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Danley BT, Hamilton BN, Tantbirojn D, Goldstein RE, Versluis A. Cuspal Flexure and Stress in Restored Teeth Caused by Amalgam Expansion. Oper Dent 2018; 43:E300-E307. [DOI: 10.2341/17-329-l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective:
Cracks in amalgam-filled teeth may be related to amalgam expansion. This study measured cuspal flexure and used finite element analysis to assess associated stress levels in amalgam-filled teeth.
Methods and Materials:
External surfaces of 18 extracted molars were scanned in three dimensions. Nine molars were restored with mesio-occluso-distal amalgam fillings; the other teeth were left intact as controls. All teeth were stored in saline and scanned after two, four, and eight weeks. Cuspal flexure and restoration expansion were determined by calculating the difference between scanned surfaces. Stresses in a flexed tooth were calculated using finite element analysis.
Results:
Cusps of amalgam-filled teeth flexed outward approximately 3 μm, and restoration surfaces expanded 4 to 8 μm during storage. Cuspal flexure was significantly higher in the amalgam group (multivariate tests, p<0.05), but storage time had no significant effect (repeated measures, p>0.05). Expansion caused stress concentrations at the cavity line angles. These stress concentrations increased stresses due to mastication 44% to 178%.
Conclusions:
Amalgam expansion pushed cavity walls outward, which created stress concentrations at the cavity line angles. Expansion stresses can raise stresses in amalgam-filled teeth and contribute to incidentally observed cracks.
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Affiliation(s)
- BT Danley
- Brent T Danley, BS, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - BN Hamilton
- Bruce N Hamilton, MS, DDS, Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - D Tantbirojn
- Daranee Tantbirojn, DDS, MS, PhD, Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - RE Goldstein
- Ronald E Goldstein, DDS, private practice, Atlanta, and clinical professor of Oral Rehabilitation, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - A Versluis
- Antheunis Versluis, PhD, College of Dentistry, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
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2
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Pedley TJ, Brumley DR, Goldstein RE. Squirmers with swirl: a model for Volvox swimming. J Fluid Mech 2016; 798:165-186. [PMID: 27795576 PMCID: PMC5070036 DOI: 10.1017/jfm.2016.306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/13/2016] [Accepted: 04/24/2016] [Indexed: 05/08/2023]
Abstract
Colonies of the green alga Volvox are spheres that swim through the beating of pairs of flagella on their surface somatic cells. The somatic cells themselves are mounted rigidly in a polymeric extracellular matrix, fixing the orientation of the flagella so that they beat approximately in a meridional plane, with axis of symmetry in the swimming direction, but with a roughly [Formula: see text] azimuthal offset which results in the eponymous rotation of the colonies about a body-fixed axis. Experiments on colonies of Volvox carteri held stationary on a micropipette show that the beating pattern takes the form of a symplectic metachronal wave (Brumley et al. Phys. Rev. Lett., vol. 109, 2012, 268102). Here we extend the Lighthill/Blake axisymmetric, Stokes-flow model of a free-swimming spherical squirmer (Lighthill Commun. Pure Appl. Maths, vol. 5, 1952, pp. 109-118; Blake J. Fluid Mech., vol. 46, 1971b, pp. 199-208) to include azimuthal swirl. The measured kinematics of the metachronal wave for 60 different colonies are used to calculate the coefficients in the eigenfunction expansions and hence predict the mean swimming speeds and rotation rates, proportional to the square of the beating amplitude, as functions of colony radius. As a test of the squirmer model, the results are compared with measurements (Drescher et al. Phys. Rev. Lett., vol. 102, 2009, 168101) of the mean swimming speeds and angular velocities of a different set of 220 colonies, also given as functions of colony radius. The predicted variation with radius is qualitatively correct, but the model underestimates both the mean swimming speed and the mean angular velocity unless the amplitude of the flagellar beat is taken to be larger than previously thought. The reasons for this discrepancy are discussed.
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Affiliation(s)
- T. J. Pedley
- Department of Applied Mathematics and Theoretical Physics,
University of Cambridge, Centre for Mathematical
Sciences, Wilberforce Road, Cambridge CB3
0WA, UK
| | - D. R. Brumley
- Ralph M. Parsons Laboratory, Department of Civil and
Environmental Engineering, Massachusetts Institute of
Technology, Cambridge, MA 02139,
USA
- Department of Civil, Environmental and Geomatic Engineering,
ETH Zurich, 8093 Zurich,
Switzerland
| | - R. E. Goldstein
- Department of Applied Mathematics and Theoretical Physics,
University of Cambridge, Centre for Mathematical
Sciences, Wilberforce Road, Cambridge CB3
0WA, UK
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3
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Epstein SE, Kent KM, Borer JS, Goldstein RE, Smith HJ, Capurro NL. Vasodilators in the management of acute myocardial infarction. Adv Cardiol 2015:138-46. [PMID: 413333 DOI: 10.1159/000401024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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4
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Wensink HH, Kantsler V, Goldstein RE, Dunkel J. Controlling active self-assembly through broken particle-shape symmetry. Phys Rev E Stat Nonlin Soft Matter Phys 2014; 89:010302. [PMID: 24580155 DOI: 10.1103/physreve.89.010302] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Indexed: 06/03/2023]
Abstract
Many structural properties of conventional passive materials are known to arise from the symmetries of their microscopic constituents. By contrast, it is largely unclear how the interplay between particle shape and self-propulsion controls the meso- and macroscale behavior of active matter. Here we use large-scale simulations of homo- and heterogeneous self-propelled particle systems to identify generic effects of broken particle-shape symmetry on collective motion. We find that even small violations of fore-aft symmetry lead to fundamentally different collective behaviors, which may facilitate demixing of differently shaped species as well as the spontaneous formation of stable microrotors. These results suggest that variation of particle shape yields robust physical mechanisms to control self-assembly of active matter, with possibly profound implications for biology and materials design.
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Affiliation(s)
- H H Wensink
- Laboratoire de Physique des Solides, Université Paris-Sud and CNRS, Bâtiment 510, 91405 Orsay Cedex, France
| | - V Kantsler
- DAMTP, Centre for Mathematical Sciences, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, United Kingdom
| | - R E Goldstein
- DAMTP, Centre for Mathematical Sciences, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, United Kingdom
| | - J Dunkel
- DAMTP, Centre for Mathematical Sciences, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, United Kingdom and Department of Mathematics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
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5
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Midence JN, Leutenegger CM, Chandler AM, Goldstein RE. Effects of recent Leptospira vaccination on whole blood real-time PCR testing in healthy client-owned dogs. J Vet Intern Med 2011; 26:149-52. [PMID: 22182214 DOI: 10.1111/j.1939-1676.2011.00852.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/05/2011] [Accepted: 11/11/2011] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Bacterin-based canine Leptospira vaccines could present a challenge for the use of whole blood real-time polymerase chain reaction (PCR) as a diagnostic tool. Recent vaccination could induce positive results if the targeted DNA fragment is present within the vaccine and in the blood of the recently vaccinated dog. OBJECTIVES The objective of this study was to assess whether 2 available 4-serovar vaccines induce a positive real-time PCR reaction in the blood of healthy recently vaccinated dogs. ANIMALS Twenty healthy dogs. METHODS This was a prospective study. Dogs were assigned to 1 of 2 vaccine groups. Both vaccines were culture-based and include Leptospira interrogans serovars Pomona, Canicola, and Icterohaemorrhagiae and Leptospira kirschneri serovar Grippotyphosa. Whole blood for real-time PCR and serum for the microscopic agglutination test (MAT) were collected prior to and 3 and 7 days after vaccination and weekly thereafter for 8 weeks. Two real-time PCR tests targeting 2 different genes were performed independently in a blinded fashion. RESULTS Both Leptospira vaccines produced positive real-time PCR reactions when assayed undiluted or diluted 1 : 100 in canine blood. However, blood samples drawn from all dogs at all time points after vaccination were negative on PCR. All dogs developed MAT titers. CONCLUSIONS AND CLINICAL IMPORTANCE Recent vaccination with 2 commercially available vaccines does not interfere with the use of real-time PCR for the identification of acute Leptospira infection in dogs.
