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Vulgaris. Psychosomatics 1996; 37: 127130 Spraker MK. Cutaneous artefactual disease: an appeal for help. Pediatr Clin North 1983; 30: 659668 Arnold LM, McElory SL, Mutasim DF, et al. Characteristics of 34 adults with psychogenic excoriation. J Clin Psychiatry 1998; 59: 509514 Sneddon J, Sneddon I. Acne excoriee: a protective device. Clin Exp Dermatol 1983; 8: 6568 Koo JYM, Smith LL. Psychologic aspects of acne. Pediatr Dermatol 1991; 8: 185188 Bach M, Bach D. Psychiatric and psychometric issues in acne excoriee. Psychother Psychosom 1993; 60: 207210 Gupta MA, Gupta AK, Schork NJ. Psychosomatic study of selfexcoriative behavior among male acne patients: preliminary observations. Int J Dermatol 1994; 33: 846848 Kenta A, Drummond LM. Acne excoriee: a case report of treatment using habit reversal. Clin Exp Dermatol 1989; 14: 163164 Arnold M, Auchenbach MB, McElroy SL. Psychogenic excoriations: clinical features, proposed diagnostic criteria, epidemiology and approaches to treatment. CNS Drugs 2001; 15: 351359 Gupta MA, Gupta AK. Olanzapine may be an effective adjunctive therapy in the management of acne excoriee: a case report. J Cutan Med Surg 2001; 5: 2527 Kreydon OP, Heckmann M, Peschen M. Delusional hyperhidrosis as a risk for medical overtreatment: a case of botuliniphilia. Arch Dermatol 2002; 138: 538539 Harth W, Linse R. Botulinophilia: the new life style venoniphilia. Hautarzt 2001; 52: 312315 Lerer B, Jacobowitz J, Wahba A. Personality features in essential hyperhidrosis. Int J Psychiatry Med 1980-1981; 10: 5967 Davidson JR, Foa EB, Connor KM, et al. Hyperhidrosis in social anxiety disorder. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26: 13271331 Rees L. An etiological study of chronic urticaria and angioneurotic edema. J Psychosom Res 1957; 2: 172189 Juhlin L. Recurrent urticaria: Clinical investigations of 330 patients. Br J Dermatol 1981; 104: 369381 Wittkower ED. Studies of the personality of patients suffering from urticaria. Psychosom Med 1953; 15: 116126 Gupta MA, Gupta AK, Schork NJ, et al. Depression modulates pruritus perception: a study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosom Med 1994; 56: 3640 Hashiro M, Okumura M. Anxiety, depression, psychosomatic symptoms and autonomic nervous function in patients with chronic urticaria. J Dermatol Sci 1994; 8: 129135 Harvey NS, Mikhail WI. Seasonal hypomania in a patient with cold urticaria. Br J Psychiatry 1986; 149: 238241 Gupta MA, Gupta AK. Severe recurrent urticaria associated with panic disorder: a syndrome responsive to selective serotonin reuptake inhibitor SSRI ; antidepressants? Cutis 1995; 56: 5354 Gupta MA, Gupta AK, Ellis CN. Antidepressant drugs in dermatology. An update. Arch Dermatol 1987; 123: 647652 Harto A, Sendagorta E, Ledo A. Doxepin in the treatment of chronic urticaria. Dermatoligica 1985; 170: 9093 Shertzer CL, Lookingbill DP. Effects of relaxation therapy and hypnotizability in chronic urticaria. Arch Dermatol 1987; 123: 913916 Sperber J, Shaw J, Bruce S. Psychological components and the role of adjunct interventions in chronic idiopathic urticaria. Psychother Psychosom 1989; 51: 135141 Buske-Kirschbaum A, Geiben A, Wermke C, et al. Preliminary evidence for herpes labialis recurrence following experimentally induced disgust. Psychother Psychosom 2001; 70: 8691 Schmidt DD, Schmidt PM, Crabtree BF, et al. The temporal relationship of psychosocial stress to cellular immunity and herpes labialis recurrences. Fam Med 1991; 23: 594599 Surman OS, Crumpacker C. Psychological aspects of herpes simplex virus infection: report of six cases. J Clin Hypn 1987; 30: 125131 Sainz B, Loutsch JM, Marquart ME, et al. Stress-associated immunomodulation and herpes simplex virus infection. Med Hypotheses 2001; 56: 348356 Longo D, Koehn K. Psychosocial factors and recurrent genital herpes: a review of prediction and psychiatric treatment studies. Int J Psychiatry Med 1993; 23: 99117 Gupta MA, Gupta AK. Herpes zoster in the medically healthy child.
