients. Results: Mean age was 45.85 ± 13.5 years. 34 (61%) were male and 22 (39%) were female. Renal osteodystrophy was found in 89%. The most common type was secondary hyperparathyroidism (Osteitis Fibrosa Cystica) in 32%. Hypophosphatemia was observed in 62% while hypercalcaemia in only 7%. Osteomalacia was common in adolescent age group (66%), Osteitis Fibrosa Cystica (OFC) in adult group (36%) while mixed variety in elder group (50%). Similarly OFC was the most common pattern in both genders. Conclusion: In the present study it was concluded that the prevalence of renal osteodystrophy was significantly increased. Secondary hyperparathyroidism (Osteitis Fibrosa Cystica) is the most common pattern of ROD followed by mixed osteodystrophy and adynamic bone disease.

ANALISIS PENGGUNAAN BENFORD’S LAW DALAM PERENCANAAN AUDIT DI DIREKTORAT JENDERAL BEA DAN CUKAI CABANG KOTA LHOKSEUMAWE

This study aims to analyze the use of Benford's Law in Audit Planning at the Directorate General of Customs and Excise, Lhokseumawe City. The data used in this study are secondary data obtained directly from the Directorate General of Customs and Excise, Lhokseumawe City in 2015-2017. Data analysis methods used in this study are First Digits, Second Digits, and Three Digits. The results show that Benford's Law requirements analysis meet the requirements, and from the results of the Benford's Law data analysis, there are differences in the actual frequency data patterns with the Benford's Law frequency pattern, and also from the differences in frequency patterns that show that Benford's Law is effective and could be used to detect predictions of audit findings appropriately.

Speakers’ knowledge of alternations is asymmetrical: Evidence from Seoul Korean verb paradigms

This paper investigates whether and how speakers track the relative frequency of different patterns of alternation in the lexicon, by investigating speakers’ behavior when they are faced with unpredictability in allomorph selection. We conducted a wug test on Seoul Korean verb paradigms, testing whether speakers can generalize reliable lexical patterns. The test was performed in two directions. In forward formation test, the pre-vocalic base and pre-consonantal non-base forms were the stimulus and response, respectively, whereas in backward formation test, the stimulus–response relation was switched. The results show patterns approximating statistical patterns in Seoul Korean verb lexicon, thus confirming the lexical frequency matching reported in many previous studies. However, contrary to the conventional assumption, the results of the backward formation test are consistent with lexical frequencies relevant for the forward formation, not backward formation. This observed asymmetry is broadly consistent with the single base hypothesis (Albright 2002a, b, 2005, 2008), in which forward, as opposed to backward formation rules play a privileged role in speakers’ morphological grammar.

Prevalence and quality of workplace risk assessments – Findings from a representative company survey in Germany

Although Workplace Risk Assessments (WRA) are legally required in all EU member states and widely considered to be a core element of occupational safety and health (OSH) management, the state of their implementation at company level is still viewed rather critically, both in quantitative and qualitative terms. In this study, data from a representative company survey (N=6500) were used to estimate the frequency of different patterns (and corresponding quality levels) of WRA practice in Germany and to determine organisational factors influencing the chance of occurence of these WRA patterns. Results show that only one out of four companies carry out WRAs which not only meet the essential procedural requirements but also take account of potential risk areas in a fairly comprehensive manner. Multinomial logistic regression analysis further revealed that company size is by far the strongest predictor of WRA activity, especially of its more developed forms. Availability of safety specialist assistance, availability of occupational health specialist assistance, affiliation to the production sector, presence of an employee representative body and a good economic situation of the company were each associated with WRA activity as well. The still considerable deficiencies in WRA coverage and quality indicated by this study clearly call for an intensification of WRA-related control and advisory efforts by the OSH authorities, primarily in small companies and in the private services sector. Findings also suggest that reinforcement of worker representation structures at company level and strengthening professional OSH expert utilisation would be beneficial for WRA implementation.