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Affiliation(s)
- J N Midence
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA
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Sykes JE, Hartmann K, Lunn KF, Moore GE, Stoddard RA, Goldstein RE. 2010 ACVIM small animal consensus statement on leptospirosis: diagnosis, epidemiology, treatment, and prevention. J Vet Intern Med 2010; 25:1-13. [PMID: 21155890 PMCID: PMC3040842 DOI: 10.1111/j.1939-1676.2010.0654.x] [Citation(s) in RCA: 185] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This report offers a consensus opinion on the diagnosis, epidemiology, treatment, and prevention of leptospirosis in dogs, an important zoonosis. Clinical signs of leptospirosis in dogs relate to development of renal disease, hepatic disease, uveitis, and pulmonary hemorrhage. Disease may follow periods of high rainfall, and can occur in dogs roaming in proximity to water sources, farm animals, or wildlife, or dogs residing in suburban environments. Diagnosis is based on acute and convalescent phase antibody titers by the microscopic agglutination test (MAT), with or without use of polymerase chain reaction assays. There is considerable interlaboratory variation in MAT results, and the MAT does not accurately predict the infecting serogroup. The recommended treatment for optimal clearance of the organism from renal tubules is doxycycline, 5 mg/kg PO q12h, for 14 days. Annual vaccination can prevent leptospirosis caused by serovars included in the vaccine and is recommended for dogs at risk of infection.
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Affiliation(s)
- J E Sykes
- Department of Medicine & Epidemiology, University of California, Davis, Davis, CA 95616, USA.
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7
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Barsheshet A, Goldenberg I, Moss AJ, Eldar M, Huang DT, McNitt S, Klein HU, Hall WJ, Brown MW, Goldberger JJ, Goldstein RE, Schuger C, Zareba W, Daubert JP. Response to preventive cardiac resynchronization therapy in patients with ischaemic and nonischaemic cardiomyopathy in MADIT-CRT. Eur Heart J 2010; 32:1622-30. [DOI: 10.1093/eurheartj/ehq407] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Goldstein RE, Narala S, Sabet N, Goldstein O, McDonough SP. Primary Hyperoxaluria in Cats Is Caused by a Mutation in the Feline GRHPR Gene. J Hered 2009. [DOI: 10.1093/jhered/esp038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Poulose BK, Holzman MD, Lao OB, Grogan EL, Goldstein RE. Laparoscopic adrenalectomy: 100 resections with clinical long-term follow-up. Surg Endosc 2004; 19:379-85. [PMID: 15624053 DOI: 10.1007/s00464-004-8914-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Accepted: 09/09/2004] [Indexed: 12/23/2022]
Abstract
BACKGROUND The operative results of 100 laparoscopic adrenal resections in 94 patients and the subsequent impact on postoperative antihypertensive therapy are presented. METHODS Clinical and follow-up data for resections performed between 1995 and 2003 were obtained from medical records, patient questionnaires, and telephone interviews. RESULTS The diseases included Conn's syndrome (27 patients), Cushing's syndrome (30 patients), pheochromocytoma (11 patients), and Other tumors (26 patients). Antihypertensive therapy was eliminated or reduced for Conn's syndrome (75%), Cushing's syndrome (27%), pheochromocytoma (88%) and patients with Other tumors (54%). Clinical improvement was observed by 12 months for pheochromocytoma patients as compared with 35 to 45 months for the other groups (p < 0.05). Multivariate analysis showed that pheochromocytoma patients were more likely to experience improvement or cure than the Other tumor group (hazard ratio, 4.87; 95% confidence interval, 1.61-14.7). CONCLUSIONS Laparoscopic adrenalectomy continues to be safe and efficacious for benign adrenal diseases. Although patients with functional tumors can expect improvement or cure, the time until improvement may be longer than previously recognized.
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Affiliation(s)
- B K Poulose
- Vanderbilt University School of Medicine, D-5203 Medical Center North, 1161 21st Avenue, Nashville, TN 37232, USA
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10
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Goldstein RE, Martin WH, Richards K. Minimally invasive radioguided parathyroidectomy (MIRP). MINERVA CHIR 2003; 58:269-79. [PMID: 12955045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The technique of parathyroidectomy has traditionally involved a bilateral exploration of the neck with the intent of visualizing 4 parathyroid glands and resecting pathologically enlarged glands. Parathyroid scanning using technetium-99m sestamibi has evolved and can now localize 80% to 90% of parathyroid adenomas. The technique of minimally invasive radioguided parathyroidectomy (MIRP) is a surgical option for most patients with primary hyperparathyroidism and a positive preoperative parathyroid scan. The technique makes use of a hand-held gamma probe that is used intraoperatively to guide the dissection in a highly directed manner with the procedure often performed under local anesthesia. The technique results in excellent cure rates while allowing most patients to leave the hospital within a few hours after the completion of the procedure. Current data also suggest the procedure can decrease hospital charges by approximately 50%. This technique may significantly change the management of primary hyperparathyroidism.
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Affiliation(s)
- R E Goldstein
- Kenneth vonRoenn MD Family Chair in Surgical, Endocrinology and Professor of Surgery, University of Louisville, KY 40202, USA.
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11
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Smith AA, Posner LP, Goldstein RE, Ludders JW, Erb HN, Simpson KW, Gleed RD. Effect of pre-medication on gastroduodenoscopy in isoflurane-anesthetized cats. Vet Anaesth Analg 2003; 30:103. [DOI: 10.1046/j.1467-2995.2003.00133_9.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
The mechanism by which spiral wave patterns appear in populations of Dictyostelium was probed experimentally by external chemical perturbation. Spiral waves, which often arise from the breakup of circular waves driven by pacemakers, typically entrain those pacemakers. We studied these processes by resetting the waves with a spatially uniform pulse of extrinsic cyclic AMP. A pattern of spirals reappeared if resetting was early in the signaling stage, but only targets emerged following late resetting, in a manner analogous to cardiac defibrillation. This supports recent hypotheses that wave pattern selection naturally occurs by slow temporal variation of the excitability of the cells.
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Affiliation(s)
- K J Lee
- National Creative Research Initiative Center for Neurodynamics and Department of Physics, Korea University, Seoul 136-701 Korea
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Abstract
Computer imaging can be helpful in demonstrating to patients the potential outcome of esthetic dental procedures. The current clinical study assesses the effectiveness of computer imaging by comparing the reactions of patient and dentist to conventional consultations versus the use of computer imaging. The responses from 35 subjects show that computer imaging consultations are more effective in helping patients decide to accept treatment. Patient satisfaction was higher (93.75%) with computer consultations than with conventional methods (83.3%). Computer imaging consultations were easier to conduct but significantly (p < .05) more time consuming.