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Cytokines expressed during an inflammatory response are tightly controlled at the transcriptional and translational levels, and they appear to act locally in that they are cleared rapidly once they diffuse into the vascular compartment. Mechanisms have also evolved to allow rapid neutralization of excess cytokine at the site of inflammation, such as the expression of soluble cytokine-binding proteins found in tissue and blood. Other mechanisms for regulating cytokine-induced pathways include natural antagonists. In the case of interleukin IL ; -1, a soluble form of IL-1 has been described that can bind with high affinity to the cell surface receptor without activating signaling 12 ; . This protein, called IL-1 receptor antagonist, and marketed as a recombinant biologic called Kineret anakinra; Figure 2F ; , competes with IL-1 for binding to receptor.
Protective [16]. A higher expression of osteocalcin, osteonectin and bone Gla protein is also associated with the intensity of the transformation of VSMC towards a calcifying phenotype [17, 18]. In contrast, other local or circulating proteins such as osteopontin, matrix-Gla protein, fetuin-A, osteoprotegerin, FGF-23 and klotho function as potent inhibitors of ectopic calcification, as shown in a number of reports based on elegant studies in genetically engineered animals, which have been reviewed elsewhere [19, 20].
Sensitivity to vasoconstrictors is mediated specifically by ER-ER- heterodimers or, rather, as a balance of dual actions mediated by ER- and ER- . Because binding of ligands to a particular ER subtype and the resulting balance of ER- and ER- actions in a tissue are clearly species dependent 14 ; , there is a potential pitfall in a global interpretation of primate and mouse steroid receptor data. Because of uncertainties inherent in KO approaches and steroid receptor phenomena that are uniquely primate, predictions of human ER actions should rely on primate data when differences from mouse or other nonprimate studies are reported 14 ; . We previously demonstrated the presence of ER- 25 ; and TPR 17, 28, 29 ; in RM aorta and coronary arteries. Although the predominant ER expressed in human VMC has been shown to be ER- 18 ; and mRNA expression for ER- and ER- has been previously demonstrated in primate coronary artery and aorta 37 ; , in this study we demonstrate, for the first time, ER- protein expression in RM aorta, coronary arteries, and coronary VMC isolated cells ; . Expression of two forms of ER in the blood vessel wall requires consideration of the possibility that ER- and ER- separately or cooperatively, with synergistic or opposing molecular actions, regulate reactivity and probably also proliferation ; in VMC and endothelial cells. ER- has been implicated in the VMC antiproliferative effects of E2 during the repair response to vascular injury in both genders 20 ; . In contrast, E2-mediated reendothelialization 46 ; is promoted by ER- 2 ; . This dichotomy of E2 effects be ajpheart.
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In this study, the perioperative use of clonidine in addition to morphine produced improved analgesia during the rst 12 h after major surgery. However, there was no improvement after this time. There was no signicant reduction in the amount of morphine consumed. The combination of morphine and clonidine were associated with a reduction in postoperative nausea and vomiting, the effects of which were seen for 24 h after surgery. Presumably the combination of improved early pain relief and reduced nausea and vomiting in Group C led to the increased patient satisfaction in this group. The improved analgesia was not sustained past the rst 12 h after surgery in this study. This may well have been because plasma clonidine concentrations were not sustained by the parameters set for the PCA device. Indeed, the enhanced analgesic effect may have been achieved by the clonidine loading dose alone. Future studies examining the use of clonidine analgesia after the rst 12 h after surgery.