CHRONIC KIDNEY DISEASE

Chronic kidney disease is usually related with anemia and the level of anemiacorrelates with the severity of renal failure. A chronic kidney disease is complicated byanemia and anemia may contribute to adverse clinical outcomes. No large-scale populationdata are available for patients with chronic kidney disease regarding prevalence of anemia,subpopulations at risk, and relationships between anemia and renal dysfunctionObjectives:Theobjective of this study is to determine the frequency of different patterns of anemia in relationto glomerular filtration rate in patients suffering from chronic kidney disease stage II and abovepatients.Material &Methods:Study Design: Cross sectional study. Setting:Medical andNephrology wards of Liaquat University Hospital Hyderabad / Jamshoro. Period:20th January2013 to 19thDecember 2013.Results:During the study period, total 339 patients of chronickidney disease with stage II and above patients were enrolled. The mean age + StandardDeviation and range) of patients was 50.65 + 11.86 (16 to 80 years, n = 339). 211(62.2%) weremale and 128(37.8%) were female. (Male to Female Ratio 1:6). Mean Hemoglobin + SD was7.16 + 3.89 (3.0 to 17.0 g/dL). The frequency of anemia was present in 285(84.1%) patientswith mean Hb+ SD 6.02 + 2.1 (g/dL). The mean weight + SD was 56.50 + 9.84 (40 to 81 kg).The mean serum creatinine + SD was 5.63 + 2.48 (0.9 to 12.0 mg/dL) and we observed thatmost frequent pattern of anemia was normocytic-normochromic anemia in 216(77.0%) patients,hypochromic-microcytic in 61(18.0%) and macroyctic in 17(5.0%) patients. We also found thatas anemia increased progressively with declining GFR with mean hemoglobin concentrationof 11.78 +2.8 g/dL in CKD stage 2, 10.14 + 3.6 g/dL in CKD stage 3, 6.8 + 3.6 g/dL in CKDstage 4, 7.44 + 4.0 g/dL in CKD stage 5.Conclusion: Frequency of anemia increases withthe progression of stage of chronic kidney disease (decreased GFR) and anemia was mostcommon in stage 5 patients of chronic kidney disease.Most frequent pattern of anemia isnormocytic normochromic anemia.

English

Chronic kidney disease is usually related with anemia and the level of anemiacorrelates with the severity of renal failure. A chronic kidney disease is complicated byanemia and anemia may contribute to adverse clinical outcomes. No large-scale populationdata are available for patients with chronic kidney disease regarding prevalence of anemia,subpopulations at risk, and relationships between anemia and renal dysfunctionObjectives:Theobjective of this study is to determine the frequency of different patterns of anemia in relationto glomerular filtration rate in patients suffering from chronic kidney disease stage II and abovepatients.Material &Methods:Study Design: Cross sectional study. Setting:Medical andNephrology wards of Liaquat University Hospital Hyderabad / Jamshoro. Period:20th January2013 to 19thDecember 2013.Results:During the study period, total 339 patients of chronickidney disease with stage II and above patients were enrolled. The mean age + StandardDeviation and range) of patients was 50.65 + 11.86 (16 to 80 years, n = 339). 211(62.2%) weremale and 128(37.8%) were female. (Male to Female Ratio 1:6). Mean Hemoglobin + SD was7.16 + 3.89 (3.0 to 17.0 g/dL). The frequency of anemia was present in 285(84.1%) patientswith mean Hb+ SD 6.02 + 2.1 (g/dL). The mean weight + SD was 56.50 + 9.84 (40 to 81 kg).The mean serum creatinine + SD was 5.63 + 2.48 (0.9 to 12.0 mg/dL) and we observed thatmost frequent pattern of anemia was normocytic-normochromic anemia in 216(77.0%) patients,hypochromic-microcytic in 61(18.0%) and macroyctic in 17(5.0%) patients. We also found thatas anemia increased progressively with declining GFR with mean hemoglobin concentrationof 11.78 +2.8 g/dL in CKD stage 2, 10.14 + 3.6 g/dL in CKD stage 3, 6.8 + 3.6 g/dL in CKDstage 4, 7.44 + 4.0 g/dL in CKD stage 5.Conclusion: Frequency of anemia increases withthe progression of stage of chronic kidney disease (decreased GFR) and anemia was mostcommon in stage 5 patients of chronic kidney disease.Most frequent pattern of anemia isnormocytic normochromic anemia.

Left Ventricular Relative Wall Thickness Versus Left Ventricular Mass Index in Non-Cardioembolic Stroke Patients

