Farid M,Steinert RF
Gavin Herbert Eye Institute, University of California, Irvine, California 92697-4375, USA. mfarid@uci.edu
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Patient selection for monovision laser refractive surgery.
Curr Opin Ophthalmol. 2009 Jul;20(4):251-4
PURPOSE OF REVIEW: To investigate the preoperative characteristics and updated patient selection criteria for presbyopic patients undergoing laser refractive surgery for monovision. RECENT FINDINGS: The role of age, sex, ocular dominance, amount of monovision, and hyperopic versus myopic treatments is reviewed and reported. The presbyopic female patient is less likely to reject monovision. Patients with a strong sighting preference do less well due to reduced interocular blur suppression. Although myopes represent the majority of monovision patients, laser-corrected monovision in hyperopes is a viable and satisfactory option. SUMMARY: Refractive surgery monovision correction represents an increasingly popular method for the presbyopic patient. Patient selection based on multiple preoperative characteristics is vitally important to the overall success and patient satisfaction.
PMID: 19491684
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German DP
Department of Zoology, University of Florida, Gainesville, FL, USA. dgerman@uci.edu
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Do herbivorous minnows have "plug-flow reactor" guts? Evidence from digestive enzyme activities, gastrointestinal fermentation, and luminal nutrient concentrations.
J Comp Physiol B. 2009 Aug;179(6):759-71
Few investigations have empirically analyzed fish gut function in the context of chemical reactor models. In this study, digestive enzyme activities, levels of gastrointestinal fermentation products [short chain fatty acids (SCFA)], luminal nutrient concentrations, and the mass of gut contents were measured along the digestive tract in herbivorous and carnivorous minnows to ascertain whether their guts function as "plug-flow reactors" (PFRs). Four of the species, Campostoma anomalum, C. ornatum, C. oligolepis, and C. pauciradii, are members of a monophyletic herbivorous clade, whereas the fifth species, Nocomis micropogon, is a carnivore from an adjacent carnivorous clade. In the context of a PFR model, the activities of amylase, trypsin and lipase, and the concentrations of glucose, protein, and lipid were predicted to decrease moving from the proximal to the distal intestine. I found support for this as these enzyme activities and nutrient concentrations generally decreased moving distally along the intestine of the four Campostoma species. Furthermore, gut content mass and the low SCFA concentrations did not change (increase or decrease) along the gut of any species. Combined with a previous investigation suggesting that species of Campostoma have rapid gut throughput rates, the data presented here generally support Campostoma as having guts that function as PFRs. The carnivorous N. micropogon showed some differences in the measured parameters, which were interpreted in the contexts of intake and retention time to suggest that PFR function breaks down in this carnivorous species.
PMID: 19363616
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Das K,Rizzuto DS,Nenadic Z
Department of Psychology, University of California, Santa Barbara, CA 93106, USA. kdas@uci.edu
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Mental state estimation for brain--computer interfaces.
IEEE Trans Biomed Eng. 2009 Aug;56(8):2114-22
Mental state estimation is potentially useful for the development of asynchronous brain--computer interfaces. In this study, four mental states have been identified and decoded from the electrocorticograms (ECoGs) of six epileptic patients, engaged in a memory reach task. A novel signal analysis technique has been applied to high-dimensional, statistically sparse ECoGs recorded by a large number of electrodes. The strength of the proposed technique lies in its ability to jointly extract spatial and temporal patterns, responsible for encoding mental state differences. As such, the technique offers a systematic way of analyzing the spatiotemporal aspects of brain information processing and may be applicable to a wide range of spatiotemporal neurophysiological signals.
PMID: 19457738
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Kaiser ML,Rubinstein M,Vokes DE,Ridgway JM,Guo S,Gu M,Crumley RL,Armstrong WB,Chen Z,Wong BJ
Department of Surgery, University of California Irvine, Orange, CA 92612, USA.
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Laryngeal epithelial thickness: a comparison between optical coherence tomography and histology.