Updated information and services can be found at: : bloodjournal.hematologylibrary cgi content full 108 3 993 Articles on similar topics may be found in the following Blood collections: Apoptosis 743 articles ; Gene Expression 1080 articles ; Neoplasia 3910 articles ; Information about reproducing this article in parts or in its entirety may be found online at: : bloodjournal.hematologylibrary misc rights.dtl#repub requests Information about ordering reprints may be found online at: : bloodjournal.hematologylibrary misc rights.dtl#reprints Information about subscriptions and ASH membership may be found online at: : bloodjournal.hematologylibrary subscriptions index.dtl and creatine.
Cluding breast cancer, 4 thus those types of tumor cells should be depleted by selection for normal CD34 progenitors. The primary objective of the prospective randomized clinical trial was to compare the toxicity of the transplant infusion when using CD34 marrow cells isolated with the CEPRATE SC stem cell concentration system CellPro Inc, Bothell, WA ; to standard unpurified BM buffy coat preparations. Additionally, we wanted to determine whether the CD34-selection procedure resulted in an autograft with comparable rate of hematopoietic recovery compared to a standard buffy coat preparation. Since the eligibility criteria included stage II, III, and IV patients and required that patients have no histologic evidence of breast cancer in the marrow, a beneficial ``purging'' effect resulting from the CD34-selection procedure was not evaluated in this study. Other published data have reported tumor reduction following CD34-selection procedure.6, 21.
Alternative treatment to iron dextran. Because our data set is small, further studies are needed to determine more conclusively the rates of reaction to different iron preparations and crixivan.
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Combining two therapeutic agents into one preparation has, potentially, many advantages. An enhanced ameliorative effect with a reduced dosage not only would reduce the risk of side effects but should also improve patient compliance. The Dorzolamide 2% Timolol 0.5% CAI beta-blocker ; combination COSOPT ; instilled bds appears to be similar in efficacy to the concomitant administration of the components bds48. Another study seemed to show the combination to be superior in lowering IOP compared with its individual components49. Another combination agent containing Latanoprost 0.005% and Timolol 0.5% Xalocam ; instilled once daily has been shown to reduce IOP effectively in patients with either ocular hypertension or glaucoma, but only demonstrated a modest degree of superiority over od dosing of Latanoprost alone 1-1.2mmHg ; and Timolol bds alone 1.9mmHg ; 50.
Interpreting organic residues from pottery and other artifacts from archaeological sites. Archaeology and the New Methodologies, invited speaker at a symposium sponsored by the Saskatchewan Association of Professional Archaeologists and the Department of Anthropology and Archaeology, University of Saskatchewan, Saskatoon, SK, January 1999. The Analysis and Identification of Lipid Residues from the Late Precontact Pottery of Western Canada using High Performance Gas Chromatography, with R. Przybylski and B.L. Sherriff. 55th Annual Plains Anthropological Conference, Boulder, Colorado, November 1997. The Identification of Residues from Late Precontact Cooking Pots from Western Canada using Gas Chromatography, with R. Przybylski and B.L. Sherriff. Manitoba Archaeological Society Conference, Brandon, Manitoba, September 1997. The Results of Using Cooking Pot Residues To Test Settlement and Subsistence Patterns Hypothesized for Late Precontact Hunter-Gatherers from Western Canada, with R. Przybylski and B.L. Sherriff. Canadian Archaeological Association 30th Annual Meeting, Saskatoon, May 1997. The Analysis of Lipid Residues from the Late Precontact Pottery of Western Canada Using High Performance Gas Chromatography: Procedures and Possibilities, with R. Przybylski and B.L. Sherriff. Canadian Archaeological Association 30th Annual Meeting, Saskatoon, May 1997. Letting Your Stomach Be Your Guide: Late Precontact Settlement and Subsistence Strategies in Western Canada, with B.L. Sherriff, 1996 Chacmool Conference, Calgary, November 1996. To Eat or Not to Eat: Precontact Subsistence in Western Canada. Archaeology Month Public