918 resultados para Loss or Regularity


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Cochlear implantation is a safe and reliable method for auditory restoration in patients with severe to profound hearing loss. Objective: To describe the surgical complications of cochlear implantation. Materials and Methods: Information from 591 consecutive multichannel cochlear implant surgeries were retrospectively analyzed. All patients were followed-up for at least one year. Forty-one patients were excluded because of missing data, follow-up loss or middle fossa approach. Results: Of 550 cochlear implantation analyzed, 341 were performed in children or adolescents, and 209 in adults. The mean hearing loss time was 6.3 +/- 6.7 years for prelingual loss and 12.1 +/- 11.6 years for postlingual. Mean follow-up was 3.9 +/- 2.8 years. Major complications occurred in 8.9% and minor in 7.8%. Problems during electrode insertion (3.8%) were the most frequent major complication followed by flap dehiscence (1.4%). Temporary facial palsy (2.2%), canal-wall lesion (2.2%) and tympanic membrane lesion (1.8%) were the more frequent minor complications. No death occurred. Conclusion: There was a low rate of surgical complications, most of them been successfully managed. These results confirm that cochlear implant is a safe surgery and most surgical complications can be managed with conservative measures or minimal intervention.

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Abstract Background DNA repair genes encode proteins that protect organisms against genetic damage generated by environmental agents and by-products of cell metabolism. The importance of these genes in life maintenance is supported by their high conservation, and the presence of duplications of such genes may be easily traced, especially in prokaryotic genomes. Results The genome sequences of two Xanthomonas species were used as the basis for phylogenetic analyses of genes related to DNA repair that were found duplicated. Although 16S rRNA phylogenetic analyses confirm their classification at the basis of the gamma proteobacteria subdivision, differences were found in the origin of the various genes investigated. Except for lexA, detected as a recent duplication, most of the genes in more than one copy are represented by two highly divergent orthologs. Basically, one of such duplications is frequently positioned close to other gamma proteobacteria, but the second is often positioned close to unrelated bacteria. These orthologs may have occurred from old duplication events, followed by extensive gene loss, or were originated from lateral gene transfer (LGT), as is the case of the uvrD homolog. Conclusions Duplications of DNA repair related genes may result in redundancy and also improve the organisms' responses to environmental challenges. Most of such duplications, in Xanthomonas, seem to have arisen from old events and possibly enlarge both functional and evolutionary genome potentiality.

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Hearing loss is one of the most common clinical findings in subjects with malformations of the ear. Treatment consists of surgery and/or adapt a hearing aid amplification by bone (HA VO). Early intervention is critical to auditory stimulation and development of speech and language. OBJECTIVE: To characterize the audiological profile of subjects with congenital malformation of the external ear and/or middle and evaluate the benefit and satisfaction of using HA VO. METHOD: A descriptive study, subjects with bilateral congenital malformations of the external ear and/or middle, conductive or mixed hearing loss, moderate or severe and HA VO users. Evaluation of the benefit test using sentence recognition in noise and measures of functional gain and satisfaction assessment questionnaire using international IQ - HA. RESULTS: 13 subjects were evaluated, 61% were male and 80% with moderate conductive hearing loss or severe. There was better performance in the evaluation proposal, provided with HA when compared to the condition without HA. CONCLUSION: HA VO showed advantages for the population studied and should be considered as an option for intervention. Satisfaction was confirmed by elevated scores obtained in IQ - HA.