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Affiliation(s)
- O S Papasotiriou
- Department of Restorative Sciences and Biomaterials, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts, USA
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14
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Goldstein RE, Long C, Swift NC, Hornof WJ, Nelson RW, Nyland TG, Feldman EC. Percutaneous ethanol injection for treatment of unilateral hyperplastic thyroid nodules in cats. J Am Vet Med Assoc 2001; 218:1298-302. [PMID: 11330617 DOI: 10.2460/javma.2001.218.1298] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- R E Goldstein
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA
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Wells AL, Long CD, Hornof WJ, Goldstein RE, Nyland TG, Nelson RW, Feldman EC. Use of percutaneous ethanol injection for treatment of bilateral hyperplastic thyroid nodules in cats. J Am Vet Med Assoc 2001; 218:1293-7. [PMID: 11330616 DOI: 10.2460/javma.2001.218.1293] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the efficacy and safety of percutaneous ethanol injection (PEI) for the treatment of hyperthyroidism caused by bilateral hyperplastic thyroid nodules in cats. DESIGN; Prospective study. ANIMALS 7 cats. PROCEDURE Hyperthyroidism was diagnosed on the basis of clinical signs and increased serum total thyroxine (TT4) concentrations. The presence of 2 cervical thyroid nodules was confirmed by use of ultrasonography and technetium Tc 99m albumin thyroid scans. After the death of 1 cat that received PEI in both thyroid nodules at the same time, the protocol was changed to injecting ethanol into 1 nodule at a time, with at least 1 month between injections. Clinical signs, serum TT4 concentrations, serum ionized calcium concentrations, laryngeal function, findings on ultrasonographic examinations of the ventral cervical region, and results of thyroid scans were monitored. RESULTS Serum TT4 concentrations transiently decreased in all 6 cats (into the reference range in 5 of 6 cats) within 4 days of the first staged ethanol injection. Each subsequent injection resulted in a transient decrease in serum TT4 concentration. The longest period of euthyroidism was 27 weeks. Adverse effects included Horner's syndrome, dysphonia, and laryngeal paralysis. One cat died of unrelated causes. One cat underwent bilateral thyroidectomy, 2 cats were treated with methimazole, and 2 cats that had increased serum TT4 concentrations were not treated further, because they remained clinically normal. CONCLUSIONS AND CLINICAL RELEVANCE Percutaneous ethanol ablation of bilateral thyroid nodules as a treatment for cats with hyperthyroidism is not recommended. This treatment is not as efficacious as the medical and surgical treatments presently used.
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Affiliation(s)
- A L Wells
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA
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16
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Goldstein RE. Intraoral camera helps predict and prevent tooth loss. Tex Dent J 2001; 118:235-8. [PMID: 11404941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The video exam has proven to be a most effective means of re-establishing trust between patient and dentist by making the patient a co-diagnostician. In fact, it is not uncommon for patients to stop the diagnosis and ask specific questions about what they see. They can begin to diagnose pathology even before the dentist mentions it. A major benefit to the dentist is that invariably the exam reveals conditions not seen with typical clinical exams even using magnification loops. Although the intraoral camera has been around for more than a decade, its benefit during the video exam is more important now than ever before (8, 9). Every new patient and all patients of record should have the benefit of a video exam, as well as the dentist.
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17
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Reddy VS, O'Neill JA, Holcomb GW, Neblett WW, Pietsch JB, Morgan WM, Goldstein RE. Twenty-five-year surgical experience with pheochromocytoma in children. Am Surg 2000; 66:1085-91; discussion 1092. [PMID: 11149577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Our objective was to analyze the presentation, diagnostic localization, operative management, histology, and long-term outcome of a single center's experience with pheochromocytomas in children. A chart review was done to identify all operatively managed pheochromocytomas in patients age 18 years or younger. Open and laparoscopic cases were included. We reviewed the presentation, diagnostic imaging, localization, operative management, pathology, and postoperative outcome of these patients. Clinic visits, contact with the tumor registry, and telephone interviews were used for follow-up. From 1973 through 1999, there were 11 children (four males and seven females) with 14 pheochromocytomas. Two (18.2%) patients had bilateral adrenal lesions and one patient had both adrenal and extra-adrenal tumors. Six (54.5%) patients had extra-adrenal lesions. The average age at operation was 14.7 years (range 9-18 years). Nine (82%) patients had significant hypertension at presentation. CT was used to localize the tumor in eight patients and urine catecholamine levels were used to confirm the diagnosis. Two of the cases were associated with inherited syndromes (multiple endocrine neoplasia 2A and von Hippel-Lindau). Ten patients underwent an open operation and one patient had a laparoscopic resection. The average patient follow-up was 9.2 years (range 9 months to 25 years). There were no operative complications and all patients were alive and well at the time of last follow-up. Three patients (27.2%) had tumors with microscopic malignant features. No tumors recurred or had evidence for metastatic spread. We conclude that peak incidence of pheochromocytomas in children is in early adolescence. Resection can be carried out safely with minimal morbidity and mortality. Current best management of this entity includes establishment of a biochemical diagnosis, adequate preoperative blockade, appropriate imaging, and an individualized operative approach based on tumor location and size.
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Affiliation(s)
- V S Reddy
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, 37232-2577, USA
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18
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Moore MC, Cherrington AD, Palmer B, Lacy DB, Goldstein RE. Disposition of a mixed meal by conscious dogs after seven days of treatment with cyclosporine A and prednisone. JPEN J Parenter Enteral Nutr 2000; 24:244-50. [PMID: 10885720 DOI: 10.1177/0148607100024004244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Combination immunosuppressive therapy, that often includes prednisone and cyclosporine A (CyA), is commonly used in the treatment of organ transplant patients. We hypothesized that CyA and prednisone treatment would alter the roles of the liver and peripheral tissues in the disposal of carbohydrates from a meal. METHODS Using the arteriovenous difference technique, we examined the disposition of an intragastrically delivered mixed meal in eight 24-hour fasted conscious dogs that had received CyA 15 mg x kg(-1) daily and prednisone 5 mg twice daily for 7 consecutive days before study (CyA-prednisone group). The results were compared with those from a group of 13 dogs (control group) receiving the same meal but no drugs. RESULTS Neither arterial blood glucose concentrations nor arterial plasma insulin or glucagon concentrations differed significantly between the groups at any time. Cumulative net gut glucose output was equivalent to 43 +/- 9 vs 57% +/- 7% of the glucose in the meal in CyA-prednisone vs control (p = .12). The CyA-prednisone group exhibited greater (p < .05) mean net hepatic glucose uptakes (15.4 +/- 4.6 vs 4.3 +/- 2.2 micromol x kg(-1) x min(-1) and net hepatic fractional extractions of glucose (7.8 +/- 1.6 and 1.5% +/- 1.0%) than the control group. Arterial blood lactate concentrations and net hepatic lactate output were greater in the CyA-prednisone group than the control group (p < .05). Hepatic glycogen content at the end of the study was 2.5-fold greater in the CyA-prednisone group than in the control group (p < .05). The nonhepatic tissues disposed of approximately 91% of the absorbed glucose in the control group but only approximately 26% in the CyA-prednisone group (p < .05). CONCLUSIONS CyA-prednisone treatment caused a marked shift in the carbohydrate disposal from a meal, enhancing the hepatic glucose uptake and decreasing peripheral glucose disposal.
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Affiliation(s)
- M C Moore
- Department of Molecular Physiology & Biophysics, Vanderbilt University, Nashville, Tennessee 37232-0615, USA
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19
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Cook B, Bar-Yaacov M, Cohen Ben-Ami H, Goldstein RE, Paroush Z, Selinger Z, Minke B. Phospholipase C and termination of G-protein-mediated signalling in vivo. Nat Cell Biol 2000; 2:296-301. [PMID: 10806481 DOI: 10.1038/35010571] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In Drosophila photoreceptors, phospholipase C (PLC) and other signalling components form multiprotein structures through the PDZ scaffold protein INAD. Association between PLC and INAD is important for termination of responses to light; the underlying mechanism is, however, unclear. Here we report that the maintenance of large amounts of PLC in the signalling membranes by association with INAD facilitates response termination, and show that PLC functions as a GTPase-activating protein (GAP). The inactivation of the G protein by its target, the PLC, is crucial for reliable production of single-photon responses and for the high temporal and intensity resolution of the response to light.
