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Background Proton pump inhibitors and laparoscopic anti-reflux surgery ( LARS) offer long-term symptom control to patients with gastro-oesophageal reflux disease ( GERD). Aim To evaluate the process of 'normalisation' of the squamous epithelium morphology of the distal oesophagus on these therapies. Methods In the LOTUS trial , 554 patients with chronic GERD were randomised to receive either esomeprazole (20-40 mg daily) or LARS. After 5 years, 372 patients remained in the study (esomeprazole, 192; LARS, 180). Biopsies were taken at the Z-line and 2 cm above, at baseline, 1, 3 and 5 years. A severity score was calculated based on: papillae elongation, basal cell hyperplasia, intercellular space dilatations and eosinophilic infiltration. The epithelial proliferative activity was assessed by Ki-67 immunohistochemistry. Results A gradual improvement in all variables over 5 years was noted in both groups, at both the Z-line and 2 cm above. The severity score decreased from baseline at each subsequent time point in both groups ( P < 0.001, all comparisons), attaining a normal level by 5 years. Corresponding decreases in Ki-67 expression were observed ( P < 0.001, all comparisons). No significant differences were found between esomeprazole treatment and LARS. Neither baseline severity score nor Ki-67 expression predicted the risk of treatment failure. Conclusions Five years of treatment is generally required before squamous epithelial cell morphology and proliferation are 'normalised' in patients with chronic GERD, despite endoscopic and symptomatic disease control. Control of the acid component of the refluxate seems to play the predominant role in restoring tissue morphology. [ABSTRACT FROM AUTHOR]

SUMMARY Meshless methods are a promising new field in computational electromagnetics. Instead of relying on an explicit mesh topology, a numerical solution is computed on an unstructured set of collocation nodes. This allows to model fine geometrical details with high accuracy and facilitates the adaptation of node distributions for optimization or refinement purposes. The radial point interpolation method (RPIM) is a meshless method based on radial basis functions. In this paper, the current state of the RPIM in electromagnetics is reviewed. The localized RPIM scheme is summarized, and the interpolation accuracy is discussed in dependence of important parameters. A time-domain implementation is presented, and important time iteration aspects are reviewed. New formulations for perfectly matched layers and waveguide ports are introduced. An unconditionally stable RPIM scheme is summarized, and its advantages for hybridization with the classical RPIM scheme are discussed in a practical example. The capabilities of an adaptive time-domain refinement strategy based on the experiences on a frequency-domain solver are discussed. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Summary: Two groups of social workers (n = 19, n = 13) carried out two different forms of assessment session, one involving an ASI (Addiction Severity Index) interview (n = 40) and one without (n = 43). After the sessions the social workers were requested to assess both the clients' experience and their own experience of the session. The clients also reported their own experience of the sessions.Findings: The results show that the social workers' assessment of the clients' experience differs from the clients' own assessments regarding the sub-scales of alliance and the clients' sense of own competence. However, no difference was observed between the social workers' assessment and the clients' negative experiences of the sessions. The results show the importance of asking the clients for their views when testing new ways of working. This will provide a more balanced picture as social workers are inclined to perceive the negative aspects and misjudge other experiences. The two different forms of session, with or without the ASI, did not affect the social workers' assessment of the clients' experience of the sessions.Applications : Testing of new methods of working in social work. [ABSTRACT FROM AUTHOR]

Discontinuous Galerkin composite finite element methods (DGCFEM) are designed to tackle approximation problems on complicated domains. Partial differential equations posed on complicated domain are common when there are mesoscopic or local phenomena which need to be modelled at the same time as macroscopic phenomena. In this paper, an optical lattice will be used to illustrate the performance of the approximation algorithm for the ground state computation of a Gross–Pitaevskii equation, which is an eigenvalue problem with eigenvector nonlinearity. We will adapt the convergence results of Marcati and Maday 2018 to this particular class of discontinuous approximation spaces and benchmark the performance of the classic symmetric interior penalty hp-adaptive algorithm against the performance of the hp-DGCFEM. [ABSTRACT FROM AUTHOR]