Presentations, sponsored by the University of Manitoba Department of Anthropology, June 1995. To Eat or Not to Eat: Fish Avoidance as a Method of Discriminating Plains from Parkland Adaptation, with B.L. Sherriff, Canadian Archaeological Association 28th Annual Meeting. Kelowna, May 1995. Functional Analysis of Precontact Pottery from the Northern Plains, Parkland and Boreal Forest. Current Archaeology: Interdisciplinary Approaches, invited speaker at a symposium sponsored by the Manitoba Archaeological Society, Winnipeg, MB, September 1994. A Consideration of Native Dietary Preferences and Implications for Archaeological Models. Canadian Archaeological Association 27th Annual Meeting. Edmonton, AB, May 1994. When Archaeologists Do History. 51st Annual Plains Conference. Saskatoon, SK, October 1993. The Analysis of Carbonized Residues on Late Precontact Pottery, with B.L. Sherriff. 51st Annual Plains Conference. Saskatoon, SK, October 1993. Saskatchewan Plains Pottery: Circa A.D. 1300 - Contact. Third Northeastern Plains Ceramic Symposium, Brandon, Manitoba, October 1991. Towards an Understanding of Late Prehistoric Pottery in Saskatchewan. Archaeological Resource Management: Problems and Issues Today Conference, Saskatoon, Saskatchewan, January, 1991 and cyanocobalamin.
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The occurrence of hypertension in a large proportion renal transplant recipients is well recognised. The persistence of HT in these patients leads to graft loss from chronic allograft nephropathy as well as a significant increase in the risk of cardiovascular events and death with a functioning graft. Whilst risk factors like donor hypertension and diabetes mellitus and calcineurin inhibitor toxicity have been identified, the underlying mechanisms remain unclear. We report on the differential expression of the Angiotensin 2 receptor in donor kidneys and it's possible link to the development of hypertension in the transplant recipient. METHODS. Pre-transplant biopsies from 25 kidneys transplanted at Nottingham were analysed. Biopsies were classified as being normal, hypertensive if donor vascular changes were present and as ATN if there was evidence of acute tubular necrosis on histology. AT2R expression was determined using a custom-designed oligonucleotide microarray MWG-Biotech HPSF Biochips ; containing 104 genes and replicates. The arrays were previously tested for intra-slide and inter-slide reliability using 6 different housekeeping genes as well as against multiplex PCRs for 8 randomly chosen genes to ensure the accuracy of the expression values. AT2R expression was standardised as a percentage of GAPDH expression in each sample and the standardised values used for analysis. Recipients were followed up for a minimum of 3 months and classed as having persistent HT at 3 months if replicate outpatient blood pressure readings showed a systolic BP 140 mmHg and or a diastolic BP 90mmHg despite being on at least 2 anti-hypertensive drugs. AT2R expression was compared using an unpaired t-test with a p-value of 0.05 taken as being significant. RESULTS. 11 of the 25 patients 44% ; went on to develop persistent HT at 3 months post transplant. The pre-transplant histology showed HT in 2, ATN in 1 and was normal in 8 cases. Those who did not develop persistent HT N 14 ; showed HT in 1, ATN in 1 and was normal in 12 cases. The relative risk of a recipient developing persistent HT if hypertensive changes were present in the donor kidney was thus only 0.27. However, the mean standardised expression value SEV ; for the AT2R in donors in the former group was 16, 895% + -13993.5 ; as compared to a mean SEV of 3, 525% + - 2518.9 ; in those who did not develop persistent HT p 0.002, highly significant ; . No significant difference in AT2R expression was present between donor kidneys showing HT and ATN on histology. CONCLUSIONS. Our results suggest that hypertensive changes in a donor kidney are a poor predictor of the risk of development of post transplant hypertension in the recipient. However, the significantly high levels of AT2R expression in donor kidneys whose recipients develop HT by 3 months suggests that some kidneys could well be preprogrammed to cause HT of renal origin in their recipients. These finding raise the intriguing question should AT2R antagonists be the drugs of first choice in post renal transplant hypertension?.