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Affiliation(s)
- B Cook
- Department of Physiology and the Kühne Minerva centre for Studies of Visual Transduction, the Hebrew University, Jerusalem, Israel
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20
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Goldstein RE, Blevins L, Delbeke D, Martin WH. Effect of minimally invasive radioguided parathyroidectomy on efficacy, length of stay, and costs in the management of primary hyperparathyroidism. Ann Surg 2000; 231:732-42. [PMID: 10767795 PMCID: PMC1421061 DOI: 10.1097/00000658-200005000-00014] [Citation(s) in RCA: 162] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the first 20 patients who underwent minimally invasive radioguided parathyroidectomies (MIRPs) performed at the authors' institution with 20 similar patients who underwent a more conventional surgical approach for primary hyperparathyroidism. SUMMARY BACKGROUND DATA The technique of parathyroidectomy has traditionally involved a bilateral exploration of the neck with the intent of visualizing four parathyroid glands and resecting enlarged parathyroid glands. Parathyroid scanning using radioisotopes has evolved and now can localize adenomas in 80% to 90% of patients. MIRP combines parathyroid scanning with a hand-held intraoperative detector that guides the surgeon to the adenoma. METHODS Forty patients with documented primary hyperparathyroidism who underwent surgery by a single surgeon between January 1998 and May 1999 were included in this study. Twenty of these patients underwent MIRP. The technique involved injecting 20 mCi technetium-99m sestamibi 2 hours before surgery and performing a parathyroid scan. If the scan was considered positive for a single adenoma, patients were taken to the operating room and given the choice of either general anesthesia or intravenous sedation with local anesthesia. Using an incision of 4 cm or less, the dissection down to the adenoma was guided by the Navigator miniature hand-held probe. An additional 20 patients who underwent more conventional bilateral or unilateral neck exploration were chosen to match the MIRP patient population. Both groups included four patients undergoing repeat surgery for persistent or recurrent primary hyperparathyroidism and one patient with multiple endocrine neoplasia type 1 syndrome. Patient demographics, preoperative calcium and parathyroid hormone levels, operative time, total time in the operating room, time in the recovery room, complications, hospital charges for the operating room, and total hospital charges were analyzed. RESULTS There were no differences in patient demographics, presenting symptoms, or preoperative calcium level between patients undergoing the standard procedure versus MIRP. Operative time, total time in the operating room, operative charges, and total hospital charges were significantly reduced in the MIRP group. All 40 patients were cured of primary hyperparathyroidism. There were no recurrent laryngeal nerve injures in either group. The mean length of stay in the standard group was 1. 35 days; in the MIRP group, 65% of patients were discharged within 5 hours after surgery. CONCLUSIONS The MIRP technique resulted in excellent cure rates for primary hyperparathyroidism while simultaneously decreasing operative time and hospital stays. These resulted in significant cost reductions without compromising patient safety. The technique may significantly change the management of primary hyperparathyroidism.
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Affiliation(s)
- R E Goldstein
- Divisions of Surgical Oncology and Endocrinology and the Department of Nuclear Medicine, Vanderbilt University Medical Center, and the Nashville VA Medical Center, Nashville, Tennessee 37232, USA.
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Abstract
We extend elasticity theory of filaments to encompass systems, such as bacterial flagella, that display competition between two helical structures of opposite chirality. A general, fully intrinsic formulation of the dynamics of bend and twist degrees of freedom is developed using the natural frame of space curves, spanning from the inviscid limit to the viscously overdamped regime applicable to cellular biology. Aspects of front propagation found in flagella are discussed.
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Affiliation(s)
- R E Goldstein
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
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Mendelson NH, Sarlls JE, Wolgemuth CW, Goldstein RE. Chiral self-propulsion of growing bacterial macrofibers on a solid surface. Phys Rev Lett 2000; 84:1627-1630. [PMID: 11017584 DOI: 10.1103/physrevlett.84.1627] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/1999] [Indexed: 05/23/2023]
Abstract
Supercoiling motions that accompany the growth of bacterial macrofibers (multicellular filamentous structures formed in B. subtilis by cell division without separation) are responsible for rolling, pivoting, and walking of fibers on a surface. Fibers possess a fulcrum about which they pivot and step in a chiral manner; forces and torques associated with cell growth, when blocked by friction, result in self-propulsion. The elastic engine that drives macrofiber motions generates torques estimated as microdyn cm and femtowatts of power; optical trapping studies yield a first direct measurement of the Young's modulus of the bacterial cell wall, the engine's "working fluid," of ca. 0.05 GPa.
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Affiliation(s)
- N H Mendelson
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, Arizona 85721, USA
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23
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Abstract
Motivated by diverse phenomena in cellular biophysics, including bacterial flagellar motion and DNA transcription and replication, we study the overdamped nonlinear dynamics of a rotationally forced filament with twist and bend elasticity. Competition between twist injection, twist diffusion, and writhing instabilities is described by coupled PDEs for twist and bend evolution. Analytical and numerical methods elucidate the twist/bend coupling and reveal two regimes separated by a Hopf bifurcation: (i) diffusion-dominated axial rotation, or twirling, and (ii) steady-state crankshafting motion, or whirling. The consequences of these phenomena for self-propulsion are investigated, and experimental tests proposed.
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Affiliation(s)
- C W Wolgemuth
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
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24
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Clements RH, Holzman MD, Blevins LS, Molpus K, Goldstein RE. Endoscopic retroperitoneal resection of a para-aortic paraganglioma: report of a case and description of a technique. Surgery 1999; 126:977-9. [PMID: 10568201 DOI: 10.1016/s0039-6060(99)70043-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- R H Clements
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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25
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Goldstein RE. Multipurpose laser offers unique approach to restorative dentistry. Dent Today 1999; 18:78-81. [PMID: 10803144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Abstract
The Groucho corepressor mediates negative transcriptional regulation in association with various DNA-binding proteins in diverse developmental contexts. We have previously implicated Groucho in Drosophila embryonic terminal patterning, showing that it is required to confine tailless and huckebein terminal gap gene expression to the pole regions of the embryo. Here we reveal an additional requirement for Groucho in this developmental process by establishing that Groucho mediates repressor activity of the Huckebein protein. Putative Huckebein target genes are derepressed in embryos lacking maternal groucho activity and biochemical experiments demonstrate that Huckebein physically interacts with Groucho. Using an in vivo repression assay, we identify a functional repressor domain in Huckebein that contains an FRPW tetrapeptide, similar to the WRPW Groucho-recruitment domain found in Hairy-related repressor proteins. Mutations in Huckebein's FRPW motif abolish Groucho binding and in vivo repression activity, indicating that binding of Groucho through the FRPW motif is required for the repressor function of Huckebein. Taken together with our earlier results, these findings show that Groucho-repression regulates sequential aspects of terminal patterning in Drosophila.
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Affiliation(s)
- R E Goldstein
- Department of Biochemistry, Hadassah Medical School, The Hebrew University, PO Box 12272, Jerusalem 91120, Israel
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27
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Abstract
Although uncommon, adrenalectomy occasionally is indicated in children. To date, this procedure has required either a laparotomy or a flank incision. The authors report the case of a child with episodic palpitations, diaphoresis, chest discomfort, and occipital headache who underwent laparoscopic adrenalectomy for pheochromocytoma without complication.
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Affiliation(s)
- R H Clements
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37212, USA
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28
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Blankenau R, Goldstein RE, Haywood VB. The current status of vital tooth whitening techniques. Compend Contin Educ Dent 1999; 20:781-4, 786, 788 passim; quiz 796. [PMID: 10649952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Tooth whitening of vital teeth continues to have a major impact on the practice of dentistry. The growing public interest in having whiter, brighter teeth is clearly evident in the advertisements from toothpaste manufacturers on "whitening" formulations of their products and by the number of individuals seeking whitening procedures from their dentists. In addition, new over-the-counter whitening products continue to emerge in a marketplace that cannot seem to get teeth white enough, bright enough, fast enough. What new products and procedures have evolved over the past decade to whiten teeth? Are they better, safer, faster, and more effective now? Are dentists meeting public demand for whiter teeth and is this quest having a positive or negative impact on the practice of dentistry or the patient's dental health? I posed these questions to a group of experts on whitening procedures to get their opinions and recommendations.