Clin Otolaryngol. 2009 Oct;34(5):460-6
OBJECTIVES: Optical coherence tomography, an imaging modality using near-infrared light, produces cross-sectional tissue images with a lateral pixel resolution of 10 microm. However, normative data is first needed on epithelial thickness for lesion characterisation, and, to date, little exists. The purpose of our study is to measure normal laryngeal epithelial thickness by in vivo optical coherence tomography, and compare these values to those obtained from fixed ex-vivo laryngectomy specimens. DESIGN AND SETTING: Prospective at a single medical center in California, United States. PARTICIPANTS: A total of 116 patients undergoing operative endoscopy. MAIN OUTCOME MEASURES: Optical coherence tomography images of clinically normal laryngeal subsites were selected. Calibrated measurements of epithelial thickness at various laryngeal subsites were recorded. Measurements of epithelial thickness from corresponding areas were obtained using optical micrometry on histologically normal regions of 15 total laryngectomy specimens. Descriptive statistics were performed. RESULTS: Mean epithelial optical coherence tomography thicknesses were: true vocal cords (81 microm), false vocal cords (78 microm), subglottis (61 microm), aryepiglottic folds (111 microm), laryngeal epiglottis (116 microm) and lingual epiglottis (170 microm). Epithelial thicknesses in fixed tissues were: true vocal cords (103 microm), false vocal cords (79 microm), aryepiglottic folds (205 microm) subglottis (61 microm), laryngeal epiglottis (38 microm) and lingual epiglottis (130 microm). CONCLUSIONS: Optical coherence tomography does not have the artifacts associated with conventional histologic techniques. The inevitable development of office-based optical coherence tomography devices will increase the precision of laryngeal measurements and contribute to the clinical application of this technology in diagnosing laryngeal disease.
PMID: 19793279
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Liu ZF,Burke K
Department of Chemistry, University of California, Irvine, California 92697-2025, USA. zhenfei.liu@uci.edu
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Adiabatic connection for strictly correlated electrons.
J Chem Phys. 2009 Sep 28;131(12):124124
Modern density functional theory (DFT) calculations employ the Kohn-Sham system of noninteracting electrons as a reference, with all complications buried in the exchange-correlation energy (E(XC)). The adiabatic connection formula gives an exact expression for E(XC). We consider DFT calculations that instead employ a reference of strictly correlated electrons. We define a "decorrelation energy" that relates this reference to the real system, and derive the corresponding adiabatic connection formula. We illustrate this theory in three situations, namely, the uniform electron gas, Hooke's atom, and the stretched hydrogen molecule. The adiabatic connection for strictly correlated electrons provides an alternative perspective for understanding DFT and constructing approximate functionals.
PMID: 19791869
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Villarreal LP
Center for Virus Research, University of California, Irvine, CA 92697, USA. lpvillar@uci.edu
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Persistence pays: how viruses promote host group survival.
Curr Opin Microbiol. 2009 Aug;12(4):467-72
Recently, we have realized that viruses numerically dominate all life. Although viruses are known to affect host survival in populations, this has not been previously evaluated in the context of host group selection. Group selection per se is not a currently accepted idea and its apparent occurrence is explained by statistical gene frequency models of kin selection. Viruses were not considered in such models. Prevalent views associate viruses and disease. Yet many viruses establish species-specific persistent, inapparent infections that are stable on an evolutionary time scale. Such persistent infections can have large effects on relative reproductive fitness of competing host populations. In this essay, I present arguments on how persistent infections can promote population survival. Mouse hepatitis virus is used as well studied examplar to re-evaluate the theoretical basis of the mouse haystack model of M Smith. This virus-centric re-examination concludes that viruses can indeed affect and promote relative group selection.
PMID: 19608458
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Perret D,Luo ZD
Department of Anesthesiology & Perioperative Care, School of Medicine, University of California Irvine, Irvine, California 92697; Department of Physical Medicine & Rehabilitation, School of Medicine, University of California Irvine, Irvine, California 92697.
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Targeting voltage-gated calcium channels for neuropathic pain management.
Neurotherapeutics. 2009 Oct;6(4):679-92
Voltage-gated calcium channels (VGCC) play obligatory roles in diverse physiological functions. Pathological conditions leading to changes in their biophysical properties and expression levels may cause malfunctions of VGCC-mediated activities, resulting in disease states. It is believed that changes in VGCC properties under pain-inducing conditions may play a causal role in the development of chronic pain, including nerve injury-induced pain or neuropathic pain. For the past several decades, preclinical and clinical research in developing VGCC blockers or modulators for chronic pain management has been fruitful, leading to some U.S. Food and Drug Administration-approved drugs currently available for chronic pain management. However, their efficacy in pain relief is limited in some patients, and their long-term use is limited by their side-effect profiles. Certainly, there is room for improvement in developing more subtype-specific VGCC blockers or modulators for chronic pain conditions. In this review, we summarized the most recent preclinical and clinical studies related to chronic pain medications acting on the VGCC. We also included clinical trials aiming to expand the application of approved VGCC drugs to different pain states derived from various pathological conditions, as well as drug combination therapies trying to improve the efficacies and side-effect profiles of current pain medications.
