Mean DL Research Articles

Evaluation of the Effect of Artemisia Absinthium L. Eye-Cream on Infra-Orbital Dark Circle: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

The relative darkening of the lower eyelid skin, which is often linked with dark circles, may make you seem fatigued and older than your real age. Considering the recommendations in the sources of Persian medicine regarding Artemisia absinthium L., the purpose of this clinical trial is investigating the effectiveness of cream prepared from the aqueous extraction of A.absinthium to remove periorbital dark circles. The eye cream is made with 20% of aqueous extract of A.absinthium in the base of the cream. It was standardized based on Artemisinin via HPLC method. For the clinical trial, 60 patients equally enrolled in two drug and placebo groups. Erythema and Pigmentation were evaluated via a mexameter instrument. The cream is standardized, including 1.29±0.02 µg/mg Artemisinin in the product. Finally, 21 and 24 patients reached the end of study in drug and placebo groups, respectively. In these groups, the difference in the mean (SD) DE, DL, Erythema and Melanin factors before and after the research were significant (p0.05). However, the rate of reduction of DE, Erythema, and Melanin and rise of DL is greater in the treatment group than in the placebo group. Furthermore, the mean value of DE and DL factors before the research were significantly different in two groups (p0.001), but after the research did not show a significant difference. The mean value of Erythema factor in the two groups before (p=0.25) and after (p=0.5) did not show a significant difference. The mean value of Melanin after the research between two groups showed a significant difference (p=0.01). The results show that the cream prepared from the herbal composition of Persian medicine improves Infra Orbital Dark circle around the eyes.

Design and Evaluation of Solid Lipid Nanoparticles Loaded Topical Gels: Repurpose of Fluoxetine in Diabetic Wound Healing.

The current study aimed to prepare a topical gel containing solid lipid nanoparticles (SLNs) encapsulating fluoxetine for diabetic wound healing effects. Fluoxetine (FX) was loaded into SLNs by employing an emulsion solvent evaporation technique using stearic acid as a lipid, and soya lecithin as a surfactant. SLNs were then evaluated for particle size, polydispersity index (PDI), zeta potential (ZP), percent entrapment efficiency (%EE), percent drug loading (%DL), and in vitro drug release. The optimized SLN (FS3) composed of FX (100 mg), SA (150 mg), and SA (100 mg) displayed mean particle size (467.3 ± 2.2nm), PDI (0.435 ± 0.02), ZP (-32.2 ± 4.47mV), EE (95.8 ± 3.38%), and DL (16.4 ± 2.4%). FTIR and DSC studies denote drug-polymer compatibility and the amorphous nature of FX in the SLNs. The drug release at 24 h was found to be (98.89 ± 2.57%) which followed the fickian diffusion mechanism. SLN (FS3) was further loaded into carbopol gel and tested for pH, spreadability, and extrudability of pharmaceutical parameters. In-vitro release of FX from the SLN gel and plain gel was compared, diabetic wound healing gel (DWH) showed sustained drug delivery. An in vivo study was also performed for DWH gel in streptozotocin-induced diabetic rats. Histopathological examination exhibited DWH gel-treated wounds have increased hydroxyproline, cellular proliferation, a rise in the number of blood vessels, and the level of collagen synthesis. Thus, DWH gel-loaded SLN encapsulated with FX could be a potential carrier for the effective treatment and management of diabetic wounds.