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Affiliation(s)
- R Blankenau
- Medical College of Georgia School of Dentistry, Augusta, USA
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29
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Long CD, Goldstein RE, Hornof WJ, Feldman EC, Nyland TG. Percutaneous ultrasound-guided chemical parathyroid ablation for treatment of primary hyperparathyroidism in dogs. J Am Vet Med Assoc 1999; 215:217-21. [PMID: 10416475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
OBJECTIVE To evaluate the efficacy, feasibility, and safety of ultrasound-guided chemical ablation of parathyroid masses in dogs with primary hyperparathyroidism. DESIGN Prospective clinical trial. ANIMALS 8 dogs. PROCEDURE In all dogs, a solitary parathyroid mass was evident ultrasonographically. Dogs were anesthetized with propofol, and a 27-gauge needle was directed into the parathyroid mass under ultrasound guidance. Ethanol (96%) was injected into the mass until there was evidence of diffusion of fluid throughout the mass. Serum total calcium, ionized calcium, phosphorus, and parathyroid hormone (PTH) concentrations were monitored daily for 5 to 7 days after the ablation procedure and again 1, 3, and 6 months after the procedure. Dogs were also monitored for adverse effects. Follow-up ultrasonography was performed 5 days and 1 month after the ablation procedure. RESULTS One injection was required in 7 dogs, and 2 injections were required in 1. Serum total and ionized calcium concentrations were within reference ranges within 24 hours after treatment in 7 dogs and within 5 days in 1 dog. Serum PTH concentration decreased and serum phosphorus concentration increased within 24 hours after treatment in all 8 dogs. Transient hypocalcemia developed in 4 dogs during the first 5 days after treatment, but only 1 dog required treatment for hypocalcemic tetany. Hypercalcemia recurred in 1 dog 1 month after the procedure and surgical removal of the parathyroid mass was required. Other adverse effects were not reported. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasound-guided chemical ablation of parathyroid masses is a safe and effective alternative to surgery for dogs with primary hyperparathyroidism.
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Affiliation(s)
- C D Long
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, USA
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Goldstein RE, O'Neill JA, Holcomb GW, Morgan WM, Neblett WW, Oates JA, Brown N, Nadeau J, Smith B, Page DL, Abumrad NN, Scott HW. Clinical experience over 48 years with pheochromocytoma. Ann Surg 1999; 229:755-64; discussion 764-6. [PMID: 10363888 PMCID: PMC1420821 DOI: 10.1097/00000658-199906000-00001] [Citation(s) in RCA: 274] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To analyze the presentation, localization, surgical management, pathology, and long-term outcome of a large series of patients with pheochromocytomas. SUMMARY BACKGROUND DATA There are several areas of controversy pertaining to pheochromocytomas. Although many studies report a higher rate of malignancy for extraadrenal pheochromocytomas than for adrenal pheochromocytomas, the number of patients with the former tumor are small and statistical analysis is lacking. There has also been recent debate as to whether microscopic features of the tumor may be predictive of future behavior. METHODS From 1950 to 1998, the authors observed 108 pheochromocytomas in 104 patients. The outcome of these patients has been followed prospectively. The medical records of these patients were reviewed for data on the presentation, localization, surgical management, pathology, and outcome. Patient survival was analyzed using Kaplan-Meier survival distributions. RESULTS This study included 66 female patients and 38 male patients. The average age at surgery was 42.3 years. Sporadic cases accounted for 84% of the patients; the other 16% had multiple endocrine neoplasia type 2, von Recklinghausen's disease, von Hippel-Lindau disease, or Carney's syndrome. Of 64 adrenal tumors, 55 were initially considered benign, 6 had microscopic malignant features, and 3 had malignant disease. Mean patient follow-up was 12.6 years. To date, in five additional patients (none with microscopic disease) malignant disease developed (13% overall rate of malignancy). Recurrence occurred as late as 15 years after resection. Of 26 extraadrenal pheochromocytomas, 14 were initially considered benign, 8 had microscopic malignant features, and 4 had malignant disease. Thus, 46% of patients had either malignant disease or tumors with malignant features. Mean patient follow-up was 11.5 years. In one patient with benign disease and in one patient with malignant features, malignant disease developed (23% overall rate of malignancy). The difference in the rate of malignancy was not statistically significant between adrenal and extraadrenal pheochromocytomas. Patients with adrenal and extraadrenal pheochromocytomas also had similar rates of survival (p = NS). CONCLUSIONS The data suggest that patients with extraadrenal pheochromocytomas have the same risk of malignancy and the same overall survival as patients with adrenal pheochromocytomas. Lifelong follow-up of these patients is mandatory.
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Affiliation(s)
- R E Goldstein
- Department of Surgery, Vanderbilt University Medical Center and the Nashville VA Medical Center, Tennessee, USA
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31
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Moss AJ, Goldstein RE, Marder VJ, Sparks CE, Oakes D, Greenberg H, Weiss HJ, Zareba W, Brown MW, Liang CS, Lichstein E, Little WC, Gillespie JA, Van Voorhees L, Krone RJ, Bodenheimer MM, Hochman J, Dwyer EM, Arora R, Marcus FI, Watelet LF, Case RB. Thrombogenic factors and recurrent coronary events. Circulation 1999; 99:2517-22. [PMID: 10330382 DOI: 10.1161/01.cir.99.19.2517] [Citation(s) in RCA: 185] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Thrombosis is a pivotal event in the pathogenesis of coronary disease. We hypothesized that the presence of blood factors that reflect enhanced thrombogenic activity would be associated with an increased risk of recurrent coronary events during long-term follow-up of patients who have recovered from myocardial infarction. METHODS AND RESULTS We prospectively enrolled 1045 patients 2 months after an index myocardial infarction. Baseline thrombogenic blood tests included 6 hemostatic variables (D-dimer, fibrinogen, factor VII, factor VIIa, von Willebrand factor, and plasminogen activator inhibitor-1), 7 lipid factors [cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, lipoprotein(a), apolipoprotein (apo)A-I, and apoB], and insulin. Patients were followed up for an average of 26 months, with the primary end point being coronary death or nonfatal myocardial infarction, whichever occurred first. The hemostatic, lipid, and insulin parameters were dichotomized into their top and the lower 3 risk quartiles and evaluated for entry into a Cox survivorship model. High levels of D-dimer (hazard ratio, 2.43; 95% CI, 1.49, 3.97) and apoB (hazard ratio, 1.82; 95% CI, 1.10, 3.00) and low levels of apoA-I (hazard ratio, 1.84; 95% CI, 1.10, 3.08) were independently associated with recurrent coronary events in the Cox model after adjustment for 6 relevant clinical covariates. CONCLUSIONS Our findings indicate that a procoagulant state, as reflected in elevated levels of D-dimer, and disordered lipid transport, as indicated by low apoA-1 and high apoB levels, contribute independently to recurrent coronary events in postinfarction patients.
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Affiliation(s)
- A J Moss
- Cardiology and Vascular Medicine, Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA
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32
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Abstract
Esthetic dentistry offers a myriad of opportunities for older adults wishing to improve their smile, oral function, and self-esteem. The challenge for dental professionals is to maintain oral health throughout the patient's lifetime, even through periods of dependence that may include residence in a nursing home. Dental professionals will have increasing opportunities to share their knowledge and expertise about the relation between oral health and overall health, with a variety of health professionals who care for the aging population.