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Different times, and that when she felt ill, it would pass as the symptoms abated. She was open about the effects of Lyme on her life, and her functioning, the endless medications and doctor's appointments several hours away. For a child who was so sick for so long, she was coping very well. Lucy's symptoms had recently worsened, and she had been on home teaching for 2 weeks. She was bothered by the fact that she had gotten sicker than she had been, taking more medication again, with the side effects she had to endure, and not seeing her friends every day. However, since she had a very hard time falling asleep at night and staying asleep, she was glad that she didn't have to get up early for school. I want to emphasize here that Lucy only needed 2 weeks of homebound instruction. Some Lyme patients are home for months, with symptoms so severe that they cannot go to school! Lucy had been tested by a Lymeliterate neuropsychologist. Her evaluation was typical of many I've seen in children with chronic Lyme superior intelligence, but indicating a wide range of functioning in different areas, one as low as the first percentile, significant problems in mental tracking, attention, concentration and very poor short term memory. She was seriously impaired in her ability to learn new material, despite her very high IQ and fabulous vocabulary. Let's look at Lucy, a student with chronic Lyme disease, who enters your classroom in the fall. You've learned what Lyme can do to the ability to learn, so you are prepared to teach this 4th grade student. Understanding the nature and extent of possible symptoms, you make no presumptions. You have reports in hand, from the doctor, and the neuropsychologist who tested her, and these comprehensive reports indicate her deficits, with specific recommendations as to her special needs. You find Lucy to be a very smart Page 15 and cyclizine.
OBSERVERS: 1. Monica Burchell, Project Manager, Patient Involvement Unit for NICE 2. Ms Lakshmi Murthy, Research Assistant, National Collaborating Centre for Nursing and Supportive Care 3. Dr Mireia Espallargues, Co-ordinator of the Health Services Assessment Unit, Catalan HTA Group 4. Tanisha Carino, Health Policy Analyst for Office of Clinical Standards and Quality Coverage and Analysis Group. Centre for Medicare and Medicaid Services, Baltimore, Maryland.
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SaO2 DEPENDANCY OF NEONATAL PULSE OXIMETRY ACCURACY: A ROOT MEAN SQUARE ERROR ANALYSIS Dale Gerstmann MD, Ryan Berg RRT, Ron Haskell RRT, Cathy Brower RRT, Brenda Smith RN. Neonatology, Utah Valley Regional Medical Center, Provo, Utah. Objective: To apply a root mean square error analysis to pulse oximeter derived SpO2 compared to arterial SaO2 values obtained from neonatal intensive care unit NICU ; patients who require arterial access. Design: 740 paired SpO2 and SaO2 values from 42 NICU patients were utilized in the analysis. Data were collected on 3 neonatal pulse oximeters. The root mean square statistic, Arms [ 1 n ; [SpO2-SaO2]ij ; 2]1 2, was calculated across patients i ; and samples j ; , then separated into 3 components: "within subject" variation VARWS ; , "between subject" variation VARBS ; , and a "bias squared" BIASSQ ; term. Arms, VARWS, VARBS, and BIASSQ were analyzed in relationship to: a ; patient accrual, and b ; arterial saturation values. Results: Based on patient accrual, values of Arms, VARWS, and VARBS stabilized by 20-25 patients, whereas the BIASSQ term stabilized somewhat sooner, by 15-20 patients. VARWS seemed consistent between devices, but VARBS was less so. Overall, device Arms was biased by the uneven distribution of samples across SaO2. All devices demonstrated a similar relationship betwen Arms and SaO , which reached minimum values over a narrow range 2 of SaO2 94-97% ; . Above and below this range Arms increased 2 fold at 99% SaO2 and 3-6 fold at 82% SaO2. The largest contributor to the increase in Arms outside the minimum range was BIASSQ, the device measurement error. This component of Arms variation is not accounted for by VARWS or VARBS, and is characterized by the slope of the difference function, [SpO2-SaO2] vs SaO2. Conclusion: The variance of neonatal pulse oximetry readings is dependent on the SaO2 at which the reading is taken. It is a function of the variability of taking readings on a single patient, taking readings between multiple patients, and the degree of equipment accuracy. The 95% confidence interval for readings at minimum Arms SaO295% ; is approximately 4 sat %, and for SpO2 at 85%, the 95% confidence interval is approximately 10 sat and cosopt.
