We present a Monte Carlo (MC) method to determine depth-dependent probability distributions of photon visitation and detection for optical reflectance measurements performed in the spatial frequency domain (SFD). These distributions are formed using an MC simulation for radiative transport that utilizes a photon packet weighting procedure consistent with the two-dimensional spatial Fourier transform of the radiative transport equation. This method enables the development of quantitative metrics for SFD optical sampling depth in layered tissue and its dependence on both tissue optical properties and spatial frequency. We validate the computed depth-dependent probability distributions using SFD measurements in a layered phantom system with a highly scattering top layer of variable thickness supported by a highly absorbing base layer. We utilize our method to establish the spatial frequency-dependent optical sampling depth for a number of tissue types and also provide a general tool to determine such depths for tissues of arbitrary optical properties.

The use of thermal ink-jet spray freeze-drying (TIJ-SFD) to engineer inhalable, excipient-free salbutamol sulphate (SS) particles was assessed. A modified Hewlett-Packard printer was used to atomise aqueous SS solutions into liquid nitrogen. The frozen droplets were freeze-dried. It was found that TIJ-SFD could process SS solutions up to 15%w/v; the porous particles produced had a physical diameter of ca. 35 μm. Next generation impactor (NGI) analysis indicated that the particles had a smaller aerodynamic size (MMAD ranging from 6 to 8.7 μm). Particles prepared from the lowest concentration SS solution were too fragile to withstand aerosolisation, but the 5%w/v solution yielded particles having the best combination of strength and aerodynamic properties. Comparison with a commercial SS formulation (Cyclocap®) showed that the SFD preparation had an almost equivalent FPF (6.4 μm) when analysed with a twin-stage impinger (TSI; 24.0 ± 1.2% and 26.4 ± 2.2%, respectively) and good performance when analysed with NGI (FPF (4.46 μm):16.5 ± 2.0 and 27.7 ± 1.7, respectively). TIJ-SFD appears to be an excellent method to prepare inhalable particles. It is scalable yet allows assessment of the viability of the pulmonary route early in the development since it can be used with very small volumes (<0.5 mL) of solution.

Twenty-one children aged between five and nine years who were small for gestational age (SFD) at birth and whose intra-uterine head growth was shown by ultrasonography to be slowing before 35 weeks were observed in a special room, using video-cameras. Their behaviour was compared with that of 21 matched control children who had had normal birthweight. The children in the SFD group were quieter, more compliant and less active than the control group, and their play behaviour suggested that they were less advanced developmentally. The behaviour of the mothers of the SFD group showed that they were aware of their child's problems and tried to compensate for it by teaching the child while they were waiting for the observational session to start, by sitting closer to the child during a drawing test, and by using more words to explain it.

The objective of this observational study was to compare the efficacy of levetiracetam and topiramate during the first 15 days of add-on treatment in adults with refractory partial epilepsy. Two cohorts of patients with>> or =3 simple or complex partial seizures with or without secondary generalisation per month over an 8-week baseline period received levetiracetam or topiramate in two distinct phases, in addition to standard antiepileptic treatment. During the first 15 days of the therapy, levetiracetam was added at the dosage of 250 mg b.i.d. or topiramate at 25mg o.i.d. Efficacy parameters included number of seizure-free days (SFDs), mean and percent reduction in seizure frequency (in general and by type), and number of seizure-free patients in the first 15 days of treatment compared to last 15 days of the baseline period. Sixty-one patients received levetiracetam and 61 topiramate. The general characteristics of the two treatment groups were similar. The total number of SFDs during 15 days before treatment was 637 with levetiracetam and 621 with topiramate; in the 15-day evaluation period the SFDs increased to 748 (17.4%) and 668 (7.6%), respectively (ANOVA, p<0.05). Twenty-six patients (42.6%) taking levetiracetam were seizure free compared to 10 (16.4%) receiving topiramate (chi-square, p=0.003). This open-label non-controlled study suggests an early efficacy of levetiracetam as add-on therapy in patients with refractory partial epilepsy: these results appear to confirm previous indications of a rapid onset of action and seem to suggest first evaluation of the patient at the dose of 500 mg/day before increasing to the considered minimum standard dose of 1000 mg/day, as some patients could respond to the starting dose.