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Affiliation(s)
- R E Goldstein
- School of Dentistry, Medical College of Georgia, Augusta, USA
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Abstract
Calcitonin gene-related peptide (CGRP) causes vasodilation in many vascular beds, resulting in hypotension and tachycardia. The current studies were conducted in overnight-fasted conscious dogs to determine the effect of different CGRP dosages on carbohydrate metabolism and catecholamine release resulting from hemodynamic changes. During a pancreatic clamp, dogs received intraportal infusions of CGRP at 13, 26, and 52 (n = 3) or 52, 105, and 210 pmol x kg(-1) x min(-1) (n = 4; 60 minutes at each rate). Blood pressure decreased (P < .05) and the heart rate and hepatic blood flow (HBF) increased a maximum of 100% and 30%, respectively (P < .05). For the five CGRP infusion rates, arterial plasma epinephrine increased approximately 1.3-, 2.4-, 7.4-, 12-fold, and eightfold basal, respectively; norepinephrine increased about 2.3-, 3.3-, 4.1-, 4.6-, and 4.8-fold basal, respectively; and cortisol increased about twofold, 3.4-fold, fivefold, sixfold, and 6.2-fold basal, respectively. At CGRP infusion rates of 52 pmol x kg(-1) x min(-1) or higher, increases (P < .05) occurred for plasma glucose, endogenous glucose production (EndoRa), and net hepatic uptake of gluconeogenic substrates (maximum change, 24 mg/dL, 1.3 mg x kg(-1) x min(-1), and 9.9 micromol x kg(-1) x min(-1), respectively). Arterial blood glycerol concentrations increased only a maximum of 30%. At the two highest CGRP infusion rates, glycerol returned to basal concentrations and arterial plasma nonesterified fatty acids (NEFAs) decreased. The increased net hepatic uptake of gluconeogenic substrates during CGRP infusion was sufficient to account for 49% to 58% of the increase in EndoRa. CGRP has no apparent direct effects on hepatic carbohydrate metabolism, but the catecholamines, at levels similar to those observed during CGRP infusion, stimulate hepatic glycogenolysis. Therefore, some factor(s) other than CGRP, probably an increase in circulating catecholamine concentrations, would appear to be responsible for at least 42% to 51% of the increase in EndoRa.
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Affiliation(s)
- M C Moore
- Department of Molecular Physiology & Biophysics, and Diabetes Research and Training Center, Vanderbilt University School of Medicine, Nashville, TN 37232-0615, USA
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Goldstein RE, Marks SL, Cowgill LD, Kass PH, Rogers QR. Plasma amino acid profiles in cats with naturally acquired chronic renal failure. Am J Vet Res 1999; 60:109-13. [PMID: 9918157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To characterize potential changes in preprandial plasma amino acid concentrations in cats with naturally acquired chronic renal failure (CRF), compared with healthy cats, and to assess potential effects of the severity of renal failure on plasma amino acid concentrations in these cats. ANIMALS 62 adult cats. PROCEDURE Preprandial plasma amino acid concentrations were evaluated in 38 cats with mild, moderate, or severe CRF and in 24 apparently healthy cats. Effects of severity of renal failure, amount of dietary protein, degree of weight loss, appetite, and body condition on plasma amino acid profiles were evaluated. RESULTS Cats with various stages of CRF had significantly (P< 0.05) decreased plasma concentrations of o-hydroxyproline, glutamate, proline, glycine, alanine, tyrosine, tryptophan, and arginine, and significantly increased plasma concentrations of asparagine, citrulline, ornithine, 1-methylhistidine, and 3-methylhistidine. Significant (P < 0.05) alterations in amino acid concentrations also were identified when cats with CRF were grouped by appetite or severity of renal disease. Amount of dietary protein, body condition, or degree of weight loss had no significant effect on plasma amino acid concentrations. CONCLUSIONS Compared with those in healthy cats, preprandial plasma amino acid profiles in cats with mild, moderate, or severe CRF are abnormal. CLINICAL RELEVANCE Despite frequency of altered plasma amino acid concentrations in cats with CRF, the magnitude of these changes is mild and of little clinical relevance. Short-term use of a commercial protein-restricted diet has no deleterious effects on plasma amino acid concentrations.
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Affiliation(s)
- R E Goldstein
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA
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Levanon D, Goldstein RE, Bernstein Y, Tang H, Goldenberg D, Stifani S, Paroush Z, Groner Y. Transcriptional repression by AML1 and LEF-1 is mediated by the TLE/Groucho corepressors. Proc Natl Acad Sci U S A 1998; 95:11590-5. [PMID: 9751710 PMCID: PMC21685 DOI: 10.1073/pnas.95.20.11590] [Citation(s) in RCA: 389] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The mammalian AML/CBFalpha runt domain (RD) transcription factors regulate hematopoiesis and osteoblast differentiation. Like their Drosophila counterparts, most mammalian RD proteins terminate in a common pentapeptide, VWRPY, which serves to recruit the corepressor Groucho (Gro). Using a yeast two-hybrid assay, in vitro association and pull-down experiments, we demonstrate that Gro and its mammalian homolog TLE1 specifically interact with AML1 and AML2. In addition to the VWRPY motif, other C-terminal sequences are required for these interactions with Gro/TLE1. TLE1 inhibits AML1-dependent transactivation of the T cell receptor (TCR) enhancers alpha and beta, which contain functional AML binding sites, in transfected Jurkat T cells. LEF-1 is an additional transcription factor that mediates transactivation of TCR enhancers. LEF-1 and its Drosophila homolog Pangolin (Pan) are involved in the Wnt/Wg signaling pathway through interactions with the coactivator beta-catenin and its highly conserved fly homolog Armadillo (Arm). We show that TLE/Gro interacts with LEF-1 and Pan, and inhibits LEF-1:beta-catenin-dependent transcription. These data indicate that, in addition to their activity as transcriptional activators, AML1 and LEF-1 can act, through recruitment of the corepressor TLE1, as transcriptional repressors in TCR regulation and Wnt/Wg signaling.
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Affiliation(s)
- D Levanon
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot 76100, Israel
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Goldstein RE, Marks SL, Kass PH, Cowgill LD. Gastrin concentrations in plasma of cats with chronic renal failure. J Am Vet Med Assoc 1998; 213:826-8. [PMID: 9743721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To determine the prevalence of hypergastrinemia in cats with naturally developing chronic renal failure (CRF) and the correlation between gastrin concentration in plasma and severity of CRF. DESIGN Cohort study. ANIMALS 30 cats with naturally developing CRF and 12 clinically normal control cats. PROCEDURE Gastrin concentrations in plasma were determined by double-antibody radioimmunoassay of blood samples obtained from cats after food was withheld 8 hours. Concentrations were compared, using a nonparametric Kruskal-Wallis ANOVA. RESULTS 18 cats with CRF had high gastrin concentrations (median, 45 pg/ml; range, < 18 to > 1,333 pg/ml), compared with those for control cats (< 18 pg/ml). Prevalence of hypergastrinemia increased with severity of renal insufficiency. Three of 9 cats with mild CRF, 6 of 11 cats with moderate CRF, and 9 of 10 cats with severe CRF had high gastrin concentrations. Gastrin concentrations were significantly different between control cats and cats with CRF, regardless of disease severity. CLINICAL IMPLICATIONS The potential role of high concentrations of gastrin on gastric hyperacidity, uremic gastritis, bleeding from the gastrointestinal tract, and associated clinical signs of hypergastrinemia (e.g., anorexia and vomiting) may justify use of histamine2-receptor antagonists or proton pump inhibitors to suppress gastric acid secretion in cats with CRF that have these clinical signs.