Stent Size Optimization in the Femoral Bifurcation Using a Fractal Model: A Morphological Analysis

Stenting of common femoral artery (CFA) bifurcation lesions is complex due to harmonious asymmetric geometry between the CFA and deep or superficial femoral artery. In order to ensure an optimal flow, the stents must be implanted according to the diameter of the CFA and the diameter of the daughter vessels. The aim of this study was to validate a mathematical formula for the CFA bifurcation in order to optimize the implantation of stents in this bifurcation with a fast and efficient method. We retrospectively included all patients who underwent transcatheter aortic valve implantation and who had a healthy CFA bifurcation on the CT-scan. Diameters of the mother vessel (Dm), daughter vessels (Dl: larger vessel; Ds: smaller vessel), and the ratio between the two were calculated. According to the latter, the following linear model was proposed: [Dm = (Dm/Dl+Ds) × (Dl+Ds)] and was compared to the four existing models (Murray, HK, Flow, Finet). Finally, we calculated the relative error between the prediction of the four models and the measurements. Overall, 110 CFA bifurcations were included. Mean CFA diameter was 7.75±1.67mm. Mean Dl diameter was 5.79±1.21mm and mean Ds diameter was 5.23±1.09mm. A reduction of 25 % was seen between the CFA and the larger daughter-vessel. The mean ratio between the CFA and the daughter vessels was 0.71. Our model [Dm=0.71× (Dl+Ds)] and the flow law were the most accurate (relative difference of 1.59±11.97% and 1.01±11.94%, respectively). However, Murray's law had a statistically significant deviation from the real mother-vessel diameter (P<0.001). We developed a simple fractal ratio between CFA and daughter vessels, which could be easily used in daily practice during CFA percutaneous reconstruction to identify the optimal diameters of the diseased vessels.

In vivo magnetic particle imaging: angiography of inferior vena cava and aorta in rats using newly developed multicore particles

Magnetic Particle Imaging (MPI) is a new imaging modality, which maps the distribution of magnetic nanoparticles (MNP) in 3D with high temporal resolution. It thus may be suited for cardiovascular imaging. Its sensitivity and spatial resolution critically depend on the magnetic properties of MNP. Therefore, we used novel multicore nanoparticles (MCP 3) for in-vivo MPI in rats and analyzed dose requirements, sensitivity and detail resolution. 8 rats were examined using a preclinical MPI scanner (Bruker Biospin GmbH, Germany) equipped with a separate receive coil. MCP 3 and Resovist were administered intravenously (i.v.) into the rats’ tail veins at doses of 0.1, 0.05 and 0.025 mmol Fe/kg followed by serial MPI acquisition with a temporal resolution of 46 volumes per second. Based on a qualitative visual scoring system MCP 3–MPI images showed a significantly (P ≤ 0.05) higher image quality than Resovist-MPI images. Morphological features such as vessel lumen diameters (DL) of the inferior vena cava (IVC) and abdominal aorta (AA) could be assessed along a 2-cm segment in mesenteric area only after administration of MCP 3 at dosages of 0.1, 0.05 mmol Fe/kg. The mean DL ± SD estimated was 2.7 ± 0.6 mm for IVC and 2.4 ± 0.7 mm for AA. Evaluation of DL of the IVC and AA was not possible in Resovist-MPI images. Our results show, that MCP 3 provide better image quality at a lower dosage than Resovist. MCP 3-MPI with a clinically acceptable dose of 0.05 mmol Fe/kg increased the visibility of vessel lumens compared to Resovist-based MPI towards possible detection of vascular abnormalities such as stenosis or aneurysms, in vivo.

Structure-induced superhydrophilicity of silica membranes through hybridization and self-assembly of different dispersed nanoparticles

Self-assembled membranes with remarkable superhydrophilicity and high optical transparency are prepared by hybridizing dispersed silica nanoparticles of mean diameters, DS and DL (DS « DL). It has been found out in the previous work that the hybridized silica sol consisting of two dispersed nanoparticles that differ greatly in size would help lead to a smaller water contact angle for the final membrane. Among the results, one hybridized membrane containing silica nanoparticles of 45 nm and 483 nm exhibits 8.9 ± 1° as for water contact angle and 90% as for transmittance within UV–Visible region. Morphology of the membranes shows hierarchical structure or cracky layer, while the specific architecture is still influenced by the gap in particle size. As a conclusion, the process of hybridization enhances the hydrophilicity and adjusts the transmittance of membranes as well. The new method is a feasible simplification comparing with the traditional ways in attaining superhydrophilicity and we hope it will apply for other hydrophilic materials to improve their wetting ability.