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One big picnic basket filled with seasonal delights. This appearance at Smoke features six of the leader's original compositions and one by bassist Derek Nievergelt. The band is wired, literally and figuratively; Pelt uses occasional electronic effects with his trumpet in order to broaden his instrument's range of emotions and the rest of the band takes advantage of the kind of 20th Century electronic technology that has been with us for several generations in order to get `plugged in' and dangerous. Like familiar voices from the family around us, these instrumental textures make everyone in the house feel right at home. Pelt, who will turn 31 in November, was born and raised in Los Angeles, went to school in Boston and settled in New York. His BA in Music from Berklee College of Music prepared him well and left him with a network of collaborations, which seems absolutely essential in this day and age of competitive business relationships. It's not his background that stands out when he takes the stage, however. It's simply what comes from deep inside him. The trumpeter is at his best with a riveting ballad, such as "Cause", or a sensual blues, such as "Blues", where he leads his band in a storm of emotions. Several selections utilize organ combo textures with a hefty groove, while others recall the electric periods of Miles Davis. Pelt's trumpet creates a delightful session that shouldn't be missed. For more information, visit maxjazz . Pelt is at Dizzy's Club Sep. 17th with Rachel Z and Jazz Standard Sep. 20th and Blue Note Sep. 24th as part of the Festival of New Trumpet Music. See calendar and cyclosporine.
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The 36-mo results of this study showed that CsA can be eliminated successfully in de novo renal transplant patients who receive SRL-based therapy. By 36 mo, there was a growing trend for improved graft survival 91.2% versus 85.1%; P 0.052 ; in SRL-ST patients, despite numerically more biopsy-proven acute rejections. Importantly, data available to date beyond 36 mo indicate that the advantage in graft survival continues to increase for patients who receive SRL-ST immunotherapy compared with those who remain on SRL-CsA-ST. As the cumulative data analysis assumes that patients without reported graft loss had functioning grafts, further confirmation is required when all patients have attained the future protocoldefined end points for graft survival at 48 and 60 mo. Graft survival including loss to follow-up was the primary analysis. More patients were lost to follow-up in the SRLCsA-ST group. Nevertheless, the conclusions would be the same for both the 36-mo and cumulative data if patients who were lost to follow-up were excluded. Notably, the advantage in the difference in graft loss censored for death in the SRL-ST group also increased from 3.7% at 36 mo to 4.7% with 41 to 54 follow-up. The incidence of first biopsy-proven acute rejection between randomization and 36 mo was 4.7% higher after CsA withdrawal. This difference was not significant, however, and could be explained by the higher incidence of acute rejection with SRL-ST therapy through month 12 in the presence of four or more HLA mismatches. All rejections after randomization were mild or moderate in severity. Moreover, patients who received SRL-ST had better renal function at 36 mo regardless of whether they had a biopsy-confirmed acute rejection or four or more HLA mismatches or both. Patients with a Banff grade 3 or vascular rejection within 1 mo before randomization 3 mo and creatine.
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