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This 9p21 locus, encode for important proteins involved in cell cycle regulation and apoptosis containing the p16/CDKN2A (cyclin-dependent kinase inhibitor 2a) tumor suppressor gene and two other related genes, p14/ARF and p15/CDKN2B. This locus, is a major target of inactivation in the pathogenesis of a number of human tumors, both solid and haematologic, and is a frequent site of loss or deletion also in acute lymphoblastic leukemia (ALL) ranging from 18% to 45% 1. In order to explore, at high resolution, the frequency and size of alterations affecting this locus in adult BCR-ABL1-positive ALL and to investigate their prognostic value, 112 patients (101 de novo and 11 relapse cases) were analyzed by genome-wide single nucleotide polymorphisms arrays and gene candidate deep exon sequencing. Paired diagnosis-relapse samples were further available and analyzed for 19 (19%) cases. CDKN2A/ARF and CDKN2B genomic alterations were identified in 29% and 25% of newly diagnosed patients, respectively. Deletions were monoallelic in 72% of cases and in 43% the minimal overlapping region of the lost area spanned only the CDKN2A/2B gene locus. The analysis at the time of relapse showed an almost significant increase in the detection rate of CDKN2A/ARF loss (47%) compared to diagnosis (p = 0.06). Point mutations within the 9p21 locus were found at very low level with only a non-synonymous substition in the exon 2 of CDKN2A. Finally, correlation with clinical outcome showed that deletions of CDKN2A/B are significantly associated with poor outcome in terms of overall survival (p = 0.0206), disease free-survival (p = 0.0010) and cumulative incidence of relapse (p = 0.0014). The inactivation of 9p21 locus by genomic deletions is a frequent event in BCR-ABL1-positive ALL. Deletions are frequently acquired at the leukemia progression and work as a poor prognostic marker.

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Species richness varies greatly across geographical regions. Eastern Arc Mountains (EAM) of Kenya and Tanzania is one of the global biodiversity hotspots. Despite this, high species diversity the explanatory factors have remained largely unexplored. Herein, this study first investigated amphibian species richness patterns in the EAM and particularly the reasons for the low richness in Taita Hills. It tested the hypothesis that the low richness is due to past forest loss or other factors. The results demonstrated that the regional species richness pattern was influenced largely by mean annual rainfall and not forest area. Secondly, using the 26 currently recorded amphibians in the Taita Hills, it investigated the relationship between amphibian species composition along anthropogenic habitat disturbance and elevation gradients. It tested the hypothesis that sites with similar environmental characteristics (temperature, rainfall and elevation), in close proximity and with similar disturbance levels (habitat types) harbour similar species composition. It was found that amphibian species composition differed in terms of elevation and was explained by both temperature and rainfall. Therefore sites with similar environmental characteristics, disturbance levels and in close proximity geographically have similar amphibian composition. Thirdly, diagnostic characters, distribution, basic life history characteristics and conservation status of all currently known amphibians in the Taita Hills were provided. Finally, first long term life history and ecological characteristics of a brevicipitid frog (Callulina sp) was provided. The results showed that this frog abundance and distribution is influenced mainly by mean monthly temperature, breeds during the long dry season and exhibit parental care. Results of this study strongly recommend increasing indigenous forest cover in order to enhance the conservation of the endemic indigenous forest associated amphibians such as Callulina sp, Boulengerula taitana and Boulengerula niedeni.