COMPARISON OF DISCOVERY LEARNING TEACHING MODEL AND STUDENT TEAM ACHIEVEMENT DIVISION (STAD) ON COGNITIVE ACHIEVEMENT ABOUT SCIENCE OF BUILDING THE TENTH YEAR STUDENTS SMK NEGERI 1 KENDAL

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(0.003)‹&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; α(0.005)), 2) There were difference using of Discovery Learning teaching model&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; and Student Team Achievement Division (STAD) to wards students cognitive&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; achievement (Sig. (0.00) ‹ α (0.005) and F&lt;span style="font-size: 8pt; color: #000000; font-style: normal; font-variant: normal;"&gt;(0.05,1,104) &lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt;(14,386) › F&lt;span style="font-size: 8pt; color: #000000; font-style: normal; font-variant: normal;"&gt;table &lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt;(3.93)), 3) STAD&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; teaching model were more effective in increasing students cognitive achievement&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; that can be seen from the average score of students cognitive achievement about&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; science of building (Mean STAD = 60.59 › Mean DL = 54.20).&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt; .&lt;br /&gt;&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;&lt;span style="font-size: 12pt; color: #000000; font-style: normal; font-variant: normal;"&gt;Teaching Model&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;

Assessment of radiation dose from abdominal quantitative CT with short scan length.

To assess radiation dose for patients who received abdominal quantitative CT and to compare the midpoint dose [DL(0)] at the centre of a 1-cm scan length with the volume CT dose index (CTDIvol). Although the size-specific dose estimate (SSDE) proposed in The American Association of Physicists in Medicine Report No. 204 is not applicable for short-length scans, commercial dose-monitoring software, such as Radimetrics™ Enterprise Platform (Bayer HealthCare, Whippany, NJ), reports SSDE for all scans. SSDE was herein compared with DL(0). Data were analyzed from 398 abdominal quantitative CT examinations in 165 males and 233 females. The CTDIvol was 4.66 mGy, and the scan length was 1 cm for all examinations. Radimetrics was used to extract patient diameter and SSDE. DL(0) was assessed using a previously reported method that takes into account both patient size and scan length. The mean patient diameter was 28.5 ± 6.3 cm (range, 16.5-46.6 cm); the mean SSDE was 6.22 ± 1.36 mGy (range, 3.12-9.42 mGy); and the mean DL(0) was 2.97 ± 0.95 mGy (range, 1.18-5.77 mGy). As patient diameter increased, the DL(0) to CTDIvol ratio decreased, ranging from 1.24 to 0.25; the DL(0) to SSDE ratio also decreased, ranging from 0.61 to 0.38. The dose to the patients from abdominal quantitative CT may be largely different from CTDIvol and SSDE. This study demonstrates the necessity of taking into account not only patient size but also scan length for evaluating the dose from short-length scans. Advances in knowledge: In CT examinations with 1-cm scan length, dose evaluation needs to take into account both patient size and scan length. An omission of either factor can result in an erroneous result.

Quantifying masking in clinical mammograms via local detectability of simulated lesions.