PMID: 19789072
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Sendroiu IE,Warner ME,Corn RM
Department of Chemistry, University of California-Irvine, Irvine, California 92697.
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Fabrication of silica-coated gold nanorods functionalized with DNA for enhanced surface plasmon resonance imaging biosensing applications.
Langmuir. 2009 Oct 6;25(19):11282-4
A novel method for preparing gold nanorods that are first coated with a thin silica film and then functionalized with single-stranded DNA (ssDNA) is presented. Coating the nanorods with 3-5 nm of silica improves their solubility and stability. Amine-modified ssDNA is attached to the silica-coated gold nanorods via a reductive amination reaction with an aldehyde trimethoxysilane monolayer. The nanorods exhibit an intense absorption band at 780 nm, and are used to enhance the sensitivity of surface plasmon resonance imaging (SPRI) measurements on DNA microarrays.
PMID: 19788208
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Zhang C,Truong KK,Zhou QY
Department of Pharmacology, University of California Irvine, Irvine, California, United States of America.
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Efferent projections of prokineticin 2 expressing neurons in the mouse suprachiasmatic nucleus.
PLoS One. 2009;4(9):e7151
The suprachiasmatic nucleus (SCN) in the hypothalamus is the predominant circadian clock in mammals. To function as a pacemaker, the intrinsic timing signal from the SCN must be transmitted to different brain regions. Prokineticin 2 (PK2) is one of the candidate output molecules from the SCN. In this study, we investigated the efferent projections of PK2-expressing neurons in the SCN through a transgenic reporter approach. Using a bacterial artificial chromosome (BAC) transgenic mouse line, in which the enhanced green fluorescence protein (EGFP) reporter gene expression was driven by the PK2 promoter, we were able to obtain an efferent projections map from the EGFP-expressing neurons in the SCN. Our data revealed that EGFP-expressing neurons in the SCN, hence representing some of the PK2-expressing neurons, projected to many known SCN target areas, including the ventral lateral septum, medial preoptic area, subparaventricular zone, paraventricular nucleus, dorsomedial hypothalamic nucleus, lateral hypothalamic area and paraventricular thalamic nucleus. The efferent projections of PK2-expressing neurons supported the role of PK2 as an output molecule of the SCN.
PMID: 19784373
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Corbin-Lickfett KA,Chen IH,Cocco MJ,Sandri-Goldin RM
Department of Microbiology and Molecular Genetics and Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, CA 92697, USA.
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The HSV-1 ICP27 RGG box specifically binds flexible, GC-rich sequences but not G-quartet structures.
Nucleic Acids Res. 2009 Sep 26;:
Herpes simplex virus 1 (HSV-1) protein ICP27, an important regulator for viral gene expression, directly recognizes and exports viral RNA through an N-terminal RGG box RNA binding motif, which is necessary and sufficient for RNA binding. An ICP27 N-terminal peptide, including the RGG box RNA binding motif, was expressed and its binding specificity was analyzed using EMSA and SELEX. DNA oligonucleotides corresponding to HSV-1 glycoprotein C (gC) mRNA, identified in a yeast three-hybrid analysis, were screened for binding to the ICP27 N-terminal peptide in EMSA experiments. The ICP27 N-terminus was able to bind most gC substrates. Notably, the ICP27 RGG box was unable to bind G-quartet structures recognized by the RGG domains of other proteins. SELEX analysis identified GC-rich RNA sequences as a common feature of recognition. NMR analysis of SELEX and gC sequences revealed that sequences able to bind to ICP27 did not form secondary structures and conversely, sequences that were not able to bind to ICP27 gave spectra consistent with base-pairing. Therefore, the ICP27 RGG box is unique in its recognition of nucleic acid sequences compared to other RGG box proteins; it prefers flexible, GC-rich substrates that do not form stable secondary structures.
PMID: 19783816
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Girard YA,Travinsky B,Schotthoefer A,Fedorova N,Eisen RJ,Eisen L,Barbour AG,Lane RS
Department of Environmental Science, Policy and Management, University of California Berkeley, 137 Mulford Hall, Berkeley, CA 94720-3114; Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, 3012 Hewitt Hall, Irvine, CA 92697; Division of Vector-Borne Infectious Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80522; Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523.
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Population structure of the Lyme borreliosis spirochete Borrelia burgdorferi in the western black-legged tick (Ixodes pacificus) in northern California.