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Das menschliche Gen human giant larvae (hugl) ist ein Homolog des hochkonservierten Drosophila Gens lethal giant larvae (lgl), welches in Epithelzellen die Funktion eines neoplastischen Tumorsuppressors und Polaritätsregulators einnimmt. Ein Verlust oder eine verminderte Expression beider Homologe des Gens, hugl-1 und hugl-2, geht einher mit dem Auftreten und der Progression verschiedener epithelialer Tumorerkrankungen wie malignen Melanomen und Brust-, Kolon- oder Lungentumoren. Die exakte Funktion der Homologe Hugl-1 und Hugl-2 bezüglich der Regulation und Aufrechterhaltung der epithelialen Zellpolarität sowie ihre Rolle in der Genese humaner Tumore ist jedoch weitgehend unbekannt. Gänzlich unbekannt ist auch die Bedeutung von Hugl-1 und Hugl-2 als Polaritätsregulatoren für die Ausbildung und den Erhalt der T-Zellmorphologie und -funktion. Ziel der vorliegenden Arbeit war es daher, die Polaritäts- und Tumorsuppressorgene hugl-1 und hugl-2 in funktionellen Analysen mittels siRNA-vermitteltem Gen-Silencing in Epithelzellen und T-Lymphozyten zu charakterisieren. Darüber hinaus wurden die Funktionen und Eigenschaften von mgl-2, dem murinen Homologen von hugl-2, im Cre/loxP-vermittelten konditionalen Knockout Mausmodell in vivo analysiert.rnrnZur Charakterisierung der biologischen Effekte von Hugl-1 und Hugl-2 auf das Wachstumsverhalten, Migration und Invasion von Epithelzellen wurden in dieser Arbeit erfolgreich unterschiedliche shRNA-Expressionskonstrukte generiert sowie Hugl-supprimierte Zelllinien etabliert. In vitro Studien sowie in vivo Tumorigenizitätsanalysen lieferten übereinstimmend Hinweise darauf, dass verminderte Hugl-1- und Hugl-2-Expressionsspiegel eine signifikante Rolle in der Vermittlung invasiver und tumorigener Eigenschaften von Epithelzellen spielen. Dabei rief der Verlust beider Homologe deutlich stärkere Reaktionen hervor als die Suppression eines einzelnen Homologen. Zudem wiesen die Überexpression des Zellzyklusregulators Cyclin D1 sowie die Hyperproliferation von Hugl-1- und/oder Hugl-2-depletierten Epithelzellen auf eine wichtige Rolle der beiden Homologe in der Zellzyklusprogression und Zellproliferation hin. Ein geringer Expressionsstatus von Hugl-1 und -2 schien darüber hinaus mit einer verstärkten Resistenzbildung gegenüber Chemotherapeutika zu korrelieren. Im Rahmen dieser Arbeit konnte weiterhin gezeigt werden, dass die untersuchten T-Lymphozyten nur Hugl-1 exprimieren und dass letzteres notwendig für den F-Aktin-vermittelten Erhalt der T-Zellpolarität und -morphologie ist. Hugl-1-supprimierte, über voneinander unabhängige Signalwege (TCR- oder Chemokinrezeptor) stimulierte T-Lymphozyten wiesen eine bedeutende Störung der Lamellipodien- und Uropodausbildung auf und ließen eine Interaktion von Hugl-1 auf Ebene des F Aktins vermuten. Des Weiteren zeigte sich, dass der Polaritätsregulator Hugl-1 die CD3/TCR-induzierte Zelladhäsion positiv beeinflusst. Die Analyse der T-Zellmigration und -motilität offenbarte in Übereinstimmung dazu die Wichtigkeit von Hugl-1 für die Polarisierung und Migration der T-Zellen sowohl im Chemokingradienten als auch auf mDCs. rnrnFür die Aufklärung der funktionellen Rolle von mgl-2 in vivo wurde in dieser Arbeit eine Tamoxifen-induzierbare, Cre/loxP-vermittelte konditionale Mauslinie generiert und analysiert. Die mgl-2-deletierten Tiere wiesen weder signifikante phänotypische Unterschiede noch Abweichungen in der Organanatomie auf und ließen daher auf eine Kompensation durch das im Darmepithel koexprimierte und möglicherweise funktionell redundante mgl-1 Gen schließen.rn

