The hepatitis C virus (HCV) envelope glycoprotein-2 inhibits the interferon (IFN)–induced, double-stranded RNA-activated protein kinase (PKR) via the PKR eukaryotic initiation factor-2α ...phosphorylation homology domain (PePHD). The present study examined the genetic variability of the PePHD in patients receiving IFN therapy. The PePHD from 12 HCV genotype 1 (HCV-1)—infected patients receiving daily IFN therapy was amplified by reverse-transcriptase polymerase chain reaction and analyzed by direct and clonal sequencing. The PePHD was highly conserved in 38 HCV GenBank isolates. There was no difference in pretreatment PePHD sequences isolated from IFN responders versus nonresponders. The major PePHD quasi-species variant did not change after 6 weeks of daily IFN therapy, and in 1 patient the major quasi-species variant did not change during 9 months of observation. Sequencing of 25 pretreatment PePHD clones from 3 patients confirmed that there was extremely low sequence variability surrounding the PePHD. The PePHD is highly conserved in HCV-1—infected IFN responders and nonresponders and does not appear to evolve in response to IFN therapy.
Twenty-four consecutive patients with cervical distraction extension injuries were retrospectively reviewed to study the safety and efficacy of various treatment protocols in this type of cervical ...spine injury. Sixteen of 24 patients with cervical distraction extension injuries underwent surgical stabilization. All patients undergoing surgical stabilization were noted to have a stable fusion at their latest follow-up. There were three instances of surgically related neurologic deterioration as a result of over-distraction of the anterior column interspace at the time of graft placement. The overall mortality rate was 42% in this aged patient population. Anterior reconstruction of the cervical spine with an anterior cervical graft and plate acting as a tension band is the ideal treatment method for stabilization of acute distraction extension injuries involving primarily the soft tissue structures (anterior longitudinal ligament and intervertebral disc). Type 2 injuries, depending on the degree of displacement and the adequacy of closed reduction, may need to be approached initially posteriorly to obtain adequate alignment, followed by an anterior reconstructive procedure. Great care should be taken during anterior graft placement to avoid over-distraction of the spine. If nonsurgical intervention is selected, close regular radiographic follow-up is necessary to detect early vertebral malalignment, which may predispose to spinal cord dysfunction. Older patients sustaining this injury have a high mortality rate.
Many authors have described spinal and bodily injuries associated with seat belt use. However, most reports have focused primarily on lap seat belts and resultant flexion-distraction injuries. This ...retrospective chart review studies the relation between the specific type of restraint or air bag and the resultant thoracolumbar spinal injury subtype and associated bodily injuries. The charts of 221 patients who had sustained thoracolumbar fractures in motor vehicle accidents during a 10-year period were reviewed, and 37 patients were identified whose accidents were clearly described as a frontal collision and whose specific form of restraint was recorded. Among the 15 patients who used a shoulder strap and lap belt device (three-point restraint), 12 patients sustained burst fractures (80%) compared with 4 of the 14 patients (28.6%) restrained with lap seat belts alone. Life-threatening intraabdominal injuries occurred in 57.1% of lap-belted victims and in 26.7% of patients who used three-point restraints, and the character of these injuries also differed. No patients in an automobile in which an air bag deployed sustained major associated bodily injuries. Among restrained occupants of head-on motor vehicle accidents who have sustained a thoracolumbar fracture, patients using lap belts are more likely to sustain the classic flexion-distraction injury patterns, whereas patients using three-point restraints may sustain a higher incidence of burst fractures. In addition, three-point restraints are associated with a decreased risk of intraabdominal injury compared with lap seat belts.
Bronchoalveolar Cell Carcinoma of the Lung Greco, Richard J.; Steiner, Robert M.; Goldman, Scott ...
The Annals of thoracic surgery,
06/1986, Letnik:
41, Številka:
6
Journal Article
Recenzirano
Odprti dostop
A multivariable analysis was performed of all patients registered and confirmed to have bronchoalveolar cell carcinoma of the lung in the Tumor Registry of Thomas Jefferson University Hospital ...between 1969 and 1983. These 122 patients were reviewed for age, sex, smoking history, occupational exposure, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, survival, and complications of treatment.
No correlation could be found in this series between a patient's age, sex, smoking history, or occupational exposure and the incidence or outcome of the disease. Seventy-one of the 122 patients in this series were asymptomatic, and the carcinoma was discovered in them by routine chest roentgenogram. Of these asymptomatic patients, 50 were seen with pathologic stage I disease. Of the 51 symptomatic patients, 32 (65%) were seen with stage IIIm
0 or IIIm
1 disease.
Despite medical evaluations, 77% of the T
1 and T
2 lesions required thoracotomy for diagnosis. The overall five-year survival rate was 42.3%, ranging from 75% for those with stage I disease to 8.7% for those with stage IIIm
1 disease.
Stereotypes and Social Judgment Manis, Melvin; Paskewitz, Joan; Cotler, Scott
Journal of personality and social psychology,
03/1986, Letnik:
50, Številka:
3
Journal Article
Recenzirano
Five experiments were conducted to study the role of correlated cues in social judgments. Respondents were initially exposed to an induction series in which there was a systematic association between ...the amount of psychopathology that was implied by various behavior samples and other readily discernable aspects of these samples (i.e., correlated cues). In two studies, for example, a series of confused definitions seemed to emanate from the patients at Central Hospital, whereas the patients at Metropolitan Hospital appeared to be the source of nonpathological definitions. The introduction of correlated cues often produced contrast effects, suggesting that our respondents may have evaluated the test definitions by implicitly comparing them to other definitions from that category (e.g., other definitions from the same hospital). Assimilation effects were observed when respondents were required to indicate their overall impressions of a given patient, or group of patients, before evaluating a particular definition.
The management of acute, displaced odontoid fractures requires the restoration of sagittal alignment and rigid external or internal immobilization to prevent late instability and achieve union. This ...report introduces a new traction technique for the reduction of posteriorly displaced type 2 odontoid fractures. Seven patients with traumatic injuries to the dens were placed in bivector traction for an awake closed reduction. Sagittal alignment was restored and maintained in all patients with no neurologic deterioration or traction-related complications during an average of 11 days (range, 2-28 days) in traction. The overall sagittal alignment corrected from an initial average of 12.2 mm (range, 5-22 mm) of posterior displacement to an average of 1.1 mm (range, 0-3 mm) at the completion of reduction. Only one patient had residual angulation, which measured 5 degrees. Three patients achieved an osseous union and the remaining four required a posterior C1-C2 fusion for nonunion. Although operative stabilization may be the preferred approach in this patient population and injury pattern, we conclude that bivector traction is a safe and effective technique for the initial management of posteriorly displaced odontoid fractures. In addition, its role can be expanded to the closed reduction of lower cervical spine fractures in patients with fixed flexion deformities secondary to ankylosing spondylitis or disseminated intraosseous segmental hyperostosis.
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