When the wavelength is much larger than the typical scale of the microstructure in a material, it is possible to define effective or homogenized material coefficients. The classical way of determination of the homogenized coefficients consists of solving an elliptic problem in a unit cell. This method and the Floquet-Bloch method, where an eigenvalue problem is solved, are numerically compared with respect to accuracy and contrast sensitivity. Moreover, we provide numerical bounds on the effective permittivity. The Floquet-Bloch method is shown to be a good alternative to the classical homogenization method, when the contrast is modest. [ABSTRACT FROM AUTHOR]

Själander A, Engström G, Berntorp E, Svensson P (Malmö University Hospital, University of Lund, Sweden). Risk of haemorrhagic stroke in patients with oral anticoagulation compared with the general population. J Intern Med 2003; 254: 434–438. To compare the incidence of haemorrhagic stroke (HS), and the risk of fatal outcome after HS in patients with oral anticoagulation (OA) treatment and in the general population. Five-year cohort study. The Anticoagulation Clinic, Malmö University Hospital, Lund, Sweden. A total of 4434 patients treated with OA (6693 treatment years) from 1 Oct 1993 to 30 Sept 1998. The population-based Stroke Register of Malmö, Lund, Sweden (STROMA). Forty-eight patients had HS according to ICD  9 code 430 and 431. HS occurred at a higher age in women compared with men (mean age 79.5 years vs. 74.7 years, P = 0.009). The age-adjusted relative risk of HS during OA treatment was 10.9 (CI 6.7–17.6) for men and 9.3 (CI 5.7–15.0) for women, as compared with the untreated general population. Number needed to harm (NNH) (person-years) was 103 for men and 188 for women. Adjusted for age and sex, OA treatment was significantly associated with fatal outcome in patients with HS (OR = 2.6, CI 1.4–4.8). Patients with OA treatment had approximately 10 times higher risk of HS as compared with the general population, and the risk increased markedly with age. OA treatment is associated with an increased case fatality in patients with HS. [ABSTRACT FROM AUTHOR]

Abstract. Dentinogenically active rat incisor odontoblasts were dissected out from animals fed a low calcium, vitamin D free diet (R 25). Protein synthesis by these cells was studied by means of short-time incubation in an in vitro system in the presence of the radioactive labeled precursors L-leucine, L-fucose and L-proline. A significantly increased leucine and proline incorporation into the protein synthesized was noted in the cells from rats fed the deficient R 25 diet compared with odontoblasts from rats fed an adequate control diet (R 47). No difference between the two groups was found when fucose was utilized as a precursor. The well known increase in predentin width when feeding a rachitogenic diet may thus be explained by an increase in organic matrix synthesis in addition to the possible negative direct effects of lowered serum Ca content. Prior to this study, the behavior of Proline as a precursor in the in vitro system was studied. The possibility of separating leucine-labeled proteins synthesized in the in vitro system by means of SDS-polyacrylamide gel electrophoresis was also shown. [ABSTRACT FROM AUTHOR]

Different rat diets, deficient in calcium and/or vitamin D, were tested for varying experimental periods to obtain changes in serum calcium values, body weight gain and odontoblast-predentine morphology. One diet, R 25, used during a 14-day period, was found to induce lowered serum calcium values and an increased predentin width in incisor teeth. Rats fed this diet demonstrated an increase an alkaline phosphatase and ATP-splitting enzyme activity in dentinogenically active incisor odontoblasts. No other metabolic changes in these cells were demonstrated by the histochemical methods employed. [ABSTRACT FROM AUTHOR]

Rats were fed a low calcium diet deficient in vitamin D for 14 days. Changes in alkaline phosphatase activities in odontoblasts dissected out from incisor teeth were studied. biochemically. A strong increase in pNPP-ase, PPi-ase, total ATP-degradation and Ca2+- ATPase was observed in the deficient animals compared with animals fed a control diet. [ABSTRACT FROM AUTHOR]

