A profile of spatial abilities in people with Down syndrome.

Background: Spatial abilities are fundamental cognitive abilities, have direct applications in daily life, serve as a cognitive foundation for many other complex skills and are used in many specialty jobs. The current study aimed to systematically and comprehensively evaluate the spatial abilities of individuals with Down syndrome (DS) relative to mental ability-matched typically developing (TD) children based on Newcombe and Shipley's double-dimension theoretical framework for classifying spatial abilities.

Methods: Forty adolescents and young adults with DS and 40 TD children completed a nonverbal intelligence test (Raven's), two measures of static-extrinsic skills (water-level task and cart task), two measures of static-intrinsic skills (figure ground and form completion), two measures of dynamic-extrinsic skills (three mountains task and dog task) and two measures of dynamic-intrinsic spatial skills (mental rotation task and block design task).

A multi-centre prospective evaluation of internet research habits among owners seeing a veterinary oncologist.

The purpose of this study is to evaluate the internet-use among pet owners seeing a veterinary oncologist. Over a two-month period, 137 questionnaires were collected at three specialty hospitals around a large urban city. Approximately 85% of respondents reported using the internet to research their pet's condition and/or treatment.

Neoadjuvant Down-Sizing of Hilar Cholangiocarcinoma with Photodynamic Therapy--Long-Term Outcome of a Phase II Pilot Study.

Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0) recurrence can be as high as 70%. Photodynamic therapy (PDT) is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0) performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years) with initially non-resectable hilar CC.

Sirolimus Use in Liver Transplant Recipients With Hepatocellular Carcinoma: A Randomized, Multicenter, Open-Label Phase 3 Trial.

Background: We investigated whether sirolimus-based immunosuppression improves outcomes in liver transplantation (LTx) candidates with hepatocellular carcinoma (HCC).

Methods: In a prospective-randomized open-label international trial, 525 LTx recipients with HCC initially receiving mammalian target of rapamycin inhibitor-free immunosuppression were randomized 4 to 6 weeks after transplantation into a group on mammalian target of rapamycin inhibitor-free immunosuppression (group A: 264 patients) or a group incorporating sirolimus (group B: 261). The primary endpoint was recurrence-free survival (RFS); intention-to-treat (ITT) analysis was conducted after 8 years.

Long-term outcome of conversion to sirolimus monotherapy after liver transplant.

Objectives: This study sought to assess the long-term efficacy and safety of conversion from a calcineurin inhibitor-based immunosuppressive regimen to sirolimus monotherapy in liver transplant recipients with renal dysfunction.

Materials And Methods: Twenty-five liver transplant recipients with calcineurin inhibitor-based immunosuppression were included in this single-center, prospective study. Indications were renal dysfunction, avoidance of tumor recurrence, combination renal dysfunction and avoidance of tumor recurrence, and calcineurin inhibitor-related adverse effects.

On the interplay of waveguide modes and leaky modes in corrugated OLEDs.

Bragg gratings incorporated into organic light-emitting diodes (OLEDs) establish a coupling between waveguide modes and useful light (leaky modes). Here we demonstrate that the net coupling direction depends on the OLED stack design. We fabricated two different device structures with gold Bragg gratings.

[Pharmaceutical care in a visceral surgical ward].

Background: Medication errors and subsequent drug-related problems (DRPs) result from lack of sufficient information during the prescribing step. The objectives of this study were to evaluate the contribution of having a pharmacist participate in clinical routine on a surgical unit by studying DRPs, and the classification of DRPs in the Pharmaceutical Care Network Europe (PCNE) system.

Materials And Methods: The pharmacotherapy of all patients of a visceral surgical ward was evaluated by a pharmacist in a prospective study design over a six-month period.

Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients.

Background: The aim of this longitudinal study was to determine age- and sex-standardised prevalence rates of cancer-related fatigue in different groups of patients.

Methods: This was a prospective study in a cohort of N=1494 cancer patients investigating fatigue at three time points t1-t3 (t1: admission to hospital, t2: discharge, t3: half a year after t1). Fatigue was measured with the Multidimensional Fatigue Inventory.

Predictors of emotional distress in patients with head and neck cancer.

Background: Patients with head and neck cancer are known to be more commonly emotionally distressed than patients with other tumors. This study investigates reasons for this difference.

Methods: Patients in this prospective cohort study included those with head and neck cancer (n = 113) and those with other cancers (n = 1690).

[Psychiatric comorbidities in visceral surgery patients with cancer].

Background: Cancer patients with mental disorders suffer from a decreased quality of life (QoL) and are in need of appropriate treatment.

Methods: A total of 99 cancer patients were interviewed during surgical inpatient treatment with a structured clinical interview for diagnosis of mental disorders (SCID). The QoL and distress were examined prospectively using the validated questionnaires EORTC QLQ-C30 and HADS.

Kidney transplant from the same donor without maintenance immunosuppression after previous hematopoietic stem cell transplant.

In January 2005, an 18-year-old male patient with acute myeloid leukemia (AML) received a haploidentical hematopoietic stem cell transplantation (HSCT) from his father. He developed hemolytic uremic syndrome and end-stage renal disease (ESRD) requiring hemodialysis on day 357 after HSCT. On day 1020 after HSCT, a living kidney donation from the stem cell donor was carried out.

Improving the outcoupling efficiency of indium-tin-oxide-free organic light-emitting diodes via rough internal interfaces.