Appl Environ Microbiol. 2009 Sep 25;:
Factors potentially contributing to the lower incidence of Lyme borreliosis (LB) in the far-western, as compared to the northeastern, US include tick host-seeking behavior resulting in fewer human tick encounters, lower densities of Borrelia burgdorferi-infected vector ticks in peridomestic environments, and genetic variation among B. burgdorferi spirochetes to which humans are exposed. We determined the population structure of B. burgdorferi in over 200 infected nymphs of the primary bridging vector to humans, Ixodes pacificus, collected in Mendocino County, CA. This was accomplished by sequence typing the spirochete lipoprotein ospC and the 16S-23S rRNA intergenic spacer (IGS). Thirteen ospC alleles belonging to 12 genotypes were found in California and the two most abundant, ospC H3 and E3, have not been detected in ticks in the Northeast. The most prevalent ospC/IGS biallelic profile in the population, found in about 22% of ticks, was a new B. burgdorferi strain defined by ospC genotype H3. Eight of the most common ospC genotypes in the northeastern US, including I and K which are associated with disseminated human infections, were absent in Mendocino County nymphs. OspC H3 was associated with hardwood-dominated habitats where reservoir western gray squirrels are commonly infected with LB spirochetes. The differences in B. burgdorferi population structure in California ticks compared to the Northeast emphasize the need for a greater understanding of the genetic diversity of spirochetes infecting California LB patients.
PMID: 19783741
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Martiny AC,Kathuria S,Berube PM
Department of Earth System Science and Ecology, University of California, Irvine, CA 92697, USA. amartiny@uci.edu
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Widespread metabolic potential for nitrite and nitrate assimilation among Prochlorococcus ecotypes.
Proc Natl Acad Sci U S A. 2009 Jun 30;106(26):10787-92
The marine cyanobacterium Prochlorococcus is the most abundant photosynthetic organism in oligotrophic regions of the oceans. The inability to assimilate nitrate is considered an important factor underlying the distribution of Prochlorococcus, and thought to explain, in part, low abundance of Prochlorococcus in coastal, temperate, and upwelling zones. Here, we describe the widespread occurrence of a genomic island containing nitrite and nitrate assimilation genes in uncultured Prochlorococcus cells from marine surface waters. These genes are characterized by low GC content, form a separate phylogenetic clade most closely related to marine Synechococcus, and are located in a different genomic region compared with an orthologous cluster found in marine Synechococcus strains. This sequence distinction suggests that these genes were not transferred recently from Synechococcus. We demonstrate that the nitrogen assimilation genes encode functional proteins and are expressed in the ocean. Also, we find that their relative occurrence is higher in the Caribbean Sea and Indian Ocean compared with the Sargasso Sea and Eastern Pacific Ocean, which may be related to the nitrogen availability in each region. Our data suggest that the ability to assimilate nitrite and nitrate is associated with microdiverse lineages within high- and low-light (LL) adapted Prochlorococcus ecotypes. It challenges 2 long-held assumptions that (i) Prochlorococcus cannot assimilate nitrate, and (ii) only LL adapted ecotypes can use nitrite. The potential for previously unrecognized productivity by Prochlorococcus in the presence of oxidized nitrogen species has implications for understanding the biogeography of Prochlorococcus and its role in the oceanic carbon and nitrogen cycles.
PMID: 19549842
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Yang ZH,van Faassen M,Burke K
Department of Chemistry, University of California, Irvine, California 92697, USA. zenghuiy@uci.edu
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Must Kohn-Sham oscillator strengths be accurate at threshold?
J Chem Phys. 2009 Sep 21;131(11):114308
The exact ground-state Kohn-Sham (KS) potential for the helium atom is known from accurate wave function calculations of the ground-state density. The threshold for photoabsorption from this potential matches the physical system exactly. By carefully studying its absorption spectrum, we show the answer to the title question is no. To address this problem in detail, we generate a highly accurate simple fit of a two-electron spectrum near the threshold, and apply the method to both the experimental spectrum and that of the exact ground-state Kohn-Sham potential.
PMID: 19778114
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Charvet CJ,Owerkowicz T,Striedter GF
Department of Neurobiology and Behavior and Center for the Neurobiology of Learning and Memory, University of California, Irvine, Calif. 92687-4550, USA. ccharvet@uci.edu
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Phylogeny of the telencephalic subventricular zone in sauropsids: evidence for the sequential evolution of pallial and subpallial subventricular zones.
