A review on imaging techniques and quantitative measurements for dynamic imaging of cerebral aneurysm pulsations.

Measurement of intracranial aneurysm wall motion may refine the current rupture risk estimation. A golden standard for measuring aneurysm pulsation is lacking. The aim is to evaluate magnitudes of aneurysm pulsation as published in current literature. Embase and PubMed were searched for publications containing quantitative measures of cardiac-cycle related cerebral aneurysm pulsation (no date or language restrictions). Eleven studies were included, covering 197 unruptured and untreated cerebral aneurysms. Quantitative pulsation measurements were extracted from the studies. Characteristics of the study population and aneurysms were taken into account, as well as the imaging modality, scanning technique and data processing methods used. A meta-analysis was performed of studies with similar methodologies and individual IA measures and locations. The magnitude of the absolute volume pulsations varied between 14 ± 9 mm3 and 106 ± 123 mm3 and the mean relative volume change varied between 5 and 36%. The meta-analysis revealed a positive correlation between size and absolute volume change. The relative volume change in Basilar artery aneurysms seems smaller. No authors were contacted for original study data and articles only describing visual pulsations were excluded. The variation in methodologies impedes an accurate estimation of the magnitude of IA pulsations. Validation of aneurysm pulsation measurement is crucial prior to clinical studies evaluating IA pulsatility in relation to IA rupture risk. Prerequisite is a reliable and robust imaging method with high spatial and temporal resolution and standardization of the image analysis methods.

Serological markers of gluten sensitivity in Border terriers with gall bladder mucocoeles.

OBJECTIVES: To evaluate serological markers of gluten sensitivity in conjunction with cholecystokinin measurement in Border terriers with gall bladder mucocoeles. MATERIALS AND METHODS: Medical records from two referral hospitals were obtained between 2011 and 2019 to identify Border terriers with gall bladder mucocoeles, non-Border terriers with gall bladder mucocoeles and control Border terriers with non-biliary diseases. Enzyme-linked immunosorbent assays were performed on stored fasted serum samples for anti-gliadin IgG, anti-canine transglutaminase-2-IgA autoantibodies and cholecystokinin. Statistical analysis was performed using the Kruskall-Wallis test to identify differences between the groups. RESULTS: Fifteen Border terriers with gall bladder mucocoeles, 17 non-Border terriers with gall bladder mucocoeles and 14 control Border terriers with non-biliary diseases were recruited. Median transglutaminase-2-IgA autoantibodies in Border terriers with gall bladder mucocoeles was 0.73 (range: 0.18 to 1.67), which was significantly greater than in control Border terriers at 0.41 (0.07 to 1.14). Median cholecystokinin concentration in Border terriers with gall bladder mucocoeles was 13 pg/mL (6 to 45 pg/mL), which was significantly lower than in control Border terriers at 103 pg/mL (9 to 397 pg/mL). There was no difference in the anti-gliadin IgG between these groups. There was no difference observed in the non-Border terriers with gall bladder mucocoeles with either of the other groups. CLINICAL SIGNIFICANCE: Reduced cholecystokinin and increased transglutaminase-2-IgA autoantibodies was detected in Border terriers with gall bladder mucocoeles; which is in part homologous to gall bladder disease identified in human coeliac disease. The results suggest an immunological disease with impaired cholecystokinin release may be affecting gall bladder motility and possibly contributing to mucocoele formation in Border terriers.

Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes.

The purpose of this study was to investigate the ophthalmic clinical findings following surgical reconstruction with autogenous bone grafts of pure blowout fractures. A retrospective review of 211 patients who underwent surgical repair of an orbital fracture between October 1996 and December 2013 was performed. Following data analysis, 60 patients who were followed up over a period of 1 year were included. A solitary floor fracture was present in 38 patients and a floor and a medial wall fracture in 22 patients. Comparing preoperative findings between these two groups, preoperative diplopia and enophthalmos were almost twice as frequent in the group with additional medial wall fractures: diplopia 8% and 14% and enophthalmos 18% and 55%, respectively. One year following surgery there was no diplopia present in either group. In the solitary floor fracture group, 3% still had enophthalmos. It can be concluded that at 1 year following the repair of pure orbital floor fractures using autogenous bone, good functional and aesthetic results can be obtained. In the group with both floor and medial wall fractures, no enophthalmos was found when both walls were reconstructed. When the medial wall was left unoperated, 29% of patients still suffered from enophthalmos after 1 year.

Genetic architecture of a morphological shape difference between two Drosophila species.