The concentration of soluble fibrinogen derivatives (SFD) and protease and procoagulant activities were determined in cell-free supernatants of equine respiratory secretions obtained from horses with chronic pulmonary disease. The concentration of neutrophils was estimated from direct smears of the secretions. Lung specimens and smears of the secretions were evaluated for the presence of fibrin or fibrinogen by use of immunohistochemical methods. Thirty-five of 80 specimens tested contained SFD. Respiratory secretions from horses with moderate or severe chronic pulmonary disease contained SFD more frequently than did secretions from mildly affected horses (P less than 0.05). Respiratory secretions with vast numbers of neutrophils had significantly (P less than 0.05) higher SFD concentrations than respiratory secretions with fewer neutrophils. Protease and procoagulant activities in respiratory secretion specimens were positively correlated with neutrophil content, clinical diagnosis, and SFD concentration. Immunohistochemically, macrophages that stained for fibrin or fibrinogen were observed in direct smears of respiratory secretions from horses with moderate and severe chronic small airway disease, but not in smears from mildly affected horses. Fibrin or fibrinogen was detected in a few thickened alveolar septa from 10 horses with moderate or severe chronic small airway disease, but not in lungs from horses with mild or no evidence of chronic small airway disease. Fibrin or fibrinogen was detected in alveolar septa, granulomas, and on alveolar macrophages in lungs of all horses with chronic granulomatous and chronic bronchointerstitial pneumonia. The presence of SFD in equine respiratory secretions may be an indicator of pulmonary inflammation.

The magnetization reversal process of an ordered Co nanorod array is shown using the images obtained from successive in-field magnetic force microscope (MFM) measurements. The magnetization reversal model is discussed according to local and whole magnetization reversal properties measured by the polar magneto-optical Kerr effect (PMOKE) and an alternating gradient magnetometer (AGM), respectively. Additionally, the dipolar field was probed using in-field MFM measurements. By removing the effect of the dipolar field, an intrinsic switching field distribution (SFD) is shown in a map with a hexagonal array. A detailed study of the dipolar field in ordered nanorod arrays with various diameters and pitches was carried out by numerical calculations.

BACKGROUND

Sorsby's fundus dystrophy (SFD) is caused by mutations in tissue inhibitor of metalloproteinase (TIMP)-3 and, with the exception of early onset, is similar to age-related macular degeneration. The pathological features of this condition relate to the accumulation of TIMP-3 in Bruch's membrane.

OBJECTIVE

To compare the extracellular membrane-binding characteristics of wild-type and four SFD-mutant TIMP-3s.

METHODS

COS-7 cells were transfected with wild-type, Ser-181, Gly-167, Ser-156 and Tyr-168 SFD-mutant TIMP-3 cDNA. The TIMP-3 proteins subsequently synthesised were harvested, analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, semiquantified by ELISA and used in binding assays on the basis of the retention of the wild-type and SFD-mutant TIMP-3 proteins by components of Bruch's membrane.

RESULTS

SFD-mutant TIMP-3s could not be distinguished from wild-type TIMP-3 by the extents to which they aggregated or adhered to type-I collagen, type-IV collagen, fibronectin, laminin, elastin, chondroitin sulphates A, B and C, and heparin sulphate. Of these macromolecules, the wild-type and SFD-mutant TIMP-3s exhibited greatest affinity for elastin and laminin.

CONCLUSIONS

The similarity in the physical and extracellular membrane-binding characteristics of wild-type and SFD-mutant TIMP-3s indicates that these properties are not responsible for the difference in timing of onset of SFD and age-related macular degeneration.