In non-cardioembolic stroke patients, the cardiac manifestations of high blood pressure are of particular interest. Emerging data suggest that echocardiographically determined left ventricular hypertrophy is independently associated with risk of ischemic stroke.The primary objective of this study was to evaluate the frequency of different patterns of left ventricular (LV) remodeling and hypertrophy in a group of consecutive patients admitted with non-cardioembolic stroke or transient ischemic attack (TIA). In particular, we were interested in how often the relative wall thickness (RWT) was abnormal in patients with normal LV mass index (LVMI). As both abnormal RWT and LVMI indicate altered LV remodeling, the secondary objective of this research was to study whether a significant number of patients would be missing the diagnosis of LV remodeling if the RWT is not measured.All patients were referred within 48 hours after a stroke or a TIA for a clinically indicated transthoracic echocardiogram. The echocardiographic findings of consecutive patients with non-cardioembolic stroke or TIA were analyzed.All necessary measurements were performed in 368 patients, who were enrolled in the study. Mean age was 63.7 ± 12.5 years, 64.4% men. Concentric remodeling carried the highest frequency, 49.2%, followed by concentric hypertrophy, 30.7%, normal pattern, 15.5%, and eccentric hypertrophy, 4.1%. The frequency of abnormal left ventricular RWT (80.4%) was significantly higher than that of abnormal LVMI (35.3%), (McNemar P < 0.05).In this group of non-cardioembolic stroke patients, abnormal LV remodeling as assessed by relative wall thickness is very frequent. As RWT was often found without increased LV mass, the abnormal left ventricular geometry may be missed if RWT is not measured or reported.

Anatomical abnormalities in multiple permanent teeth.

Anatomical abnormalities in multiple permanent teeth.

Pericentral Retinopathy and Racial Differences in Hydroxychloroquine Toxicity

To describe patterns of hydroxychloroquine retinopathy distinct from the classic parafoveal (bull's eye) maculopathy. Retrospective case series. Patients from a large multi-provider group practice and a smaller university referral practice diagnosed with hydroxychloroquine retinopathy. Patients with widespread or "end-stage" retinopathy were excluded. Review of ophthalmic studies (fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, multifocal electroretinography, visual fields) and classification of retinopathy into 1 of 3 patterns: parafoveal (retinal changes 2°-6° from the fovea), pericentral (retinal changes ≥ 8° from the fovea), or mixed (retinal changes in both parafoveal and pericentral areas). Relative frequency of different patterns of hydroxychloroquine retinopathy and comparison of risk factors. Of 201 total patients (18% Asian) with hydroxychloroquine retinopathy, 153 (76%) had typical parafoveal changes, 24 (12%) also had a zone of pericentral damage, and 24 (12%) had pericentral retinopathy without any parafoveal damage. Pericentral retinopathy alone was seen in 50% of Asian patients but only in 2% of white patients. Patients with the pericentral pattern were taking hydroxychloroquine for a somewhat longer duration (19.5 vs. 15.0 years, P < 0.01) and took a larger cumulative dose (2186 vs. 1813 g, P = 0.02) than patients with the parafoveal pattern, but they were diagnosed at a more severe stage of toxicity. Hydroxychloroquine retinopathy does not always develop in a parafoveal (bull's eye) pattern, and a pericentral pattern of damage is especially prevalent among Asian patients. Screening practices may need to be adjusted to recognize pericentral and parafoveal hydroxychloroquine retinopathy.

Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?

To determine the frequency of different patterns of centralization and their association with outcomes and MRI findings in patients experiencing sciatica. A prospective longitudinal cohort study of 176 patients with radicular pain below the knee, who all had an MDT clinical assessment. Based on their pain response, patients were divided into five groups: abolition centralization, reduction centralization, unstable centralization, peripheralization, and "no effect". Patients had an MRI. Overall, 84.8% of patients reported experiencing centralization, 7.3% peripheralized and 7.9% reported "no effect". The median reduction in RMQ scores across all the three centralization groups was 9.5 points at 3months, and 12.0 points at 12months. The peripheralization group improved similarly. The 'no effect' group improved significantly lower (p<0.001), by 3.0 at both time points. Patients who centralized, and peripheralized had a significantly reduction in leg pain, the "no effect" group demonstrated a less favorable outcome (p<0.02). There was no association between pain responses and the type of disc lesion. In patients with sciatica, centralization was common and associated with improvement in activity limitation and leg pain. Centralization was very common in ruptured disc therefore the study does not support the theory, that centralization only occurs if the intra-discal hydrostatic mechanism is functional.

Molecular genotyping of methicillin resistant and susceptible staphylococcus aureus by coagulase gene polymorphism

