Fiberoptic Colonoscopic Polypectomies

The development of fiberoptic instruments which permit direct visualization of the entire colonic lumen has made possible the safe removal of polyps from any part of the colon. The avoidance of transabdominal colotomy and polypectomy significantly decreases the mortality and morbidity as well as the duration of hospital stay. We wish to present our experience in performing the endoscopic removal of 128 colonic polyps larger than 0.5 cm in size in 103 patients, located from the cecum to the sigmoid colon and beyond the reach of the rigid sigmoidoscope. The polypectomy procedures via the colonoscope were done without mortality and with only three relatively minor complications, all of which responded to conservative measures. Endoscopic removal of colonic polyps is proposed as a safe, practical alternative to either laparotomy and colotomy or repeated barium enema studies in the management of the patient with a colonic polyp

Mineral concentrations in soil extracts, forages, and blood sera of cattle grazing on reclaimed uranium-mined land in southeastern Wyoming

The Pathfinder Uranium Mine which is located in southeastern Wyoming, was actively mined during the 1960's-1980's. Reclamation involved returning the spoil/overburden and replacing the salvaged topsoil. The area was revegetated in 1974-1977, but was not grazed until 1980-85. A grazing experiment was then conducted to determine solubility of mineral elements in soil, uptake by plants and absorption by grazing animals. Blood sera were collected at 28-30 day intervals during the three grazing/growing seasons in 1980-1982. Blood sera samples were frozen and later analyzed by ICP. When compared to published data, plants on the reclaimed site contained lower concentrations of Ca, Mg, Mn, P, and Zn; but higher concentrations of Cd, Cr and Ni than plants on adjacent undisturbed sites. When compared to expected blood sera data, animals grazing on the reclaimed site had lower concentrations of B. Ca, Cu, Mg, and Na; but higher concentrations of Cr and Fe than would be expected for most grazing animals. Livestock producers are advised to provide supplements of Ca, Mg, Mn, P, and Zn to minimize deficiency of these elements in livestock nutrition when grazing these reclaimed lands

Thinking about politics

There are distinctive modes of thinking about politics, three of which are discussed here. A mode consists of a characteristic domain of relevance, filing system, and grammar of beliefs. A person relying on Mode A treats politics as an extension of interpersonal experience. A person relying on Mode B organizes political thinking around a set of salient group identifications. A person relying on Mode C views public objects in terms of their consequences for collective goods. The three modes are illustrated by applying them to concrete issues in a hypothetical manner: Vietnam, bussing, and attitudes toward presidential candidates. The concept of surrogate attitudes is developed and various implications of the theoretical argument are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45481/1/11109_2004_Article_BF00988519.pd

MFA13 (MFA 2013)

Catalogue of a culminating student exhibition held at the Mildred Lane Kemper Art Museum, May 3-July 29, 2013. Contents include Introduction / Buzz Spector -- The collaborative turn : new models of thinking, making, and learning / Patricia Olynyk -- [Introduction] / David Schuman -- Lyndon Barrois, Jr. / Rickey Laurentiis -- Sarah Bernhardt -- Shifting Shanghais / Hsuan Ying Chen -- Serhii Chrucky / JaNae Contag -- JaNae Contag / Emily Hanson -- Carrie DeBacker / Gabriel Feldman -- Erin M. Duhigg -- José Garza / Serhii Chrucky -- Eric Gray / Ariel Lewis -- Meghan Allynn Johnson : to or towards / Blair Allyn Johnson -- Hoa Le / Maria Xia -- Christine Eunji Lee -- Lavar Munroe : the black superhero when everyone was looking for the scapegoat / Patrick Johnson -- Jon A. Orosco : architectonics / Rickey Laurentiis -- Michael Powell / Nicholas Tamarkin -- Bridget A. Purcell : welcome home / Andy Chen -- Malahat Qureshi -- Natalie Rodgers / Katie McGinnis -- Carla Fisher Schwartz / Jennifer Padgett -- Zak Smoker -- Laurencia Strauss / Maura Pellettieri -- Lili Yang -- Vivian Zapata -- Contributors -- About the Sam Fox School.https://openscholarship.wustl.edu/books/1004/thumbnail.jp