Maturation of neonatal glomerular function as evidenced by serum creatinine and creatinine clearance was assessed in 15 preterm small for dates infants (Group I) and compared with values obtained in 15 preterm appropriate for date babies (Group II), on 3rd, 7th and 14th postnatal days. The mean gestational ages were 34.2 and 32.5 weeks and birth weights 1436 +/- 302g and 1752 +/- 422 g, respectively. The mean serum creatinine values in Group I were 1.40 +/- 0.28, 1.18 +/- 0.22 and 0.92 +/- 0.11 mg/dl and for Group II, 1.22 +/- 0.22, 1.01 +/- 0.24 and 0.82 +/- 0.17 mg/dl on days 3, 7 and 14, respectively. Glomerular filtration rates as evidenced by creatinine clearance were 16.08 +/- 3.53, 21.25 +/- 4.79 and 36.96 +/- 6.44 ml/min/1.73 m2 for Group I as compared to 21.38 +/- 6.65, 35.96 +/- 11.47 and 57.61 +/- 21.61 ml/min/1.73 m2 for Group II on these days, showing statistically significant (p < 0.001) increase in renal function in both the groups from days 3 to 14. Even though the serum creatinine values in the two groups were comparable at identical postnatal ages, creatinine clearance was shown to be statistically less (p < 0.05 on day 3, p < 0.001 on day 7 and p < 0.01 on day 14, respectively) in Group I as compared to Group II, thereby implying slower renal maturation in small for dates preterm babies.

The effects of short-term oral administration of red wine polyphenolic compounds (RWPCs) on blood pressure and vascular reactivity were investigated in rats. The consequence of RWPCs treatment on agonist-induced contractility of rat aorta with respect to Ca2+ handling was assessed, by examining both intracellular Ca2+ store and extracellular Ca2+ influx components of the response. Rats were treated daily for 7 days by intragastric administration of either 5% glucose, or RWPCs (20 mg/kg) [from two different sources, i.e. Provinols (SFD, Vallont Pont d'Arc, France) and RWPC1 (INRA, Montpellier, France)]. Administration of these compounds produced a decrease in systolic blood pressure. The consequence of RWPCs treatment on vascular smooth muscle was investigated in rat aorta without endothelium exposed to noradrenaline. In Ca(2+)-free medium, RWPC1 but not Provinols treatment induced an increase in noradrenaline-induced contraction. After depletion of intracellular Ca2+ stores by noradrenaline in Ca(2+)-free medium, addition of CaCl2 in the continuous presence of agonist induced an increase in contraction, which was not significantly different between control, Provinols- and RWPC-treated rats. The presence of an inhibitor of sarcoplasmic reticulum Ca(2+)-ATPase, thapsigargin, significantly reduced noradrenaline-induced contraction in Ca(2+)-free medium in RWPCs-treated aorta, as compared to that of control. Interestingly, the inhibitory effect of thapsigargin on the response linked to the release of Ca2+ from internal stores in RWPCs-treated vessels was completely prevented in the presence of NO-synthase inhibitor, L-nitro arginine methyl ester, the inhibitor of guanylyl cyclase, oxadiazolo-quinoxaline or the protein kinase G inhibitor, 8-Bromoguanosine-3'-5-cyclic mono-phosphorothioate, Rp isomer. These results suggest that short-term administration of RWPCs in rats induced subtle alteration of thapsigargin-sensitive component of agonist-induced contraction in rat aorta linked to Ca2+ release from intracellular store. Calcium release from intracellular stores sensitive to thapsigargin was implicated in this mechanism. The prevention of the inhibitory effect of thapsigargin by the inhibitors of NO/cyclic guanosine monophosphate pathway after RWPCs treatment highlights the role of NO in this phenomenon.

