976 resultados para Knife-cut


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BACKGROUND AND AIMS: Normal weight obesity (NWO) has been defined as an excessive body fat (BF) associated with a normal body mass index (BMI). Still, little is known regarding the effect of differing cut-offs for %BF on the prevalence of NWO. We thus conducted a study to assess the effect of modifying the cut-offs for excessive %BF on the prevalence of NWO. METHODS: We examined a convenience sample of 1523 Portuguese adults. BF was measured by validated hand-held bioimpedance. NWO was defined as a BMI < 25 kg/m2 and a %BF >30% or according to sex- and age-specific %BF cut-offs. RESULTS: Prevalence of NWO was 10.1% in women and 3.2% in men. In women, prevalence of NWO increased considerably with age, and virtually all women aged over 55 with a BMI < 25 kg/m2 were actually considered as NWO. Using sex-specific cut-offs for BF (men: 29.1%; women: 37.2%) led to moderately lower prevalence of NWO in women. Using sex and age-specific cut-offs for %BF considerably decreased the prevalence of NWO in women, i.e. 0.5e2.5% (depending on the criterion) but not in men, i.e. 1.9e3.4%. CONCLUSIONS: In women, the prevalence of NWO varies considerably according to the cut-off used to define excess BF, whereas a much smaller variation is found in men. While further studies are needed to describe the risk associated with NWO using various %BF cut-offs, this study suggests that sex- and age-specific cut-offs may be preferred.

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The objective of this work was to evaluate the adaptation of anthurium (Anthurium andraeanum) cultivars as cut flowers in a subtropical area, located in north of Paraná State, Brazil. The Apalai, Ianomami, Kinã, nK 102, Parakanã, Rubi, and Terena cultivars were cultivated in a nursery under 80% shade. The number of leaves and inflorescences, floral stem length, length and width of inflorescences, and spadix length were evaluated. The experimental design was in completely randomized blocks, with six replicates and five plants per plot. During the 18 months evaluated, 'Parakanã' produced 11 inflorescences per plant, whereas the other cultivars produced seven to nine inflorescences per plant. The number of leaves produced per plant was: 'Ianomami', 25; 'Parakanã', 20; 'Apalai' and 'Terena', 15; 'Kinã' and 'Rubi', 11; and 'nK 102', 9. The Apalai, nK 102, Parakanã, and Rubi cultivars are the most recommended as cut flowers; the Ianomami cultivar is not recommended as a cut flower in this region.

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Työ sisältää ohjaislaitteiston vertailun ja valinnan rinnakkaisrakenteista robottia varten sekä kunnonvalvontajärjestelmän periaatteiden laadinnan kyseistä robottia varten. Ohjauslaitteisto sisältää teollisuustietokoneen sekä kenttäväylän. Sekä tietokoneesta että väylästä on teoriaosuus ja yksityiskohtaisempi valintaosuus. Teoriaosuudessa selitetään tarkemmin laitteiden toimintaperiaatteista. Valintaosuudessa kerrotaanmiksi jokin tietty laite on valittu käytettäväksi robotin ohjauksessa. Kunnonvalvontateoria ja rinnakkaisrakenteisen robotin kunnonvalvonnan keinot ovat työn toinen osa. Teoriaosa sisältää yleisluonteisen selvityksen vikaantumisesta ja valvonnasta. Erikoisrobotin kunnonvalvonnan keinot esitetään työssä tietyssä järjestyksessä. Ensin esitetään mahdolliset vikatilanteet. Toisessa kohdassa havainnollistetaan vikojen havaitseminen.

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The objective of the present study was longitudinal evaluation of the volumetric tumor response and functional results after Gamma Knife radiosurgery of vestibular schwannomas, performed according to the modern standards of treatment. From October 2003 to September 2007, 133 consecutive patients with vestibular schwannomas were treated according to the concept of robotic Gamma Knife microradiosurgery, which is based on precise irradiation of the lesion, sparing adjacent structures, and delivery of the high radiation energy to the target. Multiple small-sized isocenters located within the border of the neoplasm were applied. The mean marginal dose was 11.5 Gy (range, 11-12 Gy). In total, 126 cases with a minimum posttreatment follow-up of 2 years (range, 2-7 years; median, 4 years) were analyzed. Temporary enlargement was noted in 25 % of tumors at 6 months after radiosurgery. At 3 years of follow-up, tumor shrinkage, stabilization, and increase in volume were marked in 73 %, 23 %, and 4 % of cases, respectively. All progressing lesions spontaneously stabilized later on and did not require additional management. In 3 % of patients, transitory impairment of the facial nerve function was marked; however, neither its permanent dysfunction nor trigeminal neuropathy attributed to radiosurgery was noted. Impairment of hearing compared to its pretreatment level was revealed in 4 %, 12 %, 13 %, and 16 % of patients at 6 months, 1 year, 2 years, and 3 years after radiosurgery, respectively, and this trend was statistically significant (P = 0.0042). Overall, 77 % of patients with serviceable hearing before treatment preserved it 3 years thereafter. In conclusion, modern Gamma Knife radiosurgery provides effective and safe management of vestibular schwannomas. Nevertheless, possible temporary tumor enlargement, delay of its growth arrest, transient dysfunction of the cranial nerves, and gradual deterioration of hearing after irradiation should be always taken into consideration.