Brain Behav Evol. 2009;73(4):285-94
The telencephalon of birds and placental mammals harbors a proliferative subventricular zone (SVZ) in the subpallium as well as the pallium. Turtles, which are phylogenetically intermediate between bird, and mammals, exhibit at best a rudimentary SVZ. This suggests that SVZs evolved independently in mammals and birds, but it is not clear whether subpallial and pallial SVZs evolved with the origin of birds or in some earlier, non-avian sauropsid ancestor. To answer this question, we examined the brains of embryonic alligators (Ferguson stages 15-22) because crocodilians are the closest extant sister group to birds. To visualize the SVZ we labeled mitotic cells with antibodies against phosphorylated histone-3 (pH3) and proliferating cells with antibodies against proliferating cell nuclear antigen (PCNA). We found that the telencephalon of alligators contains an SVZ only in the subpallium. Because turtles, lizards and amphibians seem to lack SVZs, our finding suggests that a subpallial SVZ evolved in the last common ancestor of birds and crocodilians. Given that placental mammals and birds, but not marsupial mammals or reptiles, possess an SVZ within their pallium, we conclude that a pallial SVZ probably evolved independently in birds and placental mammals.
PMID: 19641308
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Pevzner L,Rayburn WF,Rumney P,Wing DA
Departments of Obstetrics and Gynecology, University of California, Irvine, Orange, 92869, USA. mfm@uci.edu
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Factors predicting successful labor induction with dinoprostone and misoprostol vaginal inserts.
Obstet Gynecol. 2009 Aug;114(2 Pt 1):261-7
OBJECTIVE: To evaluate the maternal and pregnancy characteristics that independently predict successful induction of labor, defined as vaginal delivery. METHODS: The study was a secondary analysis of the data collected during the Misoprostol Vaginal Insert Trial, a multisite, double-blind, randomized trial of women requiring cervical ripening before induction of labor. The primary outcome was to estimate the maternal and pregnancy characteristics that independently predict successful induction of labor. Univariable and multiple regression analyses were performed for maternal and pregnancy-related factors that potentially could predict a successful induction of labor. RESULTS: A total of 1,274 patients had sufficient labor and delivery data for a comparative analysis. Nine hundred sixteen (72%) induced patients subsequently had vaginal deliveries. Multiparity (odds ratio [OR] 4.63, 95% confidence interval [CI] 3.39-6.32, P<.001), maternal body mass index (BMI) less than 30 (OR 1.69, 95% CI 1.32-2.22, P<.001) and height greater than 5'5" (OR 1.47, 95% CI 1.15-1.9, P=.002), baseline modified Bishop score of 4 (OR 2.15, 95% CI 1.12-4.20, P=.047), and birth weight below 4,000 g (OR 2.17, 95% CI 1.51-3.13, P<.001) were significant for predicting successful induction of labor. Logistic regression analysis was performed to evaluate each factor as an independent predictor. In addition to the above-mentioned factors, maternal age younger than 35 years (OR 1.81, 95% CI 1.15-2.86, P=.01) and Hispanic race (OR 1.45, 95% CI 1.02-2.05, P=.036) each proved to significantly favor a successful induction. Conversely, African-American race was correlated with a higher incidence of cesarean delivery (OR 1.47, 95% CI 1.02-2.13, P<.001). CONCLUSION: Maternal characteristics such as BMI, parity, age, and race and neonatal birth weight are important variables to consider when predicting a successful induction of labor. The nearly 30% rate of cesarean delivery in this study underscores the importance of selecting appropriate candidates. LEVEL OF EVIDENCE: II.
PMID: 19622986
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Scholz T,Krichevsky A,Sumarto A,Jaffurs D,Wirth GA,Paydar K,Evans GR
Aesthetic and Plastic Surgery Institute, University of California, Irvine, Orange, CA, USA. tscholz@uci.edu
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Peripheral nerve injuries: an international survey of current treatments and future perspectives.
J Reconstr Microsurg. 2009 Jul;25(6):339-44
Peripheral nerve injuries are a serious health concern and leave many patients with lifelong disabilities. There is little information about incidences, current practice, outcomes, and type of research that may help delineate new strategies. A questionnaire was designed to determine characteristics of peripheral nerve injuries and the need for alternative strategies and sent to 889 plastic, hand, trauma, and orthopedic surgeons in 49 countries; 324 completed surveys were collected and analyzed (total response rate of 36.45%). The majority of institutions treat more than 3000 patients annually. Trauma was the leading cause of injury with the majority located on the upper extremity. In most cases, a primary repair was achieved, but 2.52% were unrepairable. The overall outcome was linked to their Sunderland classification (SCL). A grade 1 nerve injury (SCL-1) reached a maximum outcome after 7.15 months. SCL-2, -3, -4, and -5 needed 10.69, 14.08, 17.66, and 19.03 months, respectively. Tissue engineering was considered the most important research field, resulting in a visual analogue scale of 8.6. Despite marked advances in the treatment of peripheral nerve injuries, clinical outcomes still appear unsatisfactory. The importance of research in the field of tissue engineering should be emphasized as a pathway toward improving these outcomes.
