961 resultados para EXTENSIVE TRANSVERSE MYELITIS


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Mode of access: Internet.

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Includes bibliographical references (p. 15)

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Thesis (Ph.D.)--University of Washington, 2016-06

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AIMS Hyperinsulinism of infancy (HI) is characterized by unregulated insulin secretion in the presence of hypoglycaemia, often resulting in brain damage. Pancreatic resection for control of hypoglycaemia is frequently resisted because of the risk of diabetes mellitus (DM). We investigated retrospectively 62 children with HI from nine Australian treatment centres born between 1972 and 1998, comparing endocrine and neurological outcome in 28 patients receiving medical therapy alone with 34 who required pancreatic resection to control their hypoglycaemia. METHODS History, treatment and clinical course were ascertained from file audit and interview. Risk of DM (hazard ratio) attributable to age at surgery (< vs. greater than or equal to 100 days at last pancreatectomy) and extent of resection (< vs. greater than or equal to 95%) were calculated using Cox proportional hazards regression and categorical variables compared by the chi(2) -test. Neurological outcome (normal, mild deficit or severe deficit) was derived from the most authoritative source. RESULTS Surgically treated patients had a greater birthweight, earlier presentation and higher plasma insulin levels. Of 18 infants < 100 days and 16 greater than or equal to 100 days of age at surgery, four (all greater than or equal to 100 days) became diabetic as an immediate consequence of surgery and five (two < 100 days and three greater than or equal to 100 days) became diabetic 7-18 years later. Surgery greater than or equal to 100 days and pancreatectomy greater than or equal to 95% were associated with development of diabetes (HR = 12.61, CI 1.53-104.07 and HR = 7.03, CI 1.43-34.58, respectively). Neurodevelopmental outcome was no different between the surgical and medical groups with 44% overall with neurological deficits. Patients euglycaemic within 35 days of the first symptom of hypoglycaemia (Group A) had a better neurodevelopmental outcome than those still hypoglycaemic > 35 days from first presentation (Group B) (P = 0.007). Prolonged hypoglycaemia in Group B was due either to delayed diagnosis or to need for repeat surgery because of continued hypoglycaemia. Within Group A, medically treated patients (who presented later with apparently milder disease) had a higher incidence of neurodevelopmental deficit (n = 15, four mild, three severe deficit) compared with surgically treated patients (n = 18, two mild, none severe deficit) (P < 0.025). CONCLUSIONS Poor neurodevelopmental outcome remains a major problem in hyperinsulinism of infancy. Risk of diabetes mellitus with pancreatectomy varies according to age at surgery and extent of resection. Patients presenting early with severe disease have a better neurodevelopmental outcome and lower risk of diabetes if they are treated with early extensive surgery.

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The establishment of the dormant state in meristems involves considerable physiological and metabolic alterations necessary for surviving unfavourable growth conditions. However, a global molecular analysis of dormancy in meristems has been hampered by the difficulty in isolating meristem cells. We used cryosectioning to isolate purified cambial meristem cells from the woody plant Populus tremula during active growth and dormancy. These samples were used to generate meristem-specific cDNA libraries and for cDNA microarray experiments to define the global transcriptional changes underlying cambial dormancy. The results indicate a significant reduction in the complexity of the cambial transcriptome in the dormant state. Although cell division is terminated in the dormant cambium, the cell cycle machinery appears to be maintained in a skeletal state as suggested by the continued presence of transcripts for several cell cycle regulators. The downregulation of PttPIN1 and PttPIN2 transcripts explains the reduced basipetal polar auxin transport during dormancy. The induction of a member of the SINA family of ubiquitin ligases implicated in auxin signalling indicates a potential mechanism for modulation of auxin sensitivity during cambial dormancy. The metabolic alterations during dormancy are mirrored in the induction of genes involved in starch breakdown and the glyoxysomal cycle. Interestingly, the induction of RGA1 like gene suggests modification of gibberellin signalling in cambial dormancy. The induction of genes such as poplar orthologues of FIE and HAP2 indicates a potential role for these global regulators of transcription in orchestrating extensive changes in gene expression during dormancy.

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Traditionally, long-term calcium hydroxide dressings have been recommended for the conservative management of large periapical lesions. However, calcium hydroxide therapy has some disadvantages such as variability of treatment time, difficulties with patient follow-up and prolonged treatment periods that increase the risk of root canal contamination via microleakage and crown fractures. This paper reports the healing of large periapical lesions following conservative non-surgical treatment with calcium hydroxide dressings.