Obesity and oral estrogens are independent risk factors for venous thrombosis, and their combined effect is stronger than the sum of the isolated factors. It was the objective of this study to investigate the interaction between obesity and estrogens at the level of venous thrombotic tendency, coagulation and inflammation in a mouse model. Female C57Bl/6J mice were fed a standard fat diet (SFD) or a high fat diet (HFD) to induce nutritional obesity. After 14 weeks, while maintaining their diet, mice were orally treated eight days with 1 microg ethinylestradiol or vehicle (n=25 per group), and subsequently subjected to an inferior caval vein (ICV) thrombosis model. The ICV thrombosis model resulted in an increased thrombus weight in vehicle-treated HFD mice (3.0 +/- 0.7 mg) compared to vehicle-treated SFD mice (1.4 +/- 0.4 mg; p=0.064). Surprisingly, estrogens reduced thrombus weight, which was significant for the HFD group (0.8 +/- 0.5 mg; p=0.013). As compared to SFD feeding, HFD feeding significantly increased plasma levels of coagulation factor VIII, combined factor II/VII/X (p < 0.001), and plasminogen activator inhibitor-1 (p=0.009), causing a prothrombotic shift of the coagulation profile. Estrogens had no significant effects on this profile with either diet, whereas serum amyloid A and hepatic inflammatory cytokines were minimally affected. The synergistic effect of obesity and estrogens on the venous thrombotic risk in women could not be translated into the mouse context. Short-term ethinylestradiol administration in a mouse ICV thrombosis model counteracts the prothrombotic phenotype associated with nutritionally induced obesity, despite a comparable activated plasma coagulation profile in estrogen-treated and untreated obese mice.

[Purpose] The aim of the present study was to investigate the possibility of an interaction between stretching induced deficit (SFD) and bilateral deficits (BLD) during maximal voluntary isometric hand flexion under PNF stretch and no-stretch conditions through measurement of EMG and force production. [Subjects and Methods] Ten physically active male Caucasian students (age, 24.1±2.38 years; body mass, 79.48±11.40 kg; height, 174.15±0.8 cm) volunteered to participate in this study. EMG and force measurements of the subjects were recorded during either unilateral or bilateral 3-second maximal voluntary isometric hand flexion (MVC) against a force transducer. The paired sample t-test was used to examine the significance of differences among several conditions. Pearson product-moment correlation was used to evaluate the associations between different parameters. [Results] Stretching-induced deficits correlated with bilateral deficits in both force (r=0.85) and iEMG (r=0.89). PNF stretching caused significant decrements in the bilateral and unilateral conditions for both the right and left sides. [Conclusion] Since both force and iEMG decreases were observed in most measurements; it suggests there is a neural mechanism behinnd both the BLD and the SFD.

The primary aim of this study was to investigate facial emotion recognition (FER) in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and 20 healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of FER and the 26-item Toronto Alexithymia Scale. Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistics. This suggests that the deficit in FER observed in the patients with SFD was most likely a consequence of concurrent alexithymia. It should be noted that neither depression nor anxiety was significantly related to emotion recognition accuracy, suggesting that these variables did not contribute the emotion recognition deficit. Impaired FER observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning.

The purpose of this study was to evaluate the level and quality of psychosocial disabilities in patients suffering from somatoform disorders (SFD). Of 221 patients referred for psychiatric and cognitive-behavioral inpatient treatment, 37 were diagnosed according to DSM-IV as having SFD, 56 as pain disorder, 70 met the criteria for the subsyndromal form of SFD called the "Somatic Symptom Index" (SSI). The control group consisted of 58 patients with other mental disorders. All patients completed the Dysfunctional Analysis Questionnaire (DAQ) which measures social, vocational, personal, familial, and cognitive disabilities on psychometric scales. The results showed substantial disabilities in all somatoform subgroups; however, the levels and patterns of dysfunction in these patients were not statistically different from those in the control group. Impairment was generally more severe when patients had a comorbidity of somatoform and affective disorders. It is concluded that SFDs are associated with marked psychosocial disabilities similar to those seen in other mental disorders. The strongest predictor for psychosocial dysfunction is the comorbidity of somatoform with affective disorders, but not with anxiety disorders.

BACKGROUND

Generalized Anxiety Disorder (GAD) is a common chronic disease with a lifetime prevalence estimated to range from 4.2% to 12.7%. GAD places a substantial burden upon patients and healthcare resources.

OBJECTIVE

To determine the cost-effectiveness of escitalopram for GAD in a Canadian primary care setting from two perspectives [Ministry of Health (MoH) and society (SOC)].