Treatment of osteochondral lesions of the talus: a systematic review

The aim of this study was to summarize all eligible studies to compare the effectiveness of treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from January 1966 to December 2006 were systematically screened. The proportion of the patient population treated successfully was noted, and percentages were calculated. For each treatment strategy, study size weighted success rates were calculated. Fifty-two studies described the results of 65 treatment groups of treatment strategies for OCD of the talus. One randomized clinical trial was identified. Seven studies described the results of non-operative treatment, 4 of excision, 13 of excision and curettage, 18 of excision, curettage and bone marrow stimulation (BMS), 4 of an autogenous bone graft, 2 of transmalleolar drilling (TMD), 9 of osteochondral transplantation (OATS), 4 of autologous chondrocyte implantation (ACI), 3 of retrograde drilling and 1 of fixation. OATS, BMS and ACI scored success rates of 87, 85 and 76%, respectively. Retrograde drilling and fixation scored 88 and 89%, respectively. Together with the newer techniques OATS and ACI, BMS was identified as an effective treatment strategy for OCD of the talus. Because of the relatively high cost of ACI and the knee morbidity seen in OATS, we conclude that BMS is the treatment of choice for primary osteochondral talar lesions. However, due to great diversity in the articles and variability in treatment results, no definitive conclusions can be drawn. Further sufficiently powered, randomized clinical trials with uniform methodology and validated outcome measures should be initiated to compare the outcome of surgical strategies for OCD of the talus

Human papillomavirus prevalence, viral load and pre-cancerous lesions of the cervix in women initiating highly active antiretroviral therapy in South Africa: a cross-sectional study

Background Cervical cancer and infection with human immunodeficiency virus (HIV) are both important public health problems in South Africa (SA). The aim of this study was to determine the prevalence of cervical squamous intraepithelial lesions (SILs), high-risk human papillomavirus (HR-HPV), HPV viral load and HPV genotypes in HIV positive women initiating anti-retroviral (ARV) therapy. Methods A cross-sectional survey was conducted at an anti-retroviral (ARV) treatment clinic in Cape Town, SA in 2007. Cervical specimens were taken for cytological analysis and HPV testing. The Digene Hybrid Capture 2 (HC2) test was used to detect HR-HPV. Relative light units (RLU) were used as a measure of HPV viral load. HPV types were determined using the Roche Linear Array HPV Genotyping test. Crude associations with abnormal cytology were tested and multiple logistic regression was used to determine independent risk factors for abnormal cytology. Results The median age of the 109 participants was 31 years, the median CD4 count was 125/mm3, 66.3% had an abnormal Pap smear, the HR-HPV prevalence was 78.9% (Digene), the median HPV viral load was 181.1 RLU (HC2 positive samples only) and 78.4% had multiple genotypes. Among women with abnormal smears the most prevalent HR-HPV types were HPV types 16, 58 and 51, all with a prevalence of 28.5%. On univariate analysis HR-HPV, multiple HPV types and HPV viral load were significantly associated with the presence of low and high-grade SILs (LSIL/HSIL). The multivariate logistic regression showed that HPV viral load was associated with an increased odds of LSIL/HSIL, odds ratio of 10.7 (95% CI 2.0 – 57.7) for those that were HC2 positive and had a viral load of ≤ 181.1 RLU (the median HPV viral load), and 33.8 (95% CI 6.4 – 178.9) for those that were HC2 positive with a HPV viral load > 181.1 RLU. Conclusion Women initiating ARVs have a high prevalence of abnormal Pap smears and HR-HPV. Our results underscore the need for locally relevant, rigorous screening protocols for the increasing numbers of women accessing ARV therapy so that the benefits of ARVs are not partially offset by an excess risk in cervical cancer

A Common Variant in MIR182 Is Associated With Primary Open-Angle Glaucoma in the NEIGHBORHOOD Consortium