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The management of a large rib osteosarcoma in a two-year-old neutered male Golden Retriever is reported. The tumour was initially misdiagnosed as a chondrosarcoma following incisional biopsy. Extensive en bloc resection and chest wall reconstruction with propylene mesh was performed, and carboplatin was administered postoperatively. Approximately 270 days after surgery there was no evidence of tumour recurrence and the patient was disease free.

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Vertical-cavity surface-emitting lasers (VCSELs) and microlenses can be used to implement free space optical interconnects (FSOIs) which do not suffer from the bandwidth limitations inherent in metallic interconnects. A comprehensive link equation describing the effects of both optical and electrical noise is introduced. We have evaluated FSOI performance by examining the following metrics: the space-bandwidth product (SBP), describing the density of channels and aggregate bandwidth that can be achieved, and the carrier-to-noise ratio (CNR), which represents the relative strength of the carrier signal. The mode expansion method (MEM) was used to account for the primary cause of optical noise: laser beam diffraction. While the literature commonly assumes an ideal single-mode laser beam, we consider the experimentally determined multimodal structure of a VCSEL beam in our calculations. It was found that maximum achievable interconnect length and density for a given CNR was significantly reduced when the higher order transverse modes were present in Simulations. However, the Simulations demonstrate that free-space optical interconnects are still a suitable solution for the communications bottleneck, despite the adverse effects introduced by transverse modes.

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Several pathogenic strains of Escherichia coli exploit type III secretion to inject effector proteins into human cells, which then subvert eukaryotic cell biology to the bacterium's advantage. We have exploited bioinformatics and experimental approaches to establish that the effector repertoire in the Sakai strain of enterohemorrhagic E. coli (EHEC) O157:H7 is much larger than previously thought. Homology searches led to the identification of > 60 putative effector genes. Thirteen of these were judged to be likely pseudogenes, whereas 49 were judged to be potentially functional. In total, 39 proteins were confirmed experimentally as effectors: 31 through proteomics and 28 through translocation assays. At the protein level, the EHEC effector sequences fall into > 20 families. The largest family, the NleG family, contains 14 members in the Sakai strain alone. EHEC also harbors functional homologs of effectors from plant pathogens (HopPtoH, HopW, AvrA) and from Shigella (OspD, OspE, OspG), and two additional members of the Map/IpgB family. Genes encoding proven or predicted effectors occur in > 20 exchangeable effector loci scattered throughout the chromosome. Crucially, the majority of functional effector genes are encoded by nine exchangeable effector loci that lie within lambdoid prophages. Thus, type III secretion in E. coli is linked to a vast phage metagenome, acting as a crucible for the evolution of pathogenicity.

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We investigate the critical behavior of the spectral weight of a single quasiparticle, one of the key observables in experiment, for the particular case of the transverse Ising model. Series expansions are calculated for the linear chain and the square and simple cubic lattices. For the chain model, a conjectured exact result is discovered. For the square and simple cubic lattices, series analyses are used to estimate the critical exponents. The results agree with the general predictions of Sachdev [Quantum Phase Transitions (Cambridge University Press, Cambridge, England, 1999)].

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The Thouless-Anderson-Palmer (TAP) approach was originally developed for analysing the Sherrington-Kirkpatrick model in the study of spin glass models and has been employed since then mainly in the context of extensively connected systems whereby each dynamical variable interacts weakly with the others. Recently, we extended this method for handling general intensively connected systems where each variable has only O(1) connections characterised by strong couplings. However, the new formulation looks quite different with respect to existing analyses and it is only natural to question whether it actually reproduces known results for systems of extensive connectivity. In this chapter, we apply our formulation of the TAP approach to an extensively connected system, the Hopfield associative memory model, showing that it produces identical results to those obtained by the conventional formulation.

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We report a distinctive polarization mode coupling behaviour of tilted fibre Bragg gratings (TFBGs) with a tilted angle exceeding 45°. The ex-45° TFBGs exhibit pronounced polarization mode splitting resulted from the birefringence induced by the grating structure asymmetry. We have fabricated TFBGs with a tilted structure at 81° and studied their properties under transverse load applied to their equivalent fast and slow axes. The results show that the light coupling to the orthogonally polarized modes of the 81°-TFBGs changes only when the load is applied to their slow axis, giving a prominent directional loading response. For the view of real applications, we further investigated the possibility of interrogating such a TFBG-based load sensor using low-cost and compact-size single wavelength source and power detector. The experimental results clearly show that the 81°-TFBGs plus the proposed power-measurement interrogation scheme may be developed to an optical fibre vector sensor system capable of not just measuring the magnitude but also recognizing the direction of the applied transverse load. Using such an 81°-TFBG based load sensor, a load change as small as 1.6 × 10-2 g may be detected by employing a standard photodiode detector.