High mammographic density is known to be associated with decreased sensitivity of mammography. Recent changes in the BI-RADS density assessment address the effect of masking by densities, but the BI-RADS assessment remains qualitative and achieves only moderate agreement between radiologists. An automated, quantitative algorithm that estimates the likelihood of masking of simulated masses in a mammogram by dense tissue has been developed. The algorithm considers both the effects of loss of contrast due to density and the distracting texture or appearance of dense tissue. A local detectability (dL) map is created by tessellating the mammograms into overlapping regions of interest (ROIs), for which the detectability by a non-prewhitening observer is computed using local estimates of the noise power spectrum and volumetric breast density (VBD). The dL calculation was validated in a 4-alternative forced-choice observer study on the ROIs of 150 craniocaudal digital mammograms. The dL metric was compared against the inverse threshold contrast, (ΔμT)(-1) from the observer study, the anatomic noise parameter β, the radiologist's BI-RADS density category, and a validated measure of VBD (Cumulus). The mean dL had a high correlation of r = 0.915 and r = 0.699 with (ΔμT)(-1) in the computerized and human observer study, respectively. In comparison, the local VBD estimate had a low correlation of 0.538 with (ΔμT)(-1). The mean dL had a correlation of 0.663, 0.835, and 0.696 with BI-RADS density, β, and Cumulus VBD, respectively. The proposed dL metric may be useful in characterizing the potential for lesion masking by dense tissue. Because it uses information about the anatomic noise or tissue appearance, it is more closely linked to lesion detectability than VBD metrics.

Role of item analysis in post validation of multiple choice questions in formative assessment of medical students

Abstract Background:Multiple choice questions (MCQ) are used in the assessment of students in various fields. By this method of assessment it is possible to cover a wide range of topics in less amount of time. However the reliability of the test depends on the quality of the MCQ. The MCQ can be evaluated based on the Difficulty Index (DIFI), Discriminatory Index (Dl) and Distracter Efficiency (DE). Objectives:To evaluate the MCQs based on the Difficulty Index (DIFI), Discriminatory Index (Dl) &amp; Distracter Efficiency (DE) and develop a valid pool of questions.Also to assess learner performance and discriminate between students of higher and lower abilities. Materials and Methods:A total of 120 students were assessed based on multiple choice questions in pathology. The number of items were 20 and the number of distracters were 60. Data was entered and analyzed in MS Excel 2007 and simple proportions, mean and standard deviations were calculated. Results:Mean and standard deviations for DIFI, Dl and DE were 57.8 ± 17.4%, 0.27 ± 0.17 and 84.98 ± 20.2 % respectively. Out of the 20 items, 11 items had good level of DIFI (31 - 60%), eight (8) items were considered easy (DIFI &amp;gt;61%) and one (1) item was considered difficult (DIFI &amp;lt; 30). Mean Dl in present study was 0.27 ± 0.17. Analysis of the Dl showed good discrimination power in eighteen (18) of the items. Out of the 60 distracters, nine (9) were non -functional distracters (NFD) and were seen in eight items. Out of these, seven items had one NFD each and one item had two NFD. Conclusions:The study emphasizes on the importance of use of item analysis in construction of good quality MCQs and also in the evaluation of learner performance.