PMID: 19301234
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Nitta T,Hofacre A,Hull S,Fan H
Cancer Research Institute, Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, California.
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IDENTIFICATION AND MUTATIONAL ANALYSIS OF A REJ RESPONSE ELEMENT IN JAAGSIEKTE SHEEP RETROVIRUS RNA.
J Virol. 2009 Sep 23;:
Jaagsiekte sheep retrovirus (JSRV) is a simple betaretrovirus causing a contagious lung cancer of sheep. JSRV encodes unspliced and spliced viral RNAs, among which unspliced RNA encodes Gag and Pol proteins, and a singly spliced mRNA encodes Env protein. In another study we found that JSRV encodes a regulatory protein Rej that is responsible for synthesis of Gag polyprotein from unspliced viral RNA. Rej is encoded in 5' end of env and it enhances nuclear export or accumulation of cytoplasmic unspliced viral RNA in 293T cells but not most other cell lines ( Hofacre, et al., submitted). In this study, we found that mutations in the 3' end of the env in the context of a CMV-driven full length JSRV expression construct abolished Gag protein synthesis and released viruses in 293T cells. These mutants also showed deficits in accumulation of unspliced viral RNA in the cytoplasm. These mutants defined a Rej responsive elemnt (RejRE). Inhibition of CRM1 but not Tap function prevented nuclear export/accumulation of cytoplasmic unspliced RNA in 293T cells, similar to other complex retroviruses that express analogous regulator proteins (e.g. HIV Rev). Structural modeling of the RejRE with Zuker mFold indicated a region with a predicted stable secondary structure. Mutational analysis in this region indicated the importance of both secondary structures and primary nucleotide sequences in a central stem-bulge-stem structure. In contrast to 293T cells, mutations in the RejRE did not affect the levels of cytoplasmic unspliced RNA in 293 cells, although the unspliced RNA showed partial degradation, perhaps due to lack of translation. RejRE-containing RNA relocalized Rej protein from the nucleus to the cytoplasm in 293 and rat 208F cells, suggesting binding of Rej to the RejRE.
PMID: 19776134
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Frade Mera MJ,Guirao Moya A,Esteban Sánchez ME,Rivera Alvarez J,Cruz Ramos AM,Bretones Chorro B,Viñas Sánchez S,Jacue Izquierdo S,Montane López M
Servicio de Medicina Intensiva UCI Polivalente. Hospital Universitario 12 de Octubre. Madrid. Espaņa.
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[Analysis of 4 sedation rating scales in the critical patient.]
Enferm Intensiva. 20(3):88-94
BACKGROUND: This study aimed to verify the relationship between different Sedation Rating Scales (SRSs) for critical patients on mechanical ventilation and to know the relationship between the SRSs, clinical information and the dose of sedative and analgesia drugs (SAD). MATERIAL AND METHODS: A longitudinal, prospective analytic pilot study conducted in a Medical-Surgical Intensive Care Unit of a tertiary hospital from October-December 2006. The sample included patients who required administration of SAP and mechanical ventilation. The following biological parameters and scales were evaluated: patient's demographics, RAMSAY, Sedation Agitation Scale (SAS), Richmond Agitation Sedation Scale (RASS), Motor Activity Assessment Scale (MASS), SAD dose, mean blood pressure, cardiac rate, pupil diameter and respiratory frequency. Spearman coefficient of interrelation was used to compare the relationship between the different scales. RESULTS: A total of 2.412 measurements were made for each variable: SRS, clinical information and SAD dose in 30 patients with different diseases, 63 % males, age 52 +/- 19 years, APACHEII 24 +/- 8, SAPSII 44 +/- 16, with an ICU mortality UCI 34 %. Median and IQ range of stay in ICU 15.5 and 20 days, of mechanical ventilation 9 and 14 days, of SAD 6 and 5.5 days and of paralyzing drugs (PD) 2 and 5 days, respectively. Interrelation was detected between all the SRSs, with p < 0.0001. The relationship between SAS, RASS and MASS was direct, whereas these were related inversely to RAMSAY. No evidence of interrelation was found between the SRSs, the clinical information and the SAD doses. CONCLUSION. The RAMSAY scale that has not been validated in ICU patients has a strong interrelation with the other already validated SRSs. SRSs are subjective and do not correlate with the clinical information and the SAD doses, probably due to the sample's small size and heterogeneity.
