Video-assisted thoracoscopic surgery as a primary intervention in pediatric parapneumonic effusion and empyema.

The use and effectiveness of video-assisted thoracoscopic surgery (VATS) for the treatment of empyema and complex parapneumonic collections in pediatric patients is well documented. Timing of this intervention still remains controversial. We reviewed our experience with VATS to determine if it should be used as the initial procedure in children with pleural collections.

Standardization of surgical and pathologic variables is needed in multicenter trials of adjuvant therapy for pancreatic cancer: results from the ACOSOG Z5031 trial.

Background: Standardization of surgical and pathologic techniques is crucial to the interpretation of studies evaluating adjuvant therapies for pancreatic cancer (PC).

Methods: To assess the degree to which treatment administered prior to enrollment of patients in trials of adjuvant therapy is quality controlled, the operative and pathology reports of patients in American College of Surgeons Oncology Group (ACOSOG) Z5031-a national trial of chemoradiation following pancreaticoduodenectomy (PD)-were rigorously evaluated. We analyzed variables with the potential to influence staging or outcome.

Visuomotor binding in older adults.

Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in older adults. Although the decline should lead to reduced action integration in older adults, we found equivalent integration in both young and older adults.

Cognitive Sparing during the Administration of Whole Brain Radiotherapy and Prophylactic Cranial Irradiation: Current Concepts and Approaches.

Whole brain radiotherapy (WBRT) for the palliation of metastases, or as prophylaxis to prevent intracranial metastases, can be associated with subacute and late decline in memory and other cognitive functions. Moreover, these changes are often increased in both frequency and severity when cranial irradiation is combined with the use of systemic or intrathecal chemotherapy. Approaches to preventing or reducing this toxicity include the use of stereotactic radiosurgery (SRS) instead of WBRT; dose reduction for PCI; exclusion of the limbic circuit, hippocampal formation, and/or neural stem cell regions of the brain during radiotherapy; avoidance of intrathecal and/or systemic chemotherapy during radiotherapy; the use of high-dose, systemic chemotherapy in lieu of WBRT.

Multicenter phase II trial of adjuvant therapy for resected pancreatic cancer using cisplatin, 5-fluorouracil, and interferon-alfa-2b-based chemoradiation: ACOSOG Trial Z05031.

Background: The American College of Surgeons Oncology Group sought to confirm the efficacy of a novel interferon-based chemoradiation regimen in a multicenter phase II trial.

Patients And Methods: Patients with resected (R0/R1) adenocarcinoma of the pancreatic head were treated with adjuvant interferon-alfa-2b (3 million units s.c.

Contextual errors and failures in individualizing patient care: a multicenter study.

Background: A contextual error occurs when a physician overlooks elements of a patient's environment or behavior that are essential to planning appropriate care. In contrast to biomedical errors, which are not patient-specific, contextual errors represent a failure to individualize care.

Objective: To explore the frequency and circumstances under which physicians probe contextual and biomedical red flags and avoid treatment error by incorporating what they learn from these probes.

Endogenous orienting is reduced during the attentional blink.

We studied endogenous cuing during the attentional blink in order to examine its resistance to dual task interference. In two experiments, we found a reduced impact of endogenous cuing during the "blink" time of the attentional blink. In a third experiment endogenous cuing was intact when it was not influenced by demands imposed by an earlier target.

Isoluminant motion onset captures attention.

In their 2003 article, Abrams and Christ found that the onset of motion captured attention more effectively than either the offset of motion or continuous motion. Abrams and Christ conceptualized the capture to be occurring at a level higher than does detection of luminance changes in the stimulus. To examine this claim, in the present experiments we replicated their critical experiment but used isoluminant stimuli, which do not produce the low-level luminance transients typically associated with motion.

When meaning matters, look but don't touch: the effects of posture on reading.

Much of the reading that we do occurs near our hands. Previous research has revealed that spatial processing is enhanced near the hands, potentially benefiting several processes involved in reading; however, it is unknown whether semantic processing--another critical aspect of reading--is affected near the hands. While holding their hands either near to or far from a visual display, our subjects performed two tasks that drew on semantic processing: evaluation of the sensibleness of sentences, and the Stroop color-word interference task.

Indolent infectious tenosynovitis afflicting rheumatoid patients treated with tumor necrosis factor inhibitors: case report.

Tumor necrosis factor (TNF) is a cytokine associated with the pathogenesis of rheumatoid arthritis. Tumor necrosis factor inhibitors have become important biological treatments that favorably alter the natural history of rheumatoid disease. Side effects include an increased risk of malignancy and infection, particularly tuberculosis.

Dysregulation of promyelocytic leukemia (PML) protein expression in preeclamptic placentae.

Promyelocytic leukemia (PML) protein is a nucleoprotein that can regulate a variety of cellular stress responses. The aim of this study was to determine qualitative and quantitative changes in PML expression in preeclamptic placentae. Immunoblot, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and immunohistochemistry techniques were used to determine PML gene expression and localization in normal (n = 6) and preeclamptic (n = 6) placentae and primary cells.

Simultaneous dorsal dislocations of the carpometacarpal joints of all four fingers.

A 57-year-old right-hand-dominant woman was involved in a motor vehicle collision. Upon examination, her right hand was markedly deformed and swollen, with limited range of movement. Plain radiographs revealed dorsal dislocations of the index, long, ring, and small finger carpometacarpal joints and an avulsion fracture of the dorsal aspect of the capitate.

Differential methylation of cell-free circulating DNA among patients with pancreatic cancer versus chronic pancreatitis.