P08.24 * PREDICTIVE FACTORS OF PERITUMORAL EDEMA IN BRAIN METASTASES

OBJECT: To investigate peritumoral edema and its prognostic factors in brain metastases of lung and breast cancers, and more specifically to evaluate the effect of treatment with angiotensine-II (Ang2) inhibitors. This treatment was shown in a recent study to display a significant effect in primary brain tumor edema. MATERIALS AND METHODS: We retrospectively reviewed the medical files of all patients with newly diagnosed brain metastases consulting in our institution in the years 2012 and 2013. We measured the maximal diameter of lesions DL (contrast enhancement) and peritumoral edema DE (diameter of edema minus contrast enhancement) on the first diagnostic imaging of brain metastasis. Patients under steroids or files with insufficient informations were excluded from analysis. RESULTS: A total of 157 medical files were reviewed from which 54 patients with 170 metastases were selected for analysis. There were 87 metastases of lung adenocarcinomas, 35 of small cell carcinomas, 18 of epidermoiid lung cancer, 7 of undifferentiated and 23 of breast cancer. Median DL was 9.35mm (1-74.3), median DE was 5,98mm (0-69,5). There was no significant difference in DL or DE between the histology groups. Younger age (<65 years old), female gender and treatment with Ang2 inhibitors seem to be associated with statistically less peritumoral edema (p = 0,005; p = 0,022; p = 0,005, respectively). This finding was persistent even when the 23 metastases of breast cancer were taken out from the analysis. Both DL and DE were smaller in the 25 patients under treatment with Ang2 inhibitors (n = 84 metastases) than in the 29 patients without such treatment (n = 86 metastases) (mean DL: 10.2 vs 13.4 mm, p= 0.036; mean DE 9.5 vs 15.9 mm, p= 0.005, respectively) The delay between the diagnosis of the primary tumors and brain metastases did not have any impact on the peritumoral edema. Moreover, the diameter of edema did not seem to be associated with the location, the size or the number of lesions, neither with the pattern of contrast enhancement (annular, homogenic or necrotic). Different patterns of contrast enhancement and sizes of edema were observed even within the same patient with multiple metastases. From the main 157 files reviewed, multiple metastases were more frequent in breast cancer patients (9 patients out of 10) compared to lung adenocarcinomas (29/81) and other lung cancers (13/25). CONCLUSION: In this series of patients with lung and breast cancer, younger age (<65 years old), female gender and treatment with Ang2 inhibitors seem to be associated with statistically smaller brain metastases and peritumoral edema Peritumoral edema did not seem to be associated with any other factors like histology, delayed brain metastasis diagnosis, size, location, number of lesions or contrast enhancing pattern.

Effect of salbutamol on the measurement of single‐breath diffusing capacity

The bronchodilation and cardiovascular effects of bronchodilators may alter alveolar ventilation and perfusion distribution, which could subsequently affect single-breath diffusing capacity of the lungs for carbon monoxide (DL ,CO) measurements. The aim of this study was to investigate the effect of salbutamol on DL ,CO in subjects with and without airway obstruction and reversibility. Sixty subjects were investigated with 20 in each of the three groups: normal spirometry; irreversible obstruction; and reversible obstruction. Baseline spirometry, plethysmographic lung volumes, DL ,CO, pulse rate and arterial blood gases were measured. The same testing sequence was repeated after administration of a placebo inhaler and again after 400 μg salbutamol. Salbutamol did not affect the mean alveolar volume (VA ) (P > 0.05), transfer coefficient for carbon monoxide (DL ,CO/VA , KCO) (P > 0.05) or DL ,CO (P > 0.05) in the normal and irreversible obstruction groups. In the reversible obstruction group, salbutamol caused an increase in the mean VA compared with placebo (P < 0.001). However, the mean KCO was reduced (P < 0.001). The mean change in DL ,CO was not significant (P > 0.05). A considerable reduction in DL ,CO was found after salbutamol in four subjects in the reversible group as a result of a minor increase in VA and substantial decrease in KCO. No statistical difference in pulse rate or arterial blood gases values was detected. Salbutamol had no effect on the mean DL ,CO in any group. However, salbutamol may considerably reduce DL ,CO in some individuals with reversibility secondary to its effects on VA and KCO.

Impact of Altered Alveolar Volume on the Diffusing Capacity of the Lung for Carbon Monoxide in Obesity

Background: Studies on the diffusing capacity of the lung for carbon monoxide (DL_CO) in obese patients are conflicting, some studies showing increased DL_CO and others unaltered or reduced values in these subjects. Objectives: To compare obese patients to controls, examine the contribution of alveolar volume (VA) and CO transfer coefficient (K_CO) to DL_CO, and calculate DL_CO values adjusted for VA. Methods: We measured body mass index (BMI), waist circumference (WC), spirometry and DL_CO in 98 adult obese patients without cardiopulmonary or smoking history and 48 healthy subjects. All tests were performed in the same laboratory. Results: Using conventional reference values, mean DL_CO and VA were lower (–6%, p < 0.05, and –13%, p < 0.001, respectively), and K_CO was higher (+9%, p < 0.05) in obese patients than in controls. VA decreased whereas K_CO increased with increasing BMI and WC in the obese group. Patients with lower DL_CO had low K_CO in addition to decreased VA. In contrast, some obese patients maintained normal VA, which, coupled with high K_CO, resulted in higher DL_CO. The main result is that diffusion capacity differences between obese patients and controls disappeared using reference equations adjusting DL_CO for VA. Conclusions: Using conventional reference equations, our obese patients show slightly lower mean DL_CO, lower mean VA and higher mean K_CO than controls, but with a large range of DL_CO values and patterns. Adjusting DL_CO for VA suggests that low lung volumes are the main cause of low DL_CO and high K_CO values in obese patients.