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OBJECTIVE: To assess the iodine status of Swiss population groups and to evaluate the influence of iodized salt as a vector for iodine fortification. DESIGN: The relationship between 24 h urinary iodine and Na excretions was assessed in the general population after correcting for confounders. Single-day intakes were estimated assuming that 92 % of dietary iodine was excreted in 24 h urine. Usual intake distributions were derived for male and female population groups after adjustment for within-subject variability. The estimated average requirement (EAR) cut-point method was applied as guidance to assess the inadequacy of the iodine supply. SETTING: Public health strategies to reduce the dietary salt intake in the general population may affect its iodine supply. SUBJECTS: The study population (1481 volunteers, aged ≥15 years) was randomly selected from three different linguistic regions of Switzerland. RESULTS: The 24 h urine samples from 1420 participants were determined to be properly collected. Mean iodine intakes obtained for men (n 705) and women (n 715) were 179 (sd 68.1) µg/d and 138 (sd 57.8) µg/d, respectively. Urinary Na and Ca, and BMI were significantly and positively associated with higher iodine intake, as were men and non-smokers. Fifty-four per cent of the total iodine intake originated from iodized salt. The prevalence of inadequate iodine intake as estimated by the EAR cut-point method was 2 % for men and 14 % for women. CONCLUSIONS: The estimated prevalence of inadequate iodine intake was within the optimal target range of 2-3 % for men, but not for women.

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Biphasic response (shrinkage-regrowth-shrinkage) of tumors has never previously been reported in the postoperative course, neither after microsurgery, nor after Gamma Knife surgery (GKS). We present the case of an adult with dorsal midbrain syndrome resulting from a pilocytic astrocytoma centered on the mesencephalic tectum. The tumor extended to the third ventricle and the thalamus. Initially, due to tumor growth, a biopsy was performed and histology established. Later, a ventriculocisternostomy for obstructive hydrocephalus was performed. Finally, GKS was performed, as the tumor continued to grow. After GKS, the lesion exhibited a biphasic response, with a major shrinkage at 3 months, regrowth within the target volume at 6 and 9 months and a second phase of important shrinkage at 12 months, which persisted for the next two years. The possible mechanisms for this particular response pattern are discussed.

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Työn tavoitteena oli kuvata ja ottaa käyttöön sahauseräkohtaisen kannattavuuden laskentamenetelmä sahalle, sekä tehdä laskentamalli menetelmän tueksi. Sahauksen peruskäsitteiden jälkeen työssä on esitelty sahan tuotantoprosessi. Tuotantoprosessi on kuvattu kirjallisuuden ja asiantuntijoiden haastattelujen perusteella. Seuraavaksi kartoitettiin hyötyjä ja vaikutuksia, mitä laskentamenetelmältä odotetaan.. Kustannuslaskennan teoriaa selvitettiin kirjallisuuslähteitä käyttäen silmälläpitäen juuri tätä kehitettävää laskentamenetelmää. Lisäksi esiteltiin Uimaharjun sahalla käytettävät ja laskentaan liittyvät laskenta- ja tietojärjestelmät.Nykyisin sahalla ei ole minkäänlaista menetelmää sahauseräkohtaisen tuloksen laskemiseksi. Pienillä muutoksilla sahan tietojärjestelmään ja prosessikoneisiin voidaan sahauserä kuljettaa prosessin läpi niin, että jokaisessa prosessin vaiheessa sille saadaan kohdistettua tuotantotietoa. Eri vaiheista saatua tietoa käyttämällä saadaan tarkasti määritettyä tuotteet, joita sahauserä tuotti ja paljonko tuotantoresursseja tuottamiseen kului. Laskentamalliin syötetään tuotantotietoja ja kustannustietoa ja saadaan vastaukseksi sahauserän taloudellinen tulos.Toimenpide ehdotuksena esitetään lisätutkimusta tuotantotietojen automaattisesta keräämisestä manuaalisen työn ja virheiden poistamiseksi. Suhteellisen pienillä panoksilla voidaan jokaiselle sahauserälle kerätä tuotantotiedot täysin automaattisesti. Lisäksi kehittämäni laskentamallin tilalle tulisi hankkia sovellus, joka käyttäisi paremmin hyväksi nykyisiä tietojärjestelmiä ja poistaisi manuaalisen työvaiheen laskennassa.