PMID: 19775565
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Farid M,Steinert RF,Gaster RN,Chamberlain W,Lin A
Department of Ophthalmology, The Gavin Herbert Eye Institute, University of California-Irvine, CA 92697, USA.
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Comparison of penetrating keratoplasty performed with a femtosecond laser zig-zag incision versus conventional blade trephination.
Ophthalmology. 2009 Sep;116(9):1638-43
PURPOSE: To evaluate visual outcomes and astigmatism in patients who underwent penetrating keratoplasty (PK) with 2 different incision techniques. DESIGN: Retrospective comparison of a consecutive surgical series. PARTICIPANTS: Fifty-seven consecutive patients who underwent PK at the University of California, Irvine, academic referral practice. METHODS: A comparison of 49 eyes of 43 patients that underwent femtosecond laser zig-zag incision pattern PK versus 17 eyes of 14 patients that underwent conventional Barron suction trephination PK performed contemporaneously. All PKs were closed with an identical, 24-bite running nylon suture technique. MAIN OUTCOME MEASURES: Topographically determined astigmatism, best spectacle-corrected visual acuity (BSCVA), and recovery of full visual potential. RESULTS: The postoperative follow-up ranged from 1 to 12 months. There was a significant difference in average astigmatism between the groups at postoperative month 1 (P = 0.013) and 3 (P = 0.018). By month 3, the average astigmatism was 3 diopters (D) in the zig-zag group and 4.46 D in the conventional group. Of the patients with normal macular and optic nerve function (n(ZZ) = 32; n(con) = 14), a significant difference in BSCVA was seen at month 1 (P = 0.0003) and month 3 (P = 0.006) with 81% of the zig-zag group versus 45% of the conventional group achieving BSCVA of > or =20/40 by month 3 (P = 0.03). CONCLUSIONS: The femtosecond laser generated zig-zag-shaped incision results in a more rapid recovery of BSCVA and induces less astigmatism compared with conventional blade trephination PK. FINANCIAL DISCLOSURE(S): Proprietary commercial disclosure may be found after the references.
PMID: 19646760
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Brody JP
Department of Biomedical Engineering University of California Irvine, Irvine, California, United States of America. jpbrody@uci.edu
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Parallel routes of human carcinoma development: implications of the age-specific incidence data.
PLoS One. 2009;4(9):e7053
BACKGROUND: The multi-stage hypothesis suggests that cancers develop through a single defined series of genetic alterations. This hypothesis was first suggested over 50 years ago based upon age-specific incidence data. However, recent molecular studies of tumors indicate that multiple routes exist to the formation of cancer, not a single route. This parallel route hypothesis has not been tested with age-specific incidence data. METHODOLOGY/PRINCIPAL FINDINGS: To test the parallel route hypothesis, I formulated it in terms of a mathematical equation and then tested whether this equation was consistent with age-specific incidence data compiled by the Surveillance Epidemiology and End Results (SEER) cancer registries since 1973. I used the chi-squared goodness of fit test to measure consistency. The age-specific incidence data from most human carcinomas, including those of the colon, lung, prostate, and breast were consistent with the parallel route hypothesis. However, this hypothesis is only consistent if an immune sub-population exists, one that will never develop carcinoma. Furthermore, breast carcinoma has two distinct forms of the disease, and one of these occurs at significantly different rates in different racial groups. CONCLUSIONS/SIGNIFICANCE: I conclude that the parallel route hypothesis is consistent with the age-specific incidence data only if carcinoma occurs in a distinct sub population, while the multi-stage hypothesis is inconsistent with this data.
PMID: 19774079
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Tsui YK,Tsai FY,Hasso AN,Greensite F,Nguyen BV
Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA; Department of Radiology, Chi Mei Medical Center, Yong-Kang City, Tainan, Taiwan.
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Susceptibility-weighted imaging for differential diagnosis of cerebral vascular pathology: A pictorial review.