Use of a new cross‐linked collagen membrane for the treatment of dehiscence‐type defects at titanium implants: a prospective, randomized‐controlled double‐blinded clinical multicenter study

The aim of the present randomized-controlled double-blinded clinical multicenter study was to assess the use of either a new cross-linked (VN) or a native collagen membrane (BG) for the treatment of dehiscence-type defects at titanium implants. A total of n=54 patients were recruited in four German university clinics. According to a parallel-groups design, dehiscence-type defects at titanium implants were filled with a natural bone mineral and randomly assigned to either VN or BG. Submerged sites were allowed to heal for 4 months. Primary (e.g., changes in defect length - DeltaDL, quality of newly formed tissue [0-4] - TQ) and secondary parameters (e.g., membrane exposure, tissue conditions at dehisced sites) were consecutively recorded. Four patients were excluded due to an early wound infection (VN:3; BG:1), and one patient was lost during follow-up (VN). The mean DeltaDL was 3.0 +/- 2.5 mm in the VN, and 1.94 +/- 2.13 mm in the BG group. The assessment of TQ revealed comparable mean values in both groups (VN: 3.05 +/- 1.66, BG: 3.46 +/- 1.48). A significant correlation between membrane exposure and inflammation of the adjacent soft tissue was observed in the VN group. In both groups, the mean DL and TQ values were not significantly different at either non-exposed or exposed implant sites. The results of the present study have indicated that VN supported bone regeneration on a level non-inferior to BG. However, in case of a premature membrane exposure, cross-linking might impair soft-tissue healing or may even cause wound infections.

Postexercise reduction in lung diffusion capacity is not attenuated by skin cooling

Pulmonary diffusion capacity for carbon monoxide (DL(CO)) is reduced by approximately 10% 1-6 h after maximal exercise. The mechanisms may be interstitial alveolar oedema and reduced pulmonary capillary blood volume. It was hypothesized that thermal stress following exercise contributes to the reduction in DL(CO), and that skin cooling would attenuate the postexercise reduction in DL(CO). Cutaneous vascular conductance (CVC), mean surface temperature (MST), rectal temperature and DL(CO) were measured before and 90 min after maximal incremental cycle exercise. Thereafter, the subjects were exposed to cold air without eliciting shivering one day and another day served as control. The measurements were repeated 120 min after exercise. Twelve healthy subjects (six male) aged 20-27 years were studied. DL(CO) was reduced by 7.1% (SD = 6.3%, P = 0.003) and 7.6% (SD = 5.3%, P<0.001) 90 and 120 min after exercise in the control experiment. It was reduced by 5.6% (SD = 5.5%, P = 0.014) 90 min after exercise and remained reduced by 6.1% (SD = 6.1%, P = 0.012) after cooling despite a significant reduction in CVC and in MST from 31.9 (SD = 0.6) degrees C to 27.4 (SD = 1.9) degrees C. We conclude that the postexercise reduction in DL(CO) is present when thermal status is restored after exercise, and that it is not influenced by further skin surface cooling.