The size and shape of the posterior lobe of the male genital arch differs dramatically between Drosophila simulans and D. mauritiana. This difference can be quantified with a morphometric descriptor (PC1) based on elliptical Fourier and principal components analyses. The genetic basis of the interspecific difference in PC1 was investigated by the application of quantitative trait locus (QTL) mapping procedures to segregating backcross populations. The parental difference (35 environmental standard deviations) and the heritability of PC1 in backcross populations (>90%) are both very large. The use of multiple interval mapping gives evidence for 19 different QTL. The greatest additive effect estimate accounts for 11. 4% of the parental difference but could represent multiple closely linked QTL. Dominance parameter estimates vary among loci from essentially no dominance to complete dominance, and mauritiana alleles tend to be dominant over simulans alleles. Epistasis appears to be relatively unimportant as a source of variation. All but one of the additive effect estimates have the same sign, which means that one species has nearly all plus alleles and the other nearly all minus alleles. This result is unexpected under many evolutionary scenarios and suggests a history of strong directional selection acting on the posterior lobe.

The cell-surface proteoglycan Dally regulates Wingless signalling in Drosophila.

Wingless (Wg) is a member of the Wnt family of growth factors, secreted proteins that control proliferation and differentiation during development. Studies in Drosophila have shown that responses to Wg require cell-surface heparan sulphate, a glycosaminoglycan component of proteoglycans. These findings suggest that a cell-surface proteoglycan is a component of a Wg/Wnt receptor complex. We demonstrate here that the protein encoded by the division abnormally delayed (dally) gene is a cell-surface, heparan-sulphate-modified proteoglycan. dally partial loss-of-function mutations compromise Wg-directed events, and disruption of dally function with RNA interference produces phenotypes comparable to those found with RNA interference of wg or frizzled (fz)/Dfz2. Ectopic expression of Dally potentiates Wg signalling without altering levels of Wg and can rescue a wg partial loss-of-function mutant. We also show that dally, a regulator of Decapentaplegic (Dpp) signalling during post-embryonic development, has tissue-specific effects on Wg and Dpp signalling. Dally can therefore differentially influence signalling mediated by two growth factors, and may form a regulatory component of both Wg and Dpp receptor complexes.

Molecular dissection of a major gene effect on a quantitative trait: the level of alcohol dehydrogenase expression in Drosophila melanogaster.

A molecular mapping experiment shows that a major gene effect on a quantitative trait, the level of alcohol dehydrogenase expression in Drosophila melanogaster, is due to multiple polymorphisms within the Adh gene. These polymorphisms are located in an intron, the coding sequence, and the 3' untranslated region. Because of nonrandom associations among polymorphisms at different sites, the individual effects combine (in some cases epistatically) to produce "superalleles" with large effect. These results have implications for the interpretation of major gene effects detected by quantitative trait locus mapping methods. They show that large effects due to a single locus may be due to multiple associated polymorphisms (or sequential fixations in isolated populations) rather than individual mutations of large effect.

Genetic analysis of a morphological shape difference in the male genitalia of Drosophila simulans and D. mauritiana.

Two closely related species of Drosophila, D. simulans and D. mauritiana, differ markedly in morphology of the posterior lobe of the male genital arch. Both size and shape aspects of lobe variation can be quantified by a morphometric descriptor based on elliptical Fourier and principal components analyses. The genetic architecture of this quantitative trait (PC1) was investigated by hybridizing inbred lines to produce two backcross populations approximately 200 individuals each, which were analyzed jointly by a composite interval mapping procedure with the aid of 18 marker loci. The parental lines show a large difference in PC1 (30.4 environmental standard deviations), and the markers account for > 80% of the phenotypic variation in backcross populations. Eight of 15 intervals analyzed show convincing evidence of quantitative trait loci (QTL), and the range of estimated QTL effects is 5.7-15.9% of the parental difference (1.7-4.8 environmental standard deviations). These estimates may represent the joint effects of multiple QTL within a single interval (which averaged 23 cM in length). Although there is some evidence of partial dominance of mauritiana alleles and for epistasis, the pattern of inheritance is largely additive.

Focal vulvitis: a psychosexual problem for which surgery is not the answer.