METHODS

A 24-week decision-analytic model was constructed using Data/TreeAge software. Patients were treated with escitalopram or generic paroxetine. Clinical rates were determined from the literature; expert opinion guided model pathway development. Effectiveness was measured as 'symptom-free days' (SFDs). Analyses from MoH perspective focused on direct costs of treatment (drugs, physician visits), while SOC also accounted for indirect costs associated with workdays lost due to GAD. Unit costs of healthcare services and wage rates were obtained from standard Canadian sources (2005 Canadian $ values). Cost-effectiveness was expressed as the incremental cost-effectiveness ratio (ICER). Extensive one-way and probabilistic sensitivity analyses were conducted.

RESULTS

Escitalopram was associated with higher expected number of SFDs than paroxetine (86.4 vs. 77.0 SFD, respectively). From the MoH perspective, expected costs were Can$724 and Can$663 for escitalopram and paroxetine arms, respectively, resulting in the ICER for escitalopram vs. paroxetine of Can$6.56/SFD (Can$2362/symptom free year). From the SOC perspective, escitalopram dominated paroxetine as more effective on SFDs and less costly. Sensitivity analyses demonstrated robustness of the model. Limitations include the absence of comorbidities, which are common in practice, lack of long-term data, and assuming that dropouts in trials reflect those in practice.

CONCLUSIONS

Escitalopram was found to be cost-effective compared with paroxetine in treatment of GAD from the Canadian MoH perspective, and dominating paroxetine from the SOC perspective. Therefore, a possible advantage may exist at the population level in the treatment of GAD with escitalopram in Canada.

OBJECTIVE

The efficacy of treatments for generalized anxiety disorder has usually been measured in terms of response or remission of symptoms. These endpoints, however, may not adequately capture the transient periods of symptom abatement and relapse characteristic of chronic psychiatric disorders. Here, we evaluate the measurement of treatment effectiveness in terms of the number of symptom-free days (SFDs).

METHODS

A pooled analysis was performed of data from five manufacturer-initiated trials of venlafaxine extended-release (XR) in patients with generalized anxiety disorder without co-morbid major depressive disorder. The trials were randomized, double-blind, placebo-controlled and of 8 weeks duration (total intent-to-treat population 1295 venlafaxine XR, 544 placebo). Two of the studies had extensions up to 6 months (intent-to-treat population 514 venlafaxine XR, 253 placebo). The patients were>>or= 18 years of age with a Hamilton Rating Scale for Anxiety (HAM-A) score of>>or= 18.

METHODS

<em>SFDs</em> were estimated using weekly scores on the HAM-A. Values of 7 and 0 <em>SFDs</em>, respectively, were assigned to each week the patient had a HAM-A score of <or= 7 (the remission threshold) and>>or= 18 (the minimum threshold for anxiety). Fractional SFD values were assigned proportionately to weekly HAM-A scores between 7 and 18.

RESULTS

The median (inter-quartile range) SFDs were 19 (2-36) for venlafaxine XR and 10 (0-27) for placebo in the 8-week studies (p < 0.0001). In the 6-month extension studies the SFDs were 102 (27-139) for venlafaxine XR and 36 (0-94) for placebo (p < 0.0001).

CONCLUSIONS

SFDs differentiate between active treatment and placebo in clinical trials and may be an appropriate measure of treatment effectiveness.

Spatial Frequency Domain Spectroscopy (SFDS) is a technique for quantifying in-vivo tissue optical properties. SFDS employs structured light patterns that are projected onto tissues using a spatial light modulator, such as a digital micromirror device. In combination with appropriate models of light propagation, this technique can be used to quantify tissue optical properties (absorption, μa, and scattering, μs', coefficients) and chromophore concentrations. Here we present a handheld implementation of an SFDS device that employs line (one dimensional) imaging. This instrument can measure 1088 spatial locations that span a 3 cm line as opposed to our original benchtop SFDS system that only collects a single 1 mm diameter spot. This imager, however, retains the spectral resolution (∼1 nm) and range (450-1000 nm) of our original benchtop SFDS device. In the context of homogeneous turbid media, we demonstrate that this new system matches the spectral response of our original system to within 1% across a typical range of spatial frequencies (0-0.35 mm-1). With the new form factor, the device has tremendously improved mobility and portability, allowing for greater ease of use in a clinical setting. A smaller size also enables access to different tissue locations, which increases the flexibility of the device. The design of this portable system not only enables SFDS to be used in clinical settings but also enables visualization of properties of layered tissues such as skin.