Background: Methicillin-resistant Staphylococcus aureus (MRSA) which causes nosocomial infections is among the most important multi-resistant pathogens worldwide. Investigations of MRSA outbreaks in nosocomial settings often require strain-typing data to verify effectively that the isolates belong to the outbreak strain, and to discriminate similarity from unsimilarity strains. Quick and reliable typing methods are required to obtain information among MRSA isolates and to allow faster implementation of appropriate control measures. Objective : The aim of this study was to investigate genotyping of methicillin resistant and sensitive Staphylococcus aureus (MRSA and MSSA) in Khartoum Teaching Hospital, Sudan by using antibiotype and polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) of the coagulase gene. Methods: This is across sectional study. The samples were collected from clinical wound specimens in the wards of surgery, orthopaedic and burns at Khartoum Teaching Hospital, then processed, cultured and subsequently susceptibility test was performed using disc diffusion method. The MRSA strains were investigated by oxacillin 1[g disk diffusion method. PCR used to amplify a sequence of the coagulase (coa) gene, and the PCR products were analyzed by PCR-RFLP using Alu1 restriction enzyme. Result: Forty eight S. aureus strains were isolated and the number of MRSA identified was 9(18.75%). All strains of MRSA and MSSA were sensitive to vancomycin, while multi-drug resistance was common among MRSA strains. PCR amplification products of coa gene were approximately at 500 bp (26/48), and 580 bp (22/48). By Alu1 restriction enzyme digestion of the PCR-amplified of coagulase gene, two distinct PCR-RFLP patterns exhibited; coaA and coaB and their fragments were approximately at 190, 310 bp and 190, 390 bp with percentages of 54.2% (26/48) and 45.8% (22/48) respectively. Conclusion: PCR-RFLP is considered an attractive tool for rapidly demonstrate the frequency of different patterns and discriminate the relatedness of isolates in different hospital wards. Key words : Methicillin-resistant Staphylococcus aureus, coagulase gene, antibiotype, restriction fragment length polymorphism (RFLP)

Patterns of glaucomatous visual field defects in an older population: the Blue Mountains Eye Study.

This report aims to describe the frequency of different patterns of visual field loss in open-angle glaucoma (OAG). The Blue Mountains Eye Study examined 3654 persons (aged 49+) during 1992-1994. Humphrey supra-threshold visual fields were performed in 88.9%. Those classified as glaucoma suspects had 30-2 full-threshold fields (9.2%). Of OAG cases (n = 108) with field tests in both eyes (n = 97), unilateral defects were present in 49 (50.5%) and bilateral in 48 (49.5%). Advanced field loss was found in 16 (15.4%) subjects and in 22 (10.9%) eyes, with bilateral loss present in 6 (6.2%) cases. Of all eyes of OAG cases (n = 201), 49 (24.4%) had no defects, 52 (25.9%) upper, 61 (30.3%) lower, and 17 (8.5%) had combined upper and lower loss. Of the upper and lower cases (n = 113), the types of defects included nasal step (36), arcuate (26), nasal plus arcuate (26), and hemispherical defects (25). Of subjects with fields in at least one eye (n = 104), there was a similar proportion in the worse eye of upper defects (28.8%), lower (31.7%), and combined upper and lower (24.0%). Undiagnosed OAG was more frequent in unilateral (65.3%) than bilateral (34.7%) cases (P = 0.003). This study reports the pattern of typical glaucomatous field loss in an older Australian population.

Malignant melanoma: Patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance

OBJECTIVES: The aims of this study were to determine the frequency of different patterns of melanoma metastases to small bowel on radiological examination, and to assess the reliability of the most commonly used radiological methods for detecting these lesions. METHODS: The records of cases archived as melanoma metastatic to the small bowel of the Armed Forces Institute of Pathology were reviewed. The clinical information, type of imaging procedure performed, and radiological features were analyzed and compared to the findings at surgery and at autopsy. RESULTS: A total of 32 patients had clinical and surgical data with pathological confirmation. Seven patients had metastasis involving the duodenum, 22 had jejunal involvement, and 11 had ileal involvement. Metastases were categorized as polypoid, cavitary, infiltrating, or exoenteric. The polypoid pattern was seen in 20 patients (63%), six of whom showed multiple polypoid lesions (>10), referred to as polyposis. The “target lesion,” a discrete polypoid mass with a central ulceration, was observed in only three (9%) of the 32 patients. Eight patients (25%) demonstrated a cavitary pattern, a circumferential mass with inner marginal necrosis, and five (16%) showed an infiltrating pattern. One patient (3%) had an exoenteric lesion with a fistulous tract. The small bowel follow-through demonstrated 32 of 55 metastases (sensitivity 58%). Contrast-enhanced CT demonstrated 32 of 48 masses (sensitivity 66%). Of the six cases of malignant polyposis, none were identified using CT, and only two were diagnosed by small bowel follow-through. CONCLUSIONS: The polypoid pattern, equally distributed between the jejunum and ileum, is the most common manifestation of metastatic melanoma to the small bowel. The target lesion was infrequently seen in this series. Small bowel follow-through and conventional CT seem to be unreliable in demonstrating melanoma metastases to the small bowel.