Aberration in cranial skeletal morphology during growth due to metabolic bone diseases associated with hypocalcemia is related to abnormalities in cranial suture growth. It was found in previous experimental studies that a changed cranial growth pattern induced by hypocalcemia nnd secondary hyperparathyroidism was dependent on a decreased none apposition in viscerocranial growth sites. Of interest was the observation that obliterative osteogenesis occurred with this disturbance. In vitro studies have shown that when bone resorption is stimulated by parathyroid hormone, mitogenic factors for bone cells are released from the matrix. The aim of the current study was to elucidate a possible local regulatory mechanism for bone growth especially with regard to cranial growth. Two groups of young rats were injected daily with 150 μg and 750 μg respectively of bone matrix-derived growth factor preparation (BMDGF) for 2 weeks. By using cephalometric analysis, the BMDGF administration was shown to alter skull morphology during growth. Since the high doses of BMDGF caused markedly more changes than the low dose, the overall effect on craniofacial growth seemed to be dose dependent. The high region, as well as in the diaphysis of the tibia. Also a change in position of the viscerocranium in relation to the cranial base was found in the BMDGF-treated rats: the flexure between the viscerocranium and the cranial base being greater compared with the normal skull. This change in relationship seemed to be related to the enhanced bone apposition found in the viscerocranial sutures of BMDGF-treated rats. In as much as the preparation used was a crude preparation it is not possible to attribute the observed effects to any specific protein. However, the observations are consistent with the current knowledge on bone matrix-derived factors. It is of interest that the skull morphology in the BMDGF-treated rats were similar to the previous reports on rats with hyperparathyroidism in which obliterative osteogenesis in cranial sutures was observed. The altered viscerocranial morphology might thus be due to more differentiated cell functions in the suture as opposed to cortical bone. [ABSTRACT FROM AUTHOR]

The jaw morphology in the mandible and maxilla was studied by cephalometric analysis in two groups of edentulous subjects and in two groups of individuals in possession of all teeth. The predominating facial type in these groups was the orthognathic type. The alveolar bone height differed significantly between men and women in the edentulous groups but not in the subjects in possession of all teeth. Thus, there seemed to be a sex difference in alveolar bone diminution after extraction of all teeth. The gonial angle was significantly greater in both men and women in the edentulous groups than in either sex in the groups in possession of all teeth. Thus, the basal bone morphology in the mandible seemed to be changed in the same manner in both sexes in the edentulous groups after extraction of all teeth, in contrast to the alveolar bone diminution. Indications were found that the gonial angle might be age related. The chin angle as such was found to be less than 60° in the majority of edentulous individuals which makes this value seem to be of minor importance when selecting edentulous individuals for surgical deepening of the vestibular sulcus. [ABSTRACT FROM AUTHOR]

We report 6 children who showed clinical symptoms and laboratory signs of acute pyelonephritis but in whom bacteriuria was insignificant, with Escherichia coli 10(4)/ml, or less. None of the children had symptoms of other disease. Three of the children who were at first treated inadequately or were not treated with antibiotics developed significant bacteriuria later on (10(5)/ml, or greater). Ultrasonic scanning to evaluate kidney involvement at the acute phase of disease showed transient changes in four of the 6 children--dilatation of one or both pelves or increased ecogenicity of the renal sinus, or both. The urinary E coli strains isolated from all 6 children were P-fimbriated, as determined by a P-fimbriae specific particle agglutination test (PPA test). P-fimbriate E coli are known to be strongly associated with acute non-obstructive pyelonephritis in children and we suggest that the finding of any number of P-fimbriated E coli in the urine of children with clinical evidence of acute pyelonephritis supports this clinical diagnosis. [ABSTRACT FROM AUTHOR]