American Thoracic Society/European Respiratory Society 2005 standardization of DLCO measurement: Impact on performance

An updated standardization statement on measurement of DL(CO) was issued by the American Thoracic Society (ATS)/European Respiratory Society (ERS) Task Force in 2005. The aim of this study was to evaluate the effects of new recommendations on the success rate, test efficiency, measurement variability and reported results of DL(CO) testing. We prospectively evaluated 55 Chinese patients without previous experience of the DL(CO) test in 2006. Performance and results of the test according to the ATS 1995 and ATS/ERS 2005 acceptability criteria were compared. Using the 2005 criteria, the success rate (maximum four trials) improved from 65% to 85% (change: 20%, 95% CI: 9-31%; P = 0.001). The test efficiency as measured by two-trial and three-trial success rates increased from 25% and 51% to 60% and 78%, respectively (both P < 0.0005). The measurement variability was defined as the mean of absolute differences between two acceptable trial results of DL(CO) for each patient. The means (SD) were 0.60 (0.53) and 0.53 (0.57) mL/min/mm Hg for the old and new criteria, respectively (P = 0.623). The mean DL(CO) decreased slightly by 0.5%, from 14.93 +/- 5.74 (SD) (old criteria) to 14.86 +/- 5.75 mL/min/mm Hg (new criteria) overall, with a mean difference (SD) of -0.07 (0.20) mL/min/mm Hg for the 36 subjects meeting both criteria (paired t-test, P = 0.048). Success rate and test efficiency for DL(CO) measurement were improved when the new recommendations were adopted. The effects on measurement variability and reported results were minimal.

Percutaneous Cryoablation for the Normal Lung evaluated in Rabbits: A Radiologic-Pathologic Correlation

Purpose: To assess the CT and histological findings after cryoablation in the normal lung of rabbits. Materials and Methods: After performing chest CT on rabbits, we inserted a cryoneedle toward the lower lobe of the right lung. We performed percutaneous cryoablation that was composed of freeze-thaw-freeze cycles (25 minutes) for group 1 animals and one cycle of variable freezing time (10-20 minutes) for group 2 animals. We measured the longest (Dl) and shortest diameter (Ds) of the ablated zones that were determined after cryoablation for all of the CT images. After cryoablation, we performed a pathological examination. Results: The mean Dl and Ds of the ablated zone was 28.1±3.9 mm and 16±1.6 mm, respectively, for group 1 rabbits. For group 2 rabbits, the mean Dl and Ds was 28.7±6.3 mm and 14.4±3.8 mm, respectively, for one cycle of 20 minutes freezing time. Based on the histological findings, the ablated zone was composed of a necrotic, hemorrhagic, and inflammatory area, in order from the center to the outside. Although each area was well differentiated in group 1 rabbits, only freezing for one cycle of 20 minutes for the group 2 rabbits gave the same results as for the group 1 rabbits. Conclusion: A total freezing time of at least 20 minutes and two more freeze-thaw-freeze cycles might be important factors for providing a sufficient area of the ablated zone and uniform necrosis during cryoablation.

An Evaluation of the Body Size of High School Football Players in Northeastern Pennsylvania over Three Decades

INTRODUCTION: Position demands and competitiveness to obtain an athletic scholarship may have forced high school football players to modify their body size. Research spanning 30 years have evaluated this issue in collegiate and professional football athletes. PURPOSE: To evaluate differences among football positions and body size of high school football players in Northeastern Pennsylvania across three decades. METHODS: This retrospective study examined 574 high school football players from one AA high school in Northeastern Pennsylvania. AA high school size classification represents enrollment for males grades 9–12 of no more than 330. Review of program rosters were used to collect position, height, weight and academic classification. Data was provided for program rosters by either school nurse or certified athletic trainer. All positions of play were examined and compared over three decades (1970-2000). RESULTS: Offensive and defensive lineman (OL, DL) had a mean (SD) height of 70.58 (2.58) inches with a mean (SD) weight of 196.13 (34.27) pounds. Mean (SD) BMIfor OL and DL was 27.66 (4.15) compared to a BMI of 22.09 (1.71) for defensive backs and wide receivers. A One-way ANOVA with repeated measures revealed a significant difference (p<0.05) across decades for weight. No significant differences (p>0.05) were found across decades for either height or BMI. CONCLUSIONS: Weight of high school football players has increased over the past three decades. The impact on the health of these athletes warrants investigation.