J Neurol Sci. 2009 Sep 19;:
Susceptibility-weighted imaging (SWI) is a high-spatial resolution, three-dimensional, gradient-echo (GRE) magnetic resonance (MR) technique. This fully velocity-compensated pulse sequence utilizes the magnetic susceptibility differences of various tissues or substances, such as blood products, iron, and calcification. By postprocessing the magnitude images using a phase mask, it emphasizes the magnetic properties of different susceptibility effects. Generated minimal intensity projection (minIP) images can further demonstrate tortuous vasculature and the continuity of vessels or abnormalities across slices. SWI has been used to improve the diagnosis of neurological trauma, brain neoplasm, neurodegenerative disorders, and cerebrovascular disease because of its ability to demonstrate microbleeds and conspicuity of the veins and other sources with susceptibility effects. We have used SWI to identify cerebrovascular lesions which may be obscured on other MR sequences to aid in the differential diagnosis. We present a review with selected cases to demonstrate the usefulness of this new neuroimaging technique in improving the diagnosis of cerebral vascular pathology.
PMID: 19772973
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Chase DM,Rincon A,Deane M,Tewari KS,Brewster WR
Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA, USA.
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Socioeconomic factors may contribute to neoadjuvant chemotherapy use in metastatic epithelial ovarian carcinoma.
Gynecol Oncol. 2009 Sep 21;:
OBJECTIVE.: To identify patient characteristics which predict receipt of neoadjuvant chemotherapy (NCT) versus standard therapy (ST) in metastatic ovarian cancer. METHODS.: A retrospective matched case control study was conducted of 52 women treated with NCT compared to 104 women who received standard treatment from 1996 to 2007. The t test was used for comparison of means between the groups, and the chi(2) test was used for categorical data. Multivariable analysis was performed with logistic regression models and only two-tailed analyses with a P value <0.05 were considered statistically significant. RESULTS.: Age, employment and marital status, and insurance alone did not affect treatment allocation (P=NS). However, non-Hispanic White (NHW) patients were more as likely to receive ST (P<0.05). When insurance was stratified by ethnicity, NHW patients were twice as likely to have private insurance (OR=2.29, CI=1.16-4.53). Furthermore, medically compromised (MC) patients who were NHW were almost three times more likely to receive ST (OR=2.72, CI=1.02-5.00). In multivariate analysis, only MC and publically funded women were more likely to receive NCT (OR 3.83 CI=1.35-11.11); P=0.01). During surgery, patients receiving NCT were found to have smaller tumors and less ascites, and were more likely to be optimally debulked with lower estimated blood loss and shorter hospital stays. The median survival for ST was 55.8 months versus 26 months for NCT (P<0.001). CONCLUSIONS.: Non-clinical factors such as publically funded status and non-Hispanic White race may influence the allocation of NCT for women with metastatic ovarian cancer.
PMID: 19772939
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Kahn C
Department of Emergency Medicine, University of California-Irvine, Irvine, CA, USA.
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Commentary: moving forward by looking behind you.
Ann Emerg Med. 2009 Oct;54(4):604-5
PMID: 19769889
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Lander AD
Center for Complex Biological Systems, Department of Developmental and Cell Biology, and Department of Biomedical Engineering, University of California at Irvine, Irvine, CA 92697-2300. adlander@uci.edu.
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The 'stem cell' concept: is it holding us back?
J Biol. 2009 Sep 21;8(8):70
ABSTRACT: Developmental biology, regenerative medicine and cancer biology are increasingly occupied with the molecular characterization of stem cells. Yet recent work adds to a growing body of literature suggesting that 'stemness' cannot be reduced to the molecular features of cell types, and is instead an emergent property of cell lineages under feedback control.
PMID: 19769787
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Sassoon CS,Caiozzo VJ
Department of Medicine, University of California, Irvine, California, USA. csassoon@uci.edu.
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Bench-to-bedside review: Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment.
Crit Care. 2009 Sep 8;13(5):221
ABSTRACT: Critically ill patients may require mechanical ventilatory support and short-term high-dose corticosteroid to treat some specific underlying disease processes. Diaphragm muscle inactivity induced by controlled mechanical ventilation produces dramatic alterations in diaphragm muscle structure and significant losses in function. Although the exact mechanisms responsible for losses in diaphragm muscle function are still unknown, recent studies have highlighted the importance of proteolysis and oxidative stress. In experimental animals, short-term strategies that maintain partial diaphragm muscle neuromechanical activation mitigate diaphragmatic force loss. In animal models, studies on the influence of combined controlled mechanical ventilation and short-term high-dose methylprednisolone have given inconsistent results in regard to the effects on diaphragm muscle function. In the critically ill patient, further research is needed to establish the prevalence and mechanisms of ventilator-induced diaphragm muscle dysfunction, and the possible interaction between mechanical ventilation and the administration of high-dose corticosteroid. Until then, in caring for these patients, it is imperative to allow partial activation of the diaphragm, and to administer the lowest dose of corticosteroid for the shortest duration possible.
PMID: 19769782
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