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Die nahe verwandten T-box Transkriptionsfaktoren TBX2 und TBX3 werden in zahlreichen humanen Krebsarten überexprimiert, insbesondere in Brustkrebs und Melanomen. Die Überexpression von TBX2 und TBX3 hat verschiedene zelluläre Effekte, darunter die Unterdrückung der Seneszenz, die Förderung der Epithelialen-Mesenchymalen Transition sowie invasive Zellmotilität. Im Gegensatz dazu führt ein Funktionsverlust von TBX3 und der meisten anderen humanen T-box-Gene zu haploinsuffizienten Entwicklungsdefekten. Durch Sequenzierung des Exoms von Brustkrebsproben identifizierten Stephens et al. fünf verschiedene Mutationen in TBX3, welche allesamt die DNA-bindende T-box-Domäne betrafen. Die In-Frame-Deletion N212delN wurde zweimal gefunden. Aus der Anhäufung der Mutationen innerhalb der T-box-Domäne wurde geschlossen, dass TBX3 bei Brustkrebs ein Treibergen ist. Da Mutationen innerhalb der T-box-Domäne im Allgemeinen zu einem Funktionsverlust führen, aber die onkogene Aktivität von TBX3 meist auf eine Überexpression zurückzuführen ist, wurden die potentiellen Treibermutationen hinsichtlich einer verminderten oder gesteigerten TBX3-Funktion geprüft. Getestet wurden zwei In-Frame Deletionen, eine Missense- sowie eine Frameshift-Mutante bezüglich der DNA-Bindung in vitro und der Zielgen-Repression in Zellkultur. Zusätzlich wurde eine in silico Analyse der im The Cancer Genome Atlas (TCGA) gelisteten somatischen TBX-Brustkrebsmutationen durchgeführt. Sowohl die experimentelle als auch die in silico Analyse zeigten, dass die untersuchten Mutationen vorwiegend zum Verlust der TBX3-Funktion führen. Um den Mechanismus der Genrepression durch TBX3 besser zu verstehen, wurden weitere TBX3-Mutanten bezüglich ihrer Wirkung auf die p21-Promotoraktivität (p21-Luc-Reporter und endogene p21-Expression) analysiert. Wildtypische p21-Luc-Repression zeigten die zwei Mutationen S674A (Phosphorylierung) und D275K (SUMOylierung), welche posttranslationale Modifikationen verhindern, sowie die Interaktion mit dem Tumorsuppressor Rb1 unterbindende M302A/V304A-Mutation. Erstaunlicherweise war die endogene p21-Repression dieser Mutanten stärker als die des wildtypischen TBX3-Proteins. Alle drei Mutationen führten zu einer Stabilisierung des TBX3-Proteins. Die ursprünglich in Patienten mit Ulna-Mamma Syndrom identifizierte, DNA-bindungsdefekte Y149S-Mutante konnte weder p21-Luc noch endogenes p21 reprimieren. Mutationen in potentiellen Interaktionsdomänen für die Bindung der Co-Repressoren Groucho und C-terminalem Bindeprotein zeigten sowohl auf p21-Luc als auch auf endogenes p21-Gen wildtypische Repressoraktivität, so dass diese Co-Repressoren in COS-7-Zellen wahrscheinlich nicht an der Repression dieses Gens beteiligt sind. Da TBX2 und TBX3 interessante Ziele zur direkten Krebsbekämpfung darstellen, sollte ein zelluläres Reportersystem zur Identifikation TBX2-inhibierender, pharmakologisch aktiver Substanzen etabliert werden. Dazu sollte eine stabile Zelllinie mit vom p21-Promotor reguliertem d2EGFP-Reporter und Doxyzyklin-induzierbarem TBX2-Protein erzeugt werden, da ektopische Expression von TBX2 genetische Instabilität und Toxizität induzieren kann. In dieser Zelllinie sollte die TBX2-Expression zur Reduktion der d2EGFP-Fluoreszenz führen. Zur Erzeugung der Zelllinie wurden die folgenden drei Konstrukte Schritt-für-Schritt stabil in das Genom der Zielzelllinie COS-7 integriert: pEF1alpha-Tet3G, pTRE3G-TBX2 und p21-d2EGFP. Während die Herstellung der doppelt stabilen COS-7-Zelllinie gelang, scheiterte die Herstellung der dreifach stabilen Zelllinie.

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Excessive cantilever lengths of fixed implant-supported prostheses may have functional and biomechanical disadvantages. This study reports the clinical outcomes of unconventional implants placed for distal support of a fixed implant-supported prostheses. Seven extraoral implants with intraosseous lengths of 2.5 to 4.0 mm were placed in four patients. Distal cantilevers had a mean length of 29.8 mm (range, 18.6 to 39.3 mm). No bone loss or other adverse events were found. The prosthetic plan was maintained in all patients. Within the limits of the employed research design, this concept seems to be a successful option for fixed complete implant-supported prosthesis treatment.

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HIV-infected children have impaired antibody responses after exposure to certain antigens. Our aim was to determine whether HIV-infected children had lower varicella zoster virus (VZV) antibody levels compared with HIV-infected adults or healthy children and, if so, whether this was attributable to an impaired primary response, accelerated antibody loss, or failure to reactivate the memory VZV response.

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A large prospective, open-label, randomized trial evaluated conversion from calcineurin inhibitor (CNI)- to sirolimus (SRL)-based immunosuppression for preservation of renal function in liver transplantation patients. Eligible patients received liver allografts 6-144 months previously and maintenance immunosuppression with CNI (cyclosporine or tacrolimus) since early posttransplantation. In total, 607 patients were randomized (2:1) to abrupt conversion (<24 h) from CNI to SRL (n = 393) or CNI continuation for up to 6 years (n = 214). Between-group changes in baseline-adjusted mean Cockcroft-Gault GFR at month 12 (primary efficacy end point) were not significant. The primary safety end point, noninferiority of cumulative rate of graft loss or death at 12 months, was not met (6.6% vs. 5.6% in the SRL and CNI groups, respectively). Rates of death at 12 months were not significantly different, and no true graft losses (e.g. liver transplantation) were observed during the 12-month period. At 52 weeks, SRL conversion was associated with higher rates of biopsy-confirmed acute rejection (p = 0.02) and discontinuations (p < 0.001), primarily for adverse events. Adverse events were consistent with known safety profiles. In conclusion, liver transplantation patients showed no demonstrable benefit 1 year after conversion from CNI- to SRL-based immunosuppression.