PURPOSE. Noncoding microRNAs (miRNAs) have been implicated in the pathogenesis of glaucoma. We aimed to identify common variants in miRNA coding genes (MIR) associated with primary open-angle glaucoma (POAG). METHODS. Using the NEIGHBORHOOD data set (3853 cases/33,480 controls with European ancestry), we first assessed the relation between 85 variants in 76 MIR genes and overall POAG. Subtype-specific analyses were performed in high-tension glaucoma (HTG) and normal-tension glaucoma subsets. Second, we examined the expression of miR-182, which was associated with POAG, in postmortem human ocular tissues (ciliary body, cornea, retina, and trabecular meshwork [TM]), using miRNA sequencing (miRNA-Seq) and droplet digital PCR (ddPCR). Third, miR-182 expression was also examined in human aqueous humor (AH) by using miRNA-Seq. Fourth, exosomes secreted from primary human TM cells were examined for miR-182 expression by using miRNA-Seq. Fifth, using ddPCR we compared miR182 expression in AH between five HTG cases and five controls. RESULTS. Only rs76481776 in MIR182 gene was associated with POAG after adjustment for multiple comparisons (odds ratio [OR] ¼ 1.23, 95% confidence interval [CI]: 1.11–1.42, P ¼ 0.0002). Subtype analysis indicated that the association was primarily in the HTG subset (OR ¼ 1.26, 95% CI: 1.08–1.47, P ¼ 0.004). The risk allele T has been associated with elevated miR-182 expression in vitro. Data from ddPCR and miRNA-Seq confirmed miR-182 expression in all examined ocular tissues and TM-derived exosomes. Interestingly, miR-182 expression in AH was 2-fold higher in HTG patients than nonglaucoma controls (P ¼ 0.03) without controlling for medication treatment. CONCLUSIONS. Our integrative study is the first to associate rs76481776 with POAG via elevated miR-182 expression

A Common Variant in MIR182 Is Associated With Primary Open-Angle Glaucoma in the NEIGHBORHOOD Consortium

PURPOSE. Noncoding microRNAs (miRNAs) have been implicated in the pathogenesis of glaucoma. We aimed to identify common variants in miRNA coding genes (MIR) associated with primary open-angle glaucoma (POAG). METHODS. Using the NEIGHBORHOOD data set (3853 cases/33,480 controls with European ancestry), we first assessed the relation between 85 variants in 76 MIR genes and overall POAG. Subtype-specific analyses were performed in high-tension glaucoma (HTG) and normal-tension glaucoma subsets. Second, we examined the expression of miR-182, which was associated with POAG, in postmortem human ocular tissues (ciliary body, cornea, retina, and trabecular meshwork [TM]), using miRNA sequencing (miRNA-Seq) and droplet digital PCR (ddPCR). Third, miR-182 expression was also examined in human aqueous humor (AH) by using miRNA-Seq. Fourth, exosomes secreted from primary human TM cells were examined for miR-182 expression by using miRNA-Seq. Fifth, using ddPCR we compared miR182 expression in AH between five HTG cases and five controls. RESULTS. Only rs76481776 in MIR182 gene was associated with POAG after adjustment for multiple comparisons (odds ratio [OR] ¼ 1.23, 95% confidence interval [CI]: 1.11–1.42, P ¼ 0.0002). Subtype analysis indicated that the association was primarily in the HTG subset (OR ¼ 1.26, 95% CI: 1.08–1.47, P ¼ 0.004). The risk allele T has been associated with elevated miR-182 expression in vitro. Data from ddPCR and miRNA-Seq confirmed miR-182 expression in all examined ocular tissues and TM-derived exosomes. Interestingly, miR-182 expression in AH was 2-fold higher in HTG patients than nonglaucoma controls (P ¼ 0.03) without controlling for medication treatment. CONCLUSIONS. Our integrative study is the first to associate rs76481776 with POAG via elevated miR-182 expression

Osteochondral defects in the ankle: why painful?

Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone plate. The ankle joint has a high congruency. During loading, compressed cartilage forces its water into the microfractured subchondral bone, leading to a localized high increased flow and pressure of fluid in the subchondral bone. This will result in local osteolysis and can explain the slow development of a subchondral cyst. The pain does not arise from the cartilage lesion, but is most probably caused by repetitive high fluid pressure during walking, which results in stimulation of the highly innervated subchondral bone underneath the cartilage defect. Understanding the natural history of osteochondral defects could lead to the development of strategies for preventing progressive joint damage