This study reports on detection of a large number of biological and anthropogenic pollutants using LC-MS/MS and GC-MS technologies in settled floor dust (SFD). The latter technique was applied to obtain a general picture on the presence of microbial as well as non-microbial volatile organic compounds, whereas the targeted LC-MS/MS analysis focused on identification of species specific secondary metabolites. In the absence of moisture monitoring data the relevance of finding of stachybotrylactam and other metabolites of tertiary colonizers are confined only to accidental direct exposure to SFD. To the best of our knowledge 30 of the 71 identified volatile organic compounds (VOCs) are newly reported in SFD matrix. Coordinated application of "AMDIS and Spectconnect" was found beneficial for the evaluation and identification of prime volatile pollutants in complex environmental samples. Principal component analysis (PCA) of peak areas of 18 microbial volatile organic compounds (MVOCs) resulted in identification of nonanal as potential MVOC marker. Two more volatiles toluene and 1-tetradecanol though had discriminative influence, are not regarded as MVOC markers, considering their probable alternate origin from paints and cosmetics, respectively.

OBJECTIVE

The purpose of this study was to develop inhalable particles that can reach deep into the lungs efficiently independent of inhalation patterns of patients and inhalation devices. We prepared porous particles including L-leucine (Leu), a dispersive agent, by a spray-freeze-drying (SFD) method and examined the influence of inspiratory flow patterns and inhalation devices with various inhalation resistances.

METHODS

Four types of SFD powder with different Leu contents (0-10%) were prepared. Scanning electron microscopy and laser diffraction were used to measure the morphology and size distribution of the powders. In-vitro inhalation characteristics were determined using a twin-stage liquid impinger equipped with an inspiratory flow pattern simulator. The effects of Leu on the adhesion force and electrostatic property of the particles were evaluated.

RESULTS

The inhalation performance of the powders was improved by the addition of Leu. The powders with Leu showed a high inhalation performance regardless of inspiratory flow patterns and devices. The addition of Leu decreased the adhesion force and increased the surface potential of the powders.

CONCLUSIONS

The SFD particles with Leu showed high inhalation performance regardless of the inhalation patterns and devices, which was attributed to the decreased adhesion force between particles and increased dispersibility.

BACKGROUND

Conformal stereotactic radiosurgery and radiotherapy with linear accelerators and hole collimators yield a dose concentration in the target volume by rotation of the gantry. For small target volumes collimators with isocentre diameters of 4-45 mm are used. In this paper dosimetric measurements with a commercial high doped p-type silicon detector are demonstrated and compared to measurements with diamond detector and ionisation chamber.

METHODS

The properties of the silicon detector SFD from Scanditronix were investigated with the radiation of a Gammatron S and a Varian 2100 CD at 6 MV. The results were compared with those of a calibrated ionisation chamber (0.3 cm3) and a diamond detector.

RESULTS

At the beginning the reproductibility of the registered dose and dose rate and the temperature dependence of the Si-detector were investigated at the Gammatron S. For the comparison the absorbed dose was measured with the ionisation chamber in air. The sensitivity decreases slightly with dose and dose rate. After a period of several days without radiation again higher doses were registered. The temperature dependence causes deviations of 0.25%/K. The signal-to-noise ratio and the spatial resolution were investigated with the linear accelerator. The signal-to-noise ratio is clearly lower compared with that of the diamond detector, whereas the resolution is nearly the same.