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OBJECTIVE: Skeletal Muscle Biopsy is a minor surgical procedure for the diagnosis of different neuromuscular pathological conditions and has recently gained popularity also in the research field of age-related muscular modifications and sarcopenia. Few studies focused on the application of mini-invasive muscular biopsy in both normal and pathological conditions. The aim of our study was to describe a mini invasive ultrasound-guided skeletal muscular biopsy technique in complete spinal cord injured (SCI) patients and healthy controls with a tri-axial end-cut needle. PATIENTS AND METHODS: Skeletal muscle biopsies were collected from 6 chronic SCI patients and 3 healthy controls vastus lateralis muscle with a tri-axial end cut needle (Biopince© - Angiotech). Muscle samples were stained for ATPase to determine fibers composition, moreover, gene expression of cyclooxygenase-1 (COX-1) and prostaglandin E2 receptor has been analyzed by Real Time RT-PCR. RESULTS: All the procedures were perfomed easily without failures and complications. Control tissue was macroscopically thicker than SCI one. Control specimen displayed an equal distribution of type I and type II fibers, while SCI sample displayed a prevalence of type II fibers SCI specimen displayed a significant reduction in COX-1 gene expression. This mini-invasive approach was easy, accurate and with low complication rate in performing skeletal muscle biopsy in both SCI patients and controls. CONCLUSIONS: This technique could be useful in conditions in which the overall quantity of specimen required is small like for molecular biology analysis. For histological diagnostic purposes and/or conditions in which the original tissue is already pathologically modified, this technique should be integrated with more invasive techniques.

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Les importants progrès dans la qualité et la résolution des images obtenues par «absorptiométrie biphotonique à rayons X» ou DXA ont amélioré certaines modalités existantes et favorisé le développement de nouvelles fonctions permettant d'affiner de manière significative la prise en charge de nos patients dans diverses pathologies. On peut par exemple améliorer la prédiction du risque fracturaire par l'analyse indirecte de la micro et de la macroarchitecture osseuse, rechercher les marqueurs de pathologies associées (recherche de fractures vertébrales ou de fractures fémorales atypiques), ou évaluer le statut métabolique par la mesure de la composition corporelle. Avec les appareils DXA les plus performants, on pourra bientôt déterminer l'âge osseux, estimer le risque cardiovasculaire (par la mesure de la calcification de l'aorte abdominale), ou prédire la progression de l'arthrose articulaire et son évolution après la prise en charge chirurgicale dans la routine clinique. The significant progress on the quality and resolution of the images obtained by "Dual X-ray Absorptiometry" or DXA has permitted on one hand to improve some existing features and on the other to develop new ones, significantly refining the care of our patients in various pathologies. For example, by improving the prediction of fracture risk by indirect analysis of micro- and macro-architecture of the bone, by looking for markers of associated bone diseases (research vertebral fractures or atypical femoral fractures), or by assessing the metabolic status by the measurement of body composition. With the best performing DXA devices we will soon be able, in clinical routine, to determine bone age, to estimate cardiovascular risk (by measuring the calcification of the abdominal aorta) or to predict the progression of joint osteoarthritis and its evolution after surgical management.

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Background: Gamma Knife surgery (GKS) for vestibular schwannomas (VS) has a long-term clinical and scientific track record. After a period of de-escalation of dose prescription, results show a high rate of tumor control with improvement of clinical outcome (less than 1% facial palsy, 50-70% hearing preservation). Currently, there is controversial data about the active early treatment of intracanalicular (Koos I) VS. Methods: We prospectively analyzed 208 VS, focusing on 42 Koos I patients treated with GKS as first intention in Lausanne University Hospital, between July 2010 and February 2015. We concentrated on patient, tumor, and dosimetric characteristics. Special attention was given on the dose to the cochlea and its impact in maintaining serviceable hearing. Results: The mean follow-up period was 1.7 years (range 0.6-4.2). Twenty-six (61.9%) were females and 16 (38.1%) males. Preoperative serviceable hearing was present in 33 (78.57%) patients. The mean maximal diameter was 7.7 (5-10). The median target volume at the moment of GKS was 90 mm3 (range 17-317). The median prescription isodose volume was 118 mm3 (range 37-603). The median marginal dose administrated was 12 Gy (range 11-12). The median number of shots was 2 (range 1-9). The median isodose prescription was 50% (range 45-80%). The median maximal dose received by the cochlea in patients in GR class 1 and 2 was 4.2 Gy (mean 4.4 Gy, range 1.8-7.6). Our preliminary results showed 98% tumor control, with 30% shrinkage on MRI. The actuarial probability of keeping the same audition class for those with functional hearing at GKS was 80% at 3 years; the probability of keeping a functional hearing was more than 90%. A paraclinical evolution (on MRI and/or audiometry) at the time diagnosis, before GKS, was associated with a less good prognosis (p < 0.05). Conclusions: Our preliminary data suggest that Koos I patients should be treated early with GKS, before tumor growth, and/or hearing deterioration, as they have the highest probability of hearing preservation. The results in terms of functional outcome seemed comparable to, or even better than, the other Koos classes (i.e., larger lesions).