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A multimodal MR study including relaxometry, diffusion tensor imaging (DTI), and MR spectroscopy was performed on patients with classical phenylketonuria (PKU) and matched controls, to improve our understanding of white matter (WM) lesions. Relaxometry yields information on myelin loss or malformation and may substantiate results from DTI attributed to myelin changes. Relaxometry was used to determine four brain compartments in normal-appearing brain tissue (NABT) and in lesions: water in myelin bilayers (myelin water, MW), water in gray matter (GM), water in WM, and water with long relaxation times (cerebrospinal fluid [CSF]-like signals). DTI yielded apparent diffusion coefficients (ADCs) and fractional anisotropies. MW and WM content were reduced in NABT and in lesions of PKU patients, while CSF-like signals were significantly increased. ADC values were reduced in PKU lesions, but also in the corpus callosum. Diffusion anisotropy was reduced in lesions because of a stronger decrease in the longitudinal than in the transverse diffusion. WM content and CSF-like components in lesions correlated with anisotropy and ADC. ADC values in lesions and in the corpus callosum correlated negatively with blood and brain phenylalanine (Phe) concentrations. Intramyelinic edema combined with vacuolization is a likely cause of the WM alterations. Correlations between diffusivity and Phe concentrations confirm vulnerability of WM to high Phe concentrations.

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BACKGROUND: Body fat changes are common in patients with HIV. For patients on protease inhibitor (PI)-based highly active antiretroviral therapy (HAART), these changes have been associated with increasing exposure to therapy in general and to stavudine in particular. Our objective is to show whether such associations are more or less likely for patients on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART. METHODS: We included all antiretroviral-naive patients in the Swiss HIV Cohort Study starting HAART after April 2000 who had had body weight, CD4 cell count and plasma HIV RNA measured between 6 months before and 3 months after starting HAART, and at least one assessment of body fat changes after starting HAART. At visits scheduled every 6 months, fat loss or fat gain is reported by agreement between patient and physician. We estimate the association between reported body fat changes and both time on therapy and time on stavudine, using conditional logistical regression. RESULTS: Body fat changes were reported for 85 (9%) out of 925 patients at their first assessment; a further 165 had only one assessment. Of the remaining 675 patients, body fat changes were reported for 156 patients at a rate of 13.2 changes per 100 patient-years. Body fat changes are more likely with increasing age [odds ratio (OR) 1.18 (1.00-1.38) per 10 years], with increasing BMI [OR 1.06 (1.01-1.11)] and in those with a lower baseline CD4 cell count [OR 0.91 (0.83-1.01) per 100 cells/microl]. There is only weak evidence that body fat changes are more likely with increasing time on HAART [OR 1.16 (0.93-1.46)]. After adjusting for time on HAART, fat loss is more likely with increasing stavudine use [OR 1.70 (1.34-2.15)]. There is no evidence of an association between reported fat changes and time on NNRTI therapy relative to PI therapy in those patients who used either one therapy or the other [OR 0.98 (0.56-1.63)]. CONCLUSION: Fat loss is more likely to be reported with increasing exposure to stavudine. We find no evidence of major differences between PI and NNRTI therapy in the risk of reported body fat changes.

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OBJECTIVE: It was the aim of this study to investigate the prevalence of otologic manifestations in a cohort of Samter's syndrome patients (nasal polyps with chronic rhinosinusitis, aspirin intolerance and asthma). METHODS: We analyzed a retrospective and prospective case review from 1995 to 2005, performed in the otorhinolaryngology outpatient clinic of a tertiary referral center. Ear history, clinical examinations, treatment and outcome were evaluated using office and hospital records in 23 cases. All subjects completed a questionnaire. RESULTS: In 6 cases (26%), otological manifestations with ear pressure and conductive hearing loss occurred during an advanced stage of Samter's syndrome (>5 years after onset of the first nasal symptoms) partially responsive to systemic steroids. CONCLUSION: Recognition of the association between Samter's syndrome and otological disease is important (26% of the cases) because it could also be responsive to systemic steroids which prevent progression to irreversible hearing loss or infectious otomastoiditis.