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Affiliation(s)
- R E Goldstein
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616-8734, USA
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Borel MJ, Buchowski MS, Turner EA, Goldstein RE, Flakoll PJ. Protein turnover and energy expenditure increase during exogenous nutrient availability in sickle cell disease. Am J Clin Nutr 1998; 68:607-14. [PMID: 9734737 DOI: 10.1093/ajcn/68.3.607] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In the present study, energy expenditure (EE) and rates of whole-body protein, glucose, and lipid metabolism were assessed in 8 African American sickle cell disease (SCD) patients and in 6 healthy African American control subjects during the infusion of amino acids, glucose, and lipid. Whole-body protein, glucose, and lipid kinetics were estimated by using L-[1-(13)C]leucine, D-[6,6-(2)H2]glucose, and [(2)H5]glycerol, respectively. After a 2-h tracer equilibration period and a 0.5-h basal period, nutrients were administered intravenously for 3 h with 16% of the energy as protein, 52% as carbohydrate, and 32% as fat. Breath and blood were collected during the last 30 min of nutrient infusion and EE was measured by indirect calorimetry. EE was 14% greater (P < or = 0.05) in SCD patients [145.0 +/- 3.5 kJ x kg fat-free mass (FFM)(-1) x d(-1)] than in control subjects (126.8 +/- 3.8 kJ x kg FFM(-1) x d(-1)). Whole-body protein breakdown (4.4 +/- 0.4 compared with 3.1 +/- 0.1 mg x kg FFM(-1) x min(-1), P < or = 0.05) and protein synthesis (4.6 +/- 0.4 compared with 3.2 +/- 0.1 g x kg FFM(-1) x min(-1), P < or = 0.05) were 42% and 44% greater, respectively, in the SCD patients than in control subjects, but whole-body amino acid oxidation (0.90 +/- 0.05 compared with 1.03 +/- 0.09 mg x kg FFM(-1) x min(-1)) was not significantly different between the 2 groups. Whole-body glucose and lipid kinetics did not differ significantly between the groups. EE increased in SCD patients during exogenous nutrient availability, and the additional energy required for the accelerated rates of whole-body protein breakdown and synthesis made a significant contribution to the increase in EE. These metabolic aberrations may increase the dietary energy and protein requirements of SCD patients.
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Affiliation(s)
- M J Borel
- Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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39
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Garber DA, Goldstein RE. Education and communication: now more than ever. Pract Periodontics Aesthet Dent 1998; 10:291, 294. [PMID: 9655062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
Computer technology has revolutionized the way the world does business, allowing us to work faster, smarter, and more efficiently than ever before. Within dentistry, that translates to x-rays that use significantly smaller amounts of ionizing radiation, automated periodontal charting and storage devices, and imaging systems. Perhaps the greatest bottom-line benefit, especially in esthetic dentistry, is that these state-of-the-art developments enable dentists and hygienists to more effectively communicate with patients. The future of any restoration is based on the patient's motivation and ability to maintain an efficient oral hygiene routine. Esthetic restorations demand more vigorous home care programs to maximize their esthetic and functional life expectancy. With computerized images on screen, patients can better visualize the treatment that has been done and come to a realization that the restoration's success rests squarely on their shoulders.
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Affiliation(s)
- R E Goldstein
- School of Dentistry, Medical College of Georgia, Augusta, USA
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41
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Abstract
We present an analysis of the planar motion of single semiflexible filaments subject to viscous drag or point forcing. These are the relevant forces in dynamic experiments designed to measure biopolymer bending moduli. By analogy with the "Stokes problems" in hydrodynamics (motion of a viscous fluid induced by that of a wall bounding the fluid), we consider the motion of a polymer, one end of which is moved in an impulsive or oscillatory way. Analytical solutions for the time-dependent shapes of such moving polymers are obtained within an analysis applicable to small-amplitude deformations. In the case of oscillatory driving, particular attention is paid to a characteristic length determined by the frequency of oscillation, the polymer persistence length, and the viscous drag coefficient. Experiments on actin filaments manipulated with optical traps confirm the scaling law predicted by the analysis and provide a new technique for measuring the elastic bending modulus. Exploiting this model, we also present a reanalysis of several published experiments on microtubules.
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Affiliation(s)
- C H Wiggins
- Department of Physics, Princeton University, New Jersey 08544, USA.
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42
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Borel MJ, Buchowski MS, Turner EA, Peeler BB, Goldstein RE, Flakoll PJ. Alterations in basal nutrient metabolism increase resting energy expenditure in sickle cell disease. Am J Physiol 1998; 274:E357-64. [PMID: 9486169 DOI: 10.1152/ajpendo.1998.274.2.e357] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Basal rates of whole body protein, glucose, and lipid metabolism and resting energy expenditure (REE) were measured in eight African-American sickle cell disease (SCD) patients and in six African-American controls. Catheters were placed 1) in an antecubital vein for stable isotope infusion and 2) in a heated hand vein for arterialized venous blood. Breath and blood were collected during the last 30 min of the 2.5-h study, and REE was measured by indirect calorimetry. REE [128 +/- 5 vs. 111 +/- 1 kJ.kg fat-free mass (FFM)-1.day-1; P < 0.05 vs. controls] was 15% greater in the SCD patients. Whole body protein breakdown (5.0 +/- 0.3 vs. 3.8 +/- 0.2 mg.kg FFM-1.min-1; P < 0.05 vs. controls) and protein synthesis (4.4 +/- 0.3 vs. 3.2 +/- 0.2 mg.kg FFM-1.min-1; P < 0.05 vs. controls) were 32 and 38% greater, respectively, in the SCD patients, but whole body amino acid oxidation was similar (0.58 +/- 0.03 vs. 0.66 +/- 0.03 mg.kg FFM-1.min-1). Measures of whole body glucose and lipid metabolism were not significantly different between the groups. The additional energy required for the greater rates of whole body protein breakdown and synthesis caused by SCD contributes significantly to the observed increase in REE, suggesting that dietary energy and protein requirements are enhanced in SCD patients.
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Affiliation(s)
- M J Borel
- Department of Surgery, Vanderbilt University School of Medicine, Nashville 37232, USA
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43
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Abstract
Starving Dictyostelium amoebae emit pulses of the chemoattractant cAMP that are relayed from cell to cell as circular and spiral waves. We have recently modeled spiral wave formation in Dictyostelium. Our model suggests that a secreted protein inhibitor of an extracellular cAMP phosphodiesterase selects for spirals. Herein we test the essential features of this prediction by comparing wave propagation in wild type and inhibitor mutants. We find that mutants rarely form spirals. The territory size of mutant strains is approximately 50 times smaller than wild type, and the mature fruiting bodies are smaller but otherwise normal. These results identify a mechanism for selecting one wave symmetry over another in an excitable system and suggest that the phosphodiesterase inhibitor may be under selection because it helps regulate territory size.
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Affiliation(s)
- E Pálsson
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA
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44
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Abstract
OBJECTIVE The authors review their experience with laparoscopic adrenalectomy in patients with benign adrenal neoplasms. Efficacy, safety, and cost effectiveness of the procedure are examined. BACKGROUND Laparoscopic adrenalectomy is replacing open adrenalectomy in some medical centers as the standard surgical approach for uncomplicated tumors. However, laparoscopic adrenalectomy often is considered more difficult and more expensive than traditional "open" surgery. METHODS Perioperative and postoperative records as well as hospital charges from the first 19 patients undergoing laparoscopic unilateral adrenalectomies at the authors' medical institutions were examined and compared with 19 patients who underwent open unilateral adrenalectomies. RESULTS None of the 19 patients undergoing unilateral laparoscopic adrenalectomy required conversion to open adrenalectomy. Mean operative times as well as total hospital charges were similar in those patients undergoing either laparoscopic or open adrenalectomy. However, the morbidity and postoperative length of hospital stay were significantly less in those patients undergoing laparoscopic adrenalectomy. CONCLUSIONS Laparoscopic adrenalectomy can be performed safety and with the benefits associated with minimally invasive surgery. In addition, the procedure is cost effective. These factors suggest that laparoscopic adrenalectomy should be the preferential surgical technique for benign adrenal disease.