CONCLUSIONS

The Si-detector is qualified for dosimetry of very small fields because of the insignificant dose and dose rate dependence and in spite of some disadvantages regarding dosimetric properties compared with the diamond detector. The advantage is the availability and the cost. Measurement with ionisation chambers are not useful for collimator diameters below 20 mm.

The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas and identifies maternal and fetal risk factors associated with ECS. We included 2,748 low-risk women and 8.7% had ECS. Failure-to-progress (FTP) accounted for 68.3% of the ECS and 30.4% were performed due to suspected fetal distress (SFD). Multivariate logistic regression analyses were done to estimate the association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1.26-3.20) were associated with increased risk of ECS due to FTP.

BACKGROUND

The National French federation of comprehensive cancer centres (FNCLCC) and the French society of dermatology (SFD) initiated together the update of clinical practice guideline for the management of patients with cutaneous melanoma in collaboration with the French national cancer institute and with specialists from French public universities, general hospitals and private clinics. This work is based on the methodology developed in the "Standards, Options and Recommendations" (SOR) project.

OBJECTIVE

To update SOR guidelines for the management of patients with cutaneous melanoma previously validated in 1998 and French melanoma consensus conference published by SFD and ANAES in 1995.

METHODS

The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts who define the CPGs according to the definitions of the Standards, Options and Recommendations project. Once the guidelines have been developed, they are reviewed by independent reviewers.

RESULTS

This article is a summary version of the updated clinical practice guidelines with algorithms. The main questions addressed by the expert group in this update concerned (1) The new AJCC-UICC classification (2) Excision margins (3) Sentinel node biopsy (4) Adjuvant treatments (5) Initial staging and follow up of operated patients.

Pathological conditions are bound to affect the molecules on erythrocytes, and accordingly affect their functions. Chondroitin sulphate/dermatan sulphate (CS/DS), one of the classes of molecules found to be expressed in erythrocytes was previously observed by us to be either overexpressed in diabetic condition or undergo structural changes in hypercholesterolemic condition. Both of them had implications on their binding to extracellular matrix components (ECM). In the present work, we have explored the quantitative changes in erythrocyte glycosaminoglycans (GAGs) and their role in erythrocyte binding towards ECM components in the combined milieu of both diabetes and hypercholesterolemia (SFHD). Membrane cholesterol was significantly higher in SFHD group compared to control (SFC) and diabetic groups (SFD). Interestingly, there were no quantitative changes in CS/DS compared to SFC erythrocytes, but showed significantly increased cytoadherence to selected ECM components to various extents. Binding was partly dependent on CS/DS as digesting the chains resulted in relatively decreased cytoadherence. It also showed significantly increased binding to chondroitin sulphate and heparan sulphate. Thus, combined milieu of high glucose and high cholesterol can have more deleterious consequences than either of them independently.

OBJECTIVE

Dual-process theories stress the importance of explicit as well as implicit cognitive processes for the development of somatoform disorders (SFDs).(1) In particular, the self-concept has been demonstrated to be a key factor in SFD. Yet, the self-concept in SFDs has been studied only on an explicit but not on an implicit level.

METHODS

The present study empirically examined the implicit health-related self-concept in SFDs by using the Implicit Association Test (IAT). Twenty-two patients with SFDs (according to DSM-IV) and 27 healthy control participants (CG) completed an IAT to assess associations of the self with illness- versus health-related words.

RESULTS

(a) Patients with an SFD associated themselves more with illness-related words than patients in the CG, (b) this implicit self-concept was connected to self-reported bodily weakness in the SFD group, and (c) both the explicit and implicit health-related self-concepts were significantly related to the number and severity of bodily symptoms. However, the implicit measure had no incremental predictive value for symptom reports over the explicit self-concept measure.

CONCLUSIONS

Due to the small sample size and the failure to match the SFD group and CG on education, further confirming evidence including other clinical control groups is needed.

CONCLUSIONS

These findings are consistent with existing dual-process models of SFDs and could be of clinical relevance as they bring into focus implicit cognitive processes that may be targeted more directly for an effective treatment of SFDs.