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OBJECTIVE: To evaluate safety of same-day administration of verteporfin and ranibizumab. METHODS: Prospective, open-label, multicentre study; patients with predominantly classic (n = 13) or occult (n = 19) choroidal neovascularisation secondary to age-related macular degeneration received standard-fluence verteporfin at baseline and months 3, 6 and 9, based on fluorescein angiography (FA). Ranibizumab 0.5 mg was administered at baseline and months 1, 2 and 3. MAIN OUTCOME MEASURE: The incidence of severe vision loss (best-corrected visual acuity (BCVA) loss > or = 30 letters; primary safety assessment). RESULTS: No severe vision loss due to ocular inflammation or uveitis occurred. One patient had moderate vision loss (BCVA loss > or = 15 letters). Three patients had mild/moderate uveitis. Two serious ocular adverse events occurred (retinal pigment epithelial tear and moderate BCVA decrease). No systemic adverse events occurred. At 9 months, all lesions were inactive with no recurrent leakage on FA and optical coherence tomography; macular oedema and subretinal fluid resolved. The mean BCVA measured at 2 m improved by 6.9 letters at 4 months and 2.4 letters at 9 months. CONCLUSIONS/APPLICATION TO CLINICAL PRACTICE: Same-day verteporfin and ranibizumab was safe and not associated with severe vision loss or severe ocular inflammation. Lesions stabilized, with minimal treatment required after month 3.

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This dissertation presents a detailed study in exploring quantum correlations of lights in macroscopic environments. We have explored quantum correlations of single photons, weak coherent states, and polarization-correlated/polarization-entangled photons in macroscopic environments. These included macroscopic mirrors, macroscopic photon number, spatially separated observers, noisy photons source and propagation medium with loss or disturbances. We proposed a measurement scheme for observing quantum correlations and entanglement in the spatial properties of two macroscopic mirrors using single photons spatial compass state. We explored the phase space distribution features of spatial compass states, such as chessboard pattern by using the Wigner function. The displacement and tilt correlations of the two mirrors were manifested through the propensities of the compass states. This technique can be used to extract Einstein-Podolsky-Rosen correlations (EPR) of the two mirrors. We then formulated the discrete-like property of the propensity Pb(m,n), which can be used to explore environmental perturbed quantum jumps of the EPR correlations in phase space. With single photons spatial compass state, the variances in position and momentum are much smaller than standard quantum limit when using a Gaussian TEM00 beam. We observed intrinsic quantum correlations of weak coherent states between two parties through balanced homodyne detection. Our scheme can be used as a supplement to decoy-state BB84 protocol and differential phase-shift QKD protocol. We prepared four types of bipartite correlations ±cos2(θ12) that shared between two parties. We also demonstrated bits correlations between two parties separated by 10 km optical fiber. The bits information will be protected by the large quantum phase fluctuation of weak coherent states, adding another physical layer of security to these protocols for quantum key distribution. Using 10 m of highly nonlinear fiber (HNLF) at 77 K, we observed coincidence to accidental-coincidence ratio of 130±5 for correlated photon-pair and Two-Photon Interference visibility >98% entangled photon-pair. We also verified the non-local behavior of polarization-entangled photon pair by violating Clauser-Horne-Shimony-Holt Bell’s inequality by more than 12 standard deviations. With the HNLF at 300 K (77 K), photon-pair production rate about factor 3(2) higher than a 300 m dispersion-shifted fiber is observed. Then, we studied quantum correlation and interference of photon-pairs; with one photon of the photon-air experiencing multiple scattering in a random medium. We observed that depolarization noise photon in multiple scattering degrading the purity of photon-pair, and the existence of Raman noise photon in a photon-pair source will contribute to the depolarization affect. We found that quantum correlation of polarization-entangled photon-pair is better preserved than polarization-correlated photon-pair as one photon of the photon-pair scattered through a random medium. Our findings showed that high purity polarization-entangled photon-pair is better candidate for long distance quantum key distribution.