In a phase I study endoscopic removal of pancreatic duct stones and protein plugs was attempted in five patients suffering from chronic pancreatitis with severe chronic pain. The pancreatic duct contents could be extracted after successful sphincterotomy in three patients. Clearance of the pancreatic duct was followed by complete or partial relief of pain. The follow-up period was 17-48 months. Endoscopic extraction is, however, not without complications; it is technically difficult, and many attempts may be required. The combination of endoscopic therapy and extracorporeal shock-wave lithotripsy may be a better alternative. [ABSTRACT FROM AUTHOR]

Miniaturization of ultrasound probes has made possible endoluminal investigation of small duct systems. We have used a 360 degree transaxial real-time sector-scan imaging system with a field of view of 3-5 cm. It operates at ultra-high frequencies, which allows very high resolution. Ten jaundiced patients, aged 35-73 years, were investigated. Malignant bile-duct obstructive disease was present in eight and benign strictures in the remaining two. In all of them the intrahepatic bile ducts had undergone percutaneous transhepatic cannulation for diagnostic and therapeutic purposes. The resolution capacity has been sufficient to allow studies of the bile duct wall and adjacent tissues, and it has thus been possible to study the papilla of Vater, biliary-enteric anastomoses, and adjoining portions of the pancreatic and cystic ducts. Adjacent vessels have been identified. This preliminary study indicates that the character of strictures and the extent of tumour growth may be evaluated, thereby demonstrating the clinical potential of these miniature transducers. Endoluminal ultrasound evaluation of the bile ducts may also be possible intraoperatively and as a supplement to duodenoscopy. [ABSTRACT FROM AUTHOR]

Anticipation describes an inheritance pattern within a pedigree with an increase in disease severity or decrease in age at onset or both in successive generations. The phenomenon of anticipation has recently been shown to be correlated with the expansion of trinucleotide repeat sequences in different disorders. We have studied differences of age at onset and disease severity between two generations in 14 families with unilinear inheritance of bipolar affective disorder (BPAD). There was a significant difference in age at onset (p < 0.008), in episodes per year with (p < 0.006) and without (p < 0.03) lithium treatment, and in total episodes per year (p < 0.002) between generations I and II. Furthermore, there was a highly significant correlation (p < 0.001) in age at onset between generations I and II. No evidence for specific paternal or maternal inheritance was found. We found evidence of anticipation and could rule out ascertainment bias or some other artefact. Anticipation is thus an inheritance pattern in BPAD which suggests that the expansion of trinucleotide repeat sequences is a possible mode of inheritance in BPAD. [ABSTRACT FROM PUBLISHER]

Background: Self-assessment questionnaires which measure the functional and affective consequences of chronic obstructive pulmonary disease (COPD) give valuable information about the effects of the disease and may serve as important tools with which to evaluate treatment.Methods: A cross sectional comparative study was performed between patients with COPD (n = 68), stratified according to pulmonary function, and a healthy control group (n = 89). A battery of well established clinical and quality of life measures (the Sickness Impact Profile (SIP), Mood Adjective Check List (MACL), and Hospital Anxiety and Depression scale (HAD)) was used to examine in which functional and affective aspects the patient group differed from the control group and how these measures related to pulmonary function and smoking habits.Results: Compared with the controls, COPD affected functional status in most areas, not just those requiring physical activity. Forty six patients with forced expiratory volume in one second (FEV1) below 50% predicted showed particularly high levels of dysfunction in ambulation, eating, home management, and recreation/ pastimes (SIP). Despite this, their level of psychosocial functioning and mood status was little different from that of the healthy controls. Among the patients, a subgroup reported substantial psychological distress, but mood status was only weakly, or not at all, related to pulmonary function. Smoking habits did not affect functional status or well being.Conclusions: Quality of life is not significantly affected in patients with mild to moderate loss of pulmonary function, possibly due to coping and/or pulmonary reserve capacity. This suggests that generic self-assessment questionnaires are of limited value for detecting the early consequences of COPD. However, in later stages of the disease they are sensitive enough to discriminate between patients with different levels of pulmonary dysfunction. The low correlations between the indices of pulmonary function and the indices of affective status suggest that well being depends, to a large extent, on factors outside the clinical domain. [ABSTRACT FROM AUTHOR]