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Affiliation(s)
- J K Jacobs
- Department of Surgery, St. Thomas Hospital Nashville, Tennessee 37205, USA
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45
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Abstract
Discolored teeth are the primary aesthetic concern among dental patients. While many seek professional advice and treatment, an alarming number opt for non-professional quick-fix solutions. The in-office bleaching modality often is overlooked in favor of at-home vital bleaching. But this option has been proven to be effective, quick and safe-either alone or in combination with other aesthetic treatments-as a method of brightening and enhancing a patient's smile.
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Affiliation(s)
- R E Goldstein
- Medical College of Georgia School of Dentistry, Augusta, USA
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46
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Narins CR, Zareba W, Moss AJ, Goldstein RE, Hall WJ. Clinical implications of silent versus symptomatic exercise-induced myocardial ischemia in patients with stable coronary disease. J Am Coll Cardiol 1997; 29:756-63. [PMID: 9091521 DOI: 10.1016/s0735-1097(96)00585-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study was undertaken to better understand the functional and prognostic significance of silent relative to symptomatic ischemia. BACKGROUND Previous studies have reached conflicting conclusions as to whether painless ischemia identified during noninvasive cardiac testing is related to a lesser extent of myocardial ischemia or a different prognosis than ischemia accompanied by angina, or both. METHODS Nine hundred thirty-six clinically stable patients 1 to 6 months after an acute coronary event, either myocardial infarction or unstable angina, underwent ambulatory monitoring, exercise treadmill testing and stress thallium-201 scintigraphy. They were then followed up prospectively for a mean of 23 months for recurrent cardiac events (cardiac death, nonfatal myocardial infarction or unstable angina). RESULTS Compared with patients with symptomatic ischemia during testing (n = 125), those with silent ischemia (n = 378) demonstrated less severe and extensive reversible defects on stress thallium scintigraphy (p = 0.0008), less functional impairment during treadmill testing manifested by longer exercise duration (640 +/- 173 vs. 529 +/- 190 s, p = 0.002) and longer time to ST segment depression (530 +/- 215 vs. 419 +/- 205 s, p = 0.0001) and less frequent ST segment depression during ambulatory monitoring (9% vs. 19%, p = 0.005). Patients with symptomatic ischemia had a significantly (p = 0.004) increased number of subsequent recurrent cardiac events (28.8%) versus those with silent (18.0%) or no (17.3%) ischemia. Adverse outcomes were especially concentrated in the subgroup with symptomatic ischemia and poor exercise tolerance. The difference in cardiac event rates between patients with silent versus symptomatic ischemia persisted after adjustment for baseline clinical characteristics by Cox regression analysis. CONCLUSIONS Patients with painless ischemia during exercise testing 1 to 6 months after recovery from a coronary event have less jeopardized ischemic myocardium and fewer recurrent cardiac events than patients with symptomatic ischemia.
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Affiliation(s)
- C R Narins
- Division of Cardiology, University of Rochester School of Medicine and Dentistry, New York, USA
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47
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Goldstein RE, Mayes D, Hunter RE, Homoly P, Anusavice KJ. Managed care in dentistry. Quintessence Int 1997; 28:210-7. [PMID: 9452689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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48
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Peeler BB, Martin WH, Sandler MP, Goldstein RE. Sestamibi parathyroid scanning and preoperative localization studies for patients with recurrent/persistent hyperparathyroidism or significant comorbid conditions: development of an optimal localization strategy. Am Surg 1997; 63:37-46. [PMID: 8985069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
For patients with previous thyroid or parathyroid surgery and for those with significant comorbid conditions, noninvasive and invasive modalities exist for the preoperative localization of pathologic parathyroid tissue. Formal localization at our institution involves obtaining two studies that are independently positive for the same location. The studies utilized have included ultrasound, CT scans, MRI, technetium-99m/thallium-201 (Tc-Tl) imaging, and more recently, (99m)Tc-sestamibi (20-25 mCi) (MIBI) scans. These were followed by arteriography and/or venous sampling if necessary. From January 1992 through October 1995, 25 patients underwent preoperative parathyroid localization (10 reoperation, 3 grave hypercalcemia, 2 concurrent goiter, 2 cerebral vascular accident, 1 bleeding disorder, and 1 malignant ventricular arrhythmia) and were evaluated prospectively during the changeover from Tc-Tl to MIBI scanning at our institution. A total of 92 studies were obtained. All 25 patients were operated on by a single surgeon, and in each case the parathyroid adenoma was successfully resected with minimal morbidity (1 permanent hypoparathyroid and 1 temporary recurrent laryngeal nerve injury). True positives interpreted preoperatively: MIBI, 14 of 19 (74%); CT scan, 13 of 19 (68%); Tc-Tl, 4 of 8 (50%), ultrasound, 9 of 20 (45%); MRI, 8 of 14 (57%); arteriography, 3 of 7 (43%); venous sampling, 3 of 4 (75%); and positron emission tomography, 0 of 1. There were no false-positive MIBI scans. These results suggest that when formal parathyroid localization is needed in reoperative/complicated patients, 1) MIBI appears to be the most sensitive and specific study, and 2) the MIBI scan should be the initial study in any situation in which preoperative localization is needed. Ultrasound can be useful for patients with significant comorbidities who have not been previously explored. CT or MRI should then be used if further evaluation is needed. If the use of these noninvasive modalities does not produce positive gland localization, selective venous sampling should be utilized as the definitive procedure.
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Affiliation(s)
- B B Peeler
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA
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49
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Abstract
The shrinking of liquid handling systems to the micron and submicron size range entails moving into the area of small Reynolds numbers. The fluid dynamics in this regime are very different from the macroscale. We present an intuitive explanation of how the different physics of small Reynolds numbers flow, along with microscopic sizes, can influence device design, and give examples from our own work using fluid flow in microfabricated devices designed for biological processing.
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Affiliation(s)
- J P Brody
- Center for Bioengineering, University of Washington, Seattle 98195-2141, USA
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50
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Goldstein RE, Andrews M, Hall WJ, Moss AJ. Marked reduction in long-term cardiac deaths with aspirin after a coronary event. Multicenter Myocardial Ischemia Research Group. J Am Coll Cardiol 1996; 28:326-30. [PMID: 8800105 DOI: 10.1016/0735-1097(96)00150-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES We sought to assess the role of aspirin in a precisely defined cohort with coronary disease receiving current therapy. BACKGROUND Prior results suggest that aspirin modestly decreases cardiac mortality in patients with coronary disease. However, these findings reflect heterogeneous study conditions and earlier management strategies. METHODS We utilized findings from the Multicenter Study of Myocardial Ischemia, which enrolled 936 subjects 1 to 6 months after an acute myocardial infarction (n = 651 [70%]) or unstable angina (n = 285 [30%]). The follow-up period averaged 23 months, with treatment determined by referring physicians. RESULTS At enrollment, 751 patients (80%) took aspirin regularly, usually 250 to 325 mg/day. Before enrollment, 291 patients (31%) had thrombolysis, and 352 (38%) had coronary angioplasty. During follow-up, cardiac death occurred in 22 patients, all-cause mortality in 31 and cardiac death or nonfatal myocardial infarction in 70. Each of these outcomes was significantly less frequent among aspirin users. Cardiac death rate was markedly reduced: 1.6% for aspirin users and 5.4% for nonusers (p = 0.005). These differences were not explained by imbalances in predictors of postinfarction risk or therapy other than aspirin (Cox hazard ratio 0.37, p = 0.023). They persisted at least 2 years after enrollment. The difference in mortality rate was particularly prominent after thrombolysis: 0.9% for aspirin users and 8.8% for nonusers (p = 0.004). CONCLUSIONS Reduction in cardiac deaths among aspirin users is substantially greater than that reported previously. Although derived secondarily, our findings suggest that current practice leads to situations in which aspirin exerts a long-term, life-protecting action, particularly after thrombolysis.
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Affiliation(s)
- R E Goldstein
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799, USA
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