In the last decade focal vulvitis has been identified as a distinct syndrome, characterized by unexplained burning vulvar pain and superficial dyspareunia. A 'Woodruff perineoplasty' has been recommended as a treatment method. A research project was conducted, investigating the long-term results of surgical treatment and the etiology of focal vulvitis. Results showed that the great majority of women continued to suffer from focal vulvitis after the operation, which leads to the conclusion that the procedure should be abandoned. Retrospective data revealed several immediate causes of mechanical and chemical irritation of the vulva. All women exhibited 'inadequate sexual behavior': having intercourse without a sufficient amount of lubrication and/or in the presence of hypertonia of the pelvic floor. Psychosexual processes were further characterized by deterioration of sexual and general well-being, resulting in lack of libido and depression, which contributed considerably to the problem. An integrated approach to treatment is recommended, which incorporates protection of the vulvar skin, relaxation of pelvic muscles and sexological treatment of the psychosexual and relational aspects.

The effect of an intronic polymorphism on alcohol dehydrogenase expression in Drosophila melanogaster.

Several lines of evidence indicate that natural selection controls the frequencies of an allozyme polymorphism at the alcohol dehydrogenase (Adh) locus in Drosophila melanogaster. However, because of associations among sequence polymorphisms in the Adh region, it is not clear whether selection acts directly (or solely) on the allozymic site. This problem has been approached by using in vitro mutagenesis to distinguish among the effects on Adh expression of individual polymorphisms. This study shows that a polymorphism within the first Adh intron (delta 1) has a significant effect on the level of ADH protein. Like the allozyme, delta 1 shows a geographic cline in frequency, indicating that it may also be a target of natural selection. These results suggest that multisite selection models may be required to understand the evolutionary dynamics of individual loci.

Detection of arterial intimal lesions: an experimental study comparing ultrasonography and arteriography.

In an experimental study the diagnostic value of intra-operative ultrasonography in the detection of arterial intimal lesions was investigated. A human carotid artery was placed in a pulsatile circuit with a roller pump and tubes. Intimal lesions (1-5 mm) were created and ultrasonography and biplane arteriography were performed. The ultrasonograms and arteriograms obtained were interpreted by three observers, who were blind to the procedures performed and the results were compared to the macroscopic defects. The mean sensitivity between observers for ultrasonography was 84% with a specificity of 95.7%. For biplane arteriography the mean sensitivity was 42% with a specificity of 94.5%. The differences between ultrasonography and biplane arteriography were statistically significant (p less than 0.02). It is concluded from this is concluded from this in vitro study that ultrasonography provides more accurate information concerning intimal lesions of the arterial wall than biplane arteriography.

Color-flow duplex criteria for grading stenosis in infrainguinal vein grafts.

Color-flow duplex scanning of infrainguinal vein bypasses was used to identify failing grafts. Several duplex parameters were compared to determine their value in identifying and quantifying the degree of stenosis. Intraarterial digital subtraction angiography was used as the "gold standard" to determine the severity of the stenosis. The goal of this study was to identify specific color-flow duplex criteria for grading stenotic lesions. After a retrospective analysis some of these parameters were prospectively validated. The surveillance protocol required a color-flow duplex scan every 3 months for the first year and every 6 months during the second year. One hundred sixteen vein grafts in 112 patients were studied. Forty-three stenoses were identified and classified into categories from 30% to 49%, 50% to 69%, and 70% to 99% diameter reduction. These stenoses were identified in either the bypass graft or adjacent inflow or outflow arteries. Failing grafts were evaluated further by intraarterial digital subtraction angiography. Patients with normal appearing bypasses (without suspected stenotic lesions) had intravenous digital subtraction angiography. The five duplex parameters that were studied included the following: (1) graft peak systolic velocity (PSV-graft), (2) the maximum peak systolic velocity (at the site of a stenosis or in normal grafts at the narrowest segment of the bypass) (PSV-max), (3) the ratio between PSV-graft and PSV-max, (PSV-index), (4) end-diastolic velocity (EDV) at a stenosis or from narrowest graft segment, (5) color-flow image diameter measurements. For discrimination of different degrees of stenosis, threshold values of these parameters were calculated by receiver operating characteristic analysis. Diameter reduction measured by color-flow imaging was best to identify all stenotic lesions greater than 29% (sensitivity 88%, specificity 99%). Peak systolic velocity-index proved optimal identification of stenoses greater than 49% (sensitivity 89%, specificity 92%), and 70% to 99% stenoses were associated with increased EDV (sensitivity 91%, specificity 100%). The PSV-index criteria were then validated prospectively in a separate group of vein grafts. The data support the value of surveillance of femorodistal vein grafts and demonstrate that calculation of the degree of graft stenosis is feasible.

Complete acromioclavicular dislocations: treatment with a Dacron ligament.