We present low-cost texturing methods to produce different surface roughnesses on glass substrates. Using sand blasting, abrasion and wet etching we achieve roughnesses of about 50 nm to 250 nm (root mean squared roughness Rq). These textured substrates are used as extraction elements for guided modes and substrate modes in organic light-emitting diodes (OLEDs).

Identifying tumor patients' depression.

Purpose: The aim of this study was to compare the precision of two different methods in detecting clinical depression in tumor patients: the use of a screening questionnaire versus the assessment by health care providers (nurses and doctors).

Methods: During their first days of inpatient cancer treatment, tumor patients were interviewed using the Structured Clinical Interview for DSM (SCID). Their physicians and nurses were asked to assess the mental health of the patients and their need for professional psychosocial support.

A prospective randomised, open-labeled, trial comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing liver transplantation for hepatocellular carcinoma.

Background: The potential anti-cancer effects of mammalian target of rapamycin (mTOR) inhibitors are being intensively studied. To date, however, few randomised clinical trials (RCT) have been performed to demonstrate anti-neoplastic effects in the pure oncology setting, and at present, no oncology endpoint-directed RCT has been reported in the high-malignancy risk population of immunosuppressed transplant recipients. Interestingly, since mTOR inhibitors have both immunosuppressive and anti-cancer effects, they have the potential to simultaneously protect against immunologic graft loss and tumour development.

A new vagal anchor electrode for real-time monitoring of the recurrent laryngeal nerve.

Background: Despite conventional neuromonitoring, the recurrent laryngeal nerve (RLN) is still at risk for damage during thyroid surgery. The feasibility of continuous RLN monitoring by vagal nerve (VN) stimulation with a new anchor electrode should be shown, and electromyographic signal alterations of stressed RLN were analyzed to be alerted to imminent nerve failure whereby the nerve damage becomes reversible.

Methods: VN stimulation was achieved in 23 pigs.

Anxiety and depression in cancer patients compared with the general population.

The objective of this study was to compare the prevalence of anxiety and depression in cancer patients with the prevalence found in the general population, using the Hospital Anxiety and Depression Scale (HADS). Participants were 1529 cancer patients treated between 2002 and 2004 in Germany and 2037 persons from the German general population. In the cancer patients, the risk of psychiatric distress was nearly twice that of the general population.

Successful liver transplantation in antituberculosis therapy-induced acute fulminant hepatic failure.

The antituberculosis drugs isoniazid, rifampin, and pyrazinamide expose patients to the risk of hepatotoxicity ranging from an asymptomatic increase in aminotransferase concentrations to fulminant hepatic failure. Herein, we report a case of acute fulminant hepatic failure that developed at 3 weeks after initiation of antituberculosis therapy (ATT) in a 31-year-old man with acute pulmonary tuberculosis in whom pretreatment liver function had been normal. The ATT regimen was changed to include less toxic substances, and an urgent orthotopic liver transplantation was performed successfully.

Impact of daclizumab, low-dose cyclosporine, mycophenolate mofetil and steroids on renal function after kidney transplantation.

Background: Early and long-term use of cyclosporine A (CsA) leads to increased risks of renal toxicity. We hypothesized that administration of daclizumab in combination with mycophenolate mofetil (MMF) allows a relevant reduction in the dose of CsA.

Methods: We carried out a 3-year, prospective, randomized, controlled clinical multi-centre trial in 156 patients.

Indocyanine green R15 ratio depends directly on liver perfusion flow rate.

Background: Indocyanine green (ICG) is a synthetic dye that is widely used to evaluate liver function in critically ill patients, before liver resection or after liver transplantation. Controversy still exists about the impact exerted on the ICG ratio after 15 min (ICG R15) by differences in liver perfusion rates, hyperdynamic states, or patient cardiac output. We studied the role of different liver perfusion rates on the ICG R15 ratio in a normothermic extracorporeal liver perfusion system under standardized conditions.

Serum peptidome profiling revealed platelet factor 4 as a potential discriminating Peptide associated with pancreatic cancer.

Purpose: Mass spectrometry-based serum peptidome profiling is a promising tool to identify novel disease-associated biomarkers, but is limited by preanalytic factors and the intricacies of complex data processing. Therefore, we investigated whether standardized sample protocols and new bioinformatic tools combined with external data validation improve the validity of peptidome profiling for the discovery of pancreatic cancer-associated serum markers.

Experimental Design: For the discovery study, two sets of sera from patients with pancreatic cancer (n = 40) and healthy controls (n = 40) were obtained from two different clinical centers.

A new anchor electrode design for continuous neuromonitoring of the recurrent laryngeal nerve by vagal nerve stimulations.

Purpose: Intraoperative neuromonitoring has the limitation that the recurrent laryngeal nerve (RLN) is still at risk for damage between two stimulations with a handheld bipolar stimulation electrode. The purpose of this study was to establish the vagal anchor electrode for real-time monitoring of the RLN in surgical routine and to be alerted to imminent nerve failure by electromyography (EMG) signal analysis whereby the nerve damage becomes reversible.

Patients And Methods: This fully implantable electrode has been used in addition to a conventional handheld bipolar stimulation electrode during thyroid surgery on 45 consecutive patients (78 nerves at risk) stratified to low- and high-risk groups.

Quality of care and emotional support from the inpatient cancer patient's perspective.

Background: Patient satisfaction and emotional support are crucial elements of cancer care. Little is known, however, about which areas of care are important from the patient's perspective and the roles emotional distress and support play in this context.

Methods: Multicenter prospective study was conducted (n = 396 cancer patients; t1 = after admission to hospital, t2 = before discharge).