Background: : Although patients with chronic pancreatitis (CP) have an increased risk of pancreatic cancer (PanCa), the timely detection of PanCa often is difficult, because the symptoms of CP and PanCa are very similar. Moreover, secondary inflammation may be identified in PanCa, further complicating diagnosis. To improve the survival of patients with PanCa, a reliable test to differentiate CP from PanCa is needed.

Intracranial metastatic disease spares the limbic circuit: a review of 697 metastatic lesions in 107 patients.

Purpose: We report the incidence of metastatic involvement of the limbic circuit in a retrospective review of patients treated at our institution. This review was performed to assess the feasibility of selectively sparing the limbic system during whole-brain radiotherapy and prophylactic cranial irradiation.

Methods And Materials: We identified 697 intracranial metastases in 107 patients after reviewing contrast-enhanced CT and/or MR image sets for each patient.

Visual field asymmetry in attentional capture.

The present study examined the spatial distribution of involuntary attentional capture over the two visual hemi-fields. A new experiment, and an analysis of three previous experiments showed that distractors in the left visual field that matched a sought-for target in color produced a much larger capture effect than identical distractors in the right visual field, revealing a visual field asymmetry in color-based contingent capture. On the other hand, abrupt onsets in the two hemi-fields did not differ in the magnitude of their capture effect, indicating a symmetric distribution of onset capture.

Immunologic recovery following autologous stem-cell transplantation with pre- and posttransplantation rituximab for low-grade or mantle cell lymphoma.

Background: Rituximab may improve transplant outcomes but may delay immunologic recovery.

Patients And Methods: Seventy-seven patients with low-grade or mantle cell lymphoma received autologous stem-cell transplantation (ASCT) on a phase II study. Rituximab 375 mg/m(2) was administered 3 days before mobilization-dose cyclophosphamide, then weekly for four doses after count recovery from ASCT.

Evaluation of four volume-based image registration algorithms.

We evaluated 4 volume-based automatic image registration algorithms from 2 commercially available treatment planning systems (Philips Syntegra and BrainScan). The algorithms based on cross correlation (CC), local correlation (LC), normalized mutual information (NMI), and BrainScan mutual information (BSMI) were evaluated with: (1) the synthetic computed tomography (CT) images, (2) the CT and magnetic resonance (MR) phantom images, and (3) the CT and MR head image pairs from 12 patients with brain tumors. For the synthetic images, the registration results were compared with known transformation parameters, and all algorithms achieved accuracy of submillimeter in translation and subdegree in rotation.

Variation in post-surgical lumpectomy cavity volume with delay in initiation of breast irradiation because of chemotherapy.

Purpose: The addition of a radiotherapy boost has been shown to improve local control in breast conservation therapy. Three dimensional planning provides more accurate targeting of the operative bed than clinical setup using the lumpectomy scar. However, contraction of the lumpectomy cavity over time may have implications for the volume of tissue included in the boost field.

Ultrasound guidance versus electrical stimulation for infraclavicular brachial plexus perineural catheter insertion.

Objective: Electrical stimulation (ES)- and ultrasound-guided placement techniques have been described for infraclavicular brachial plexus perineural catheters but to our knowledge have never been previously compared in a randomized fashion, leaving the optimal method undetermined. We tested the hypothesis that infraclavicular catheters placed via ultrasound guidance alone require less time for placement and produce equivalent results compared with catheters placed solely via ES.

Methods: Preoperatively, patients receiving an infraclavicular perineural catheter for distal upper extremity surgery were randomly assigned to either ES with a stimulating catheter or ultrasound guidance with a nonstimulating catheter.

Application of holographic display in radiotherapy treatment planning II: a multi-institutional study.

We hypothesized that use of a true 3D display providing easy visualization of patient anatomy and dose distribution would lead to the production of better quality radiation therapy treatment plans. We report on a randomized prospective multi-institutional study to evaluate a novel 3D display for treatment planning.The Perspecta Spatial 3D System produces 360 degrees holograms by projecting crosssectional images on a diffuser screen rotating at 900 rpm.

Ultrasound-guided perineural catheter and local anesthetic infusion in the perioperative management of pediatric limb salvage: a case report.

Local anesthetic perineural infusion has emerged as an effective analgesic technique in pediatric patients, but it can also complement surgical perioperative management in complex cases that require optimal tissue perfusion such as limb salvage. We report the successful use of brachial plexus perineural infusion in the care of a child following near-amputation of her dominant hand. An ultrasound-guided infraclavicular brachial plexus catheter was placed in the recovery room after complex reconstructive surgery and a continuous infusion of 0.

Review and commentary on the role of radiation therapy in the adjuvant management of pancreatic cancer.

Currently, pancreatic cancer is fatal in over 90% of cases. Complete resection (if possible) is required for cure but the optimal adjuvant therapy is controversial. Given that pancreatic cancer frequently recurs both locoregionally and distantly, oncologic principles support the role of both adjuvant chemotherapy and radiotherapy.

Integrating top-down with bottom-up conservation policy in Africa.

Developed nations intervened in conservation policy across Africa during the 20th century to address needs to protect species and biodiversity that were based on their own perceptions and priorities. In the 21st century, conservationists in Africa have revised these perceptions and begun the process of identifying conservation priorities from an African perspective and in consideration of Africans' priorities. Although foreign conservation interveners struggled to identify mechanisms to which local people would respond, African conservationists are now demonstrating how to integrate the continent's unique socioeconomic circumstances into efforts to protect biodiversity.

Using movement and intentions to understand human activity.

During perception, people segment continuous activity into discrete events. They do so in part by monitoring changes in features of an ongoing activity. Characterizing these features is important for theories of event perception and may be helpful for designing information systems.