A series of 20 patients was treated for a complete acromioclavicular dislocation (Tossy III). Reduction of the clavicle is maintained by a Dacron ligament, which provides dynamic fixation. The mean follow-up period was 3.9 years. For 19 patients the results were good or excellent; in one case the result was poor. Advantages of the method described are ease of the procedure, absence of pins and a 1-week period of immobilization. An important result is the short sick leave with an average of 3.3 weeks, which is favourable compared with other operative and non-operative methods. The recent tendency to treat complete acromioclavicular dislocations non-operatively is based on the poor results of the Phemister and Bosworth operation; however, cerclage with a Dacron ligament has a low complication rate and gives a high percentage of anatomical reduction. It is therefore considered an effective method to treat complete acromioclavicular dislocations.

Hospital administrators' response to AIDS. Results of a national survey.

Executives are just beginning to adapt to the presence of the epidemic. Two-thirds have been involved in AIDS care and these hospitals appear to be in the forefront in developing structural responses and initiating procedures to deal with the disease. Through the use of rating scale analysis, we were able to show a continuum of responses by which hospitals cope with the disease. First, educational efforts are begun, then human resource departments begin to refer employees with AIDS to caregivers. And the most developed response is for hospitals to establish specific policies for employees, ultimately requiring them to report whether or not they have the disease to their supervisor. Executives' attitudes also seem to be affected by whether or not their hospitals have cared for any AIDS patients. In contrast to the contact hypothesis used to explain prejudice, experienced administrators are more authoritarian in reacting to the crisis. For example, more experienced than inexperienced hospital administrators agree that all patients should be routinely tested for AIDS. Our findings are corroborated in a recently reported study of house staff who had been exposed to patients with AIDS. House officers who had cared for a greater number of AIDS patients showed a greater level of concern about acquiring the disease than those with less exposure. Just as experience among house officers serves to produce increasing concern for their personal safety, so too experience on the part of the executives appears to intensify anxiety in their attitudes. Experienced administrators are more likely to advocate specialized facilities for the care of AIDS patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Quantitative analysis of RNA produced by slow and fast alleles of Adh in Drosophila melanogaster.

The alcohol dehydrogenase (ADH) locus (Adh) of Drosophila melanogaster in polymorphic on a world-wide basis for two allozymes, Fast and Slow. This study was undertaken to determine whether the well-established difference in ADH protein concentration between the allozymes is due to a difference in mRNA levels. RNA gel blot hybridization and an RNase protection assay were used to quantify ADH mRNA levels. Each method used an Adh null mutant as an internal standard. Several Slow and Fast allele pairs of different geographic origins were analyzed. The results provide strong evidence that the ADH protein concentration difference is not accounted for by RNA level.

Use of P-element-mediated transformation to identify the molecular basis of naturally occurring variants affecting Adh expression in Drosophila melanogaster.

The purpose of the work reported here is to identify the molecular basis of the difference in level of expression between the polymorphic Slow and Fast alcohol dehydrogenase (Adh) alleles in Drosophila melanogaster. Previous studies have shown that Fast lines typically have a two- to threefold higher activity level than Slow lines and they also have a substantially higher level of ADH-protein (estimated immunologically). The results of a restriction fragment length polymorphism study in relation to ADH activity variation had previously suggested that the difference in Adh expression between allozymes might not be due entirely to the amino acid replacement substitution, but could be due in part to linkage disequilibrium with a regulatory site polymorphism. Here we describe an approach that makes use of P-element-mediated transformation in order to identify the nucleotide substitution(s) responsible for this difference in ADH level. This approach consists of generating recombinants in vitro between Adh region clones derived from a typical Slow/Fast pair of alleles and then testing for the effects of particular restriction fragments on expression in vivo by transformation. Using this approach, the effect on both ADH activity and ADH-protein level clearly maps to a 2.3-kb restriction fragment that includes all of the Adh coding sequence and some intron and 3' flanking sequence, but excludes all of the 5' flanking sequence of the distal (adult) transcriptional unit. Comparison of Kreitman's DNA sequences for this fragment from several Slow and Fast alleles showing the typical difference in activity level shows that only three nucleotide substitutions distinguish all Fast from all Slow alleles. Thus, it is likely that one or more of these substitutions causes the major difference in Adh expression between allozymic classes. One of these substitutions is, of course, the Slow/Fast amino acid replacement substitution (at 1490) while the other two are nearby third position silent substitutions (at 1443 and 1527). A quantitative analysis of variation among transformant stocks shows that the P-element transformation approach can be used to localize even relatively small effects on gene expression (on the order of 20%).