The Effect of Red Cell Transfusion on Nitric Oxide Diffusing Capacity

Background: The diffusion capacity of the lung for nitric oxide (DL_NO) is supposed to reflect the properties of the alveolocapillary membrane better than the diffusion capacity of the lung for carbon monoxide (DL_CO), due to a much stronger binding of NO to haemoglobin (Hb). Objectives: The aim of this study was to investigate the effect of Hb concentration on the DL_NO. Methods: The DL_NO and DL_CO (single-breath method) were measured in 10 anaemic patients before and shortly after red cell transfusion. Results: The mean increase in Hb concentration was 2.6 g/dl. Whereas DL_CO increased as predicted by the reference equations, the DL_NO did not change: mean DL_CO rose from 13.6 to 16.5 ml/min/mm Hg (increase of 122%), mean DL_CO corrected for Hb rose from 18.8 to 19.3 ml/min/mm Hg (103%) and mean DL_NO rose from 75.6 to 77.8 ml/min/mm Hg (103%). Conclusion: The DL_NO is not influenced by Hb concentration.

Sensitivity to combined frequency and amplitude speech cues by cochlear implant users

Although a considerable amount of work has been directed toward examining the sensitivity of the cochlear implant (CI) user to various acoustic cues, less has examined the ability to combine cues. The sensitivity to concurrent cues was examined using an adaptive 3I-2AFC paradigm. Stimuli were synthesized three-syllable words having middle syllables that possessed an increase in fundamental frequency, amplitude or both. Sensitivity to increments in the individual cues was first measured for five subjects with a CI and five age-matched controls. These DLs were then used to equate sensitivity to the two cues and create stimuli having concurrent increments. It was found that the presence of the two cues reduced the mean DL to half that of either cue alone, for both groups of subjects. Thus, this combination of cues is similar across groups and simply additive. Individual differences in the ability of CI users to combine cues were more strongly predictive of performance on speech recognition tests than was sensitivity to either cue alone. These results have implications for the perception of the multiplicity of speech cues. [Work supported by NIDCD.]

Thin-section chest CT findings of primary Sjögren's syndrome: correlation with pulmonary function.

The purpose of this study was to describe thin-section CT findings of lung involvement in patients with primary Sjögren's syndrome (PSS), and to correlate them with pulmonary function tests (PFT). The chest thin-section CT examinations of 35 patients with proven diagnosis of PSS and respiratory symptoms were retrospectively assessed by two observers, in a first step independently with interobserver evaluation, and in a second step in consensus. The extent of the most frequent CT findings was scored. Correlation was made with PFT in 31 of these patients. Three main CT patterns were identified with good interobserver agreement (kappa coefficient 0.71): 19 of 35 (54%) large and/or small airways disease; 7 of 35 (20%) interstitial lung fibrosis (ILF); and 5 of 35 (14%) suggestive of lymphocytic interstitial pneumonia (LIP). The CT scans were normal in 2 patients (6%) and showed only dilatation of pulmonary vessels due to pulmonary arterial hypertension in two others (6%). Airway disease patients had predominantly obstructive profiles (mean FEV(1)/FVC ratio 69.7+/-12.7%, mean MEF(25) 50.1+/-22.9%), whereas patients with ILF and LIP had predominantly restrictive profiles and/or a decreased diffusing lung capacity (mean TLC 87.0+/-26.0 and 64.6+/-18.6%, mean DL(CO) 57.4+/-21.2 and 52.0+/-8.0%). Significant correlation ( p<0.01) was found between the scores of ground-glass attenuation and TLC ( r=-0.84) and DL(CO) ( r=-0.70) and between the score of air trapping and FEV1 ( r=-1.0). In patients with PSS and respiratory symptoms, thin-section CT may provide characterization of lung involvement which correlates with pulmonary function.