Search

The high rate of oil production with the use of water flooding, complex geological and physical conditions of the carbonate reservoir of the deposit (fractures, faults) lead to progressive watering of the extracted products. The field has considerable oil reserves and is at the development stage II, the average water cut is more than 60%, most of the remaining reserves pass into reserves difficult to recover category. This article focuses on determining relations between blocks and practical application of the results of indicator study method in order to determine the porosity and permeability properties of fractured carbonate formations. According to this study method, the introduction of complementary technologies to improve the existing development system was proposed.

Michal Mauda-Havakuk,1 Andrew S Mikhail,1 Matthew F Starost,2 Elizabeth C Jones,3 Baktiar Karim,4 David E Kleiner,5 Ari Partanen,1 Juan A Esparza-Trujillo,1 Ivane Bakhutashvili,1 Paul G Wakim,6 Michael T Kassin,1 Andrew L Lewis,7 John W Karanian,1 Bradford J Wood,8 William F Pritchard1 1Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 2Division of Veterinary Resources, National Institutes of Health, Bethesda, MD, USA; 3Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 4National Cancer Institute, National Institutes of Health, Frederick, MD, USA; 5Center for Cancer Research, Clinical Center, National Cancer Institute, Bethesda, MD, USA; 6Biostatistics and Clinical Epidemiology Service, National Institutes of Health Clinical Center, Bethesda, MD, USA; 7Biocompatibles UK Ltd (a BTG International Group Company), Camberley, UK; 8Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institute of Biomedical Imaging and Bioengineering and National Cancer Institute Center for Cancer Research, National Institutes of Health, Bethesda, MD, USACorrespondence: William F PritchardCenter for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Room 3N320B, MSC 1182, Bethesda, MD, 20892, USATel +1 240-760-0153Fax +1 301-496-9933Email william.pritchard@nih.govBackground: Woodchucks chronically infected with woodchuck hepatitis virus (WHV), which resembles human hepatitis B virus, develop spontaneous hepatic tumors and may be an important biological and immunological model for human HCC. Nonetheless, this model requires further validation to fully realize its translational potential.Methods: Woodchucks infected at birth with WHV that had developed HCC (n=12) were studied. Computed tomography, ultrasound, and magnetic resonance imaging were performed under anesthesia. LI-RADS scoring and correlative histologic analysis of sectioned tissues were performed. For immune characterization of tumors, CD3 (T cells), CD4 (T helpers), NCAM (Natural killers), FOXP3 (T-regulatory), PDL-1 (inhibitory checkpoint protein), and the human hepatocellular carcinoma (HCC) biomarker alpha-fetoprotein (AFP) immunohistochemical stains were performed.Results: Forty tumors were identified on imaging of which 29 were confirmed to be HCC with 26 categorized as LR-4 or 5. The remainder of the tumors had benign histology including basophilic foci, adenoma, and lipidosis as well as pre-malignant dysplastic foci. LR-4 and LR-5 lesions showed high sensitivity (90%) and specificity (100%) for malignant and pre-malignant tumors. Natural killers count was found to be 2– 5 times lower in tumors relative to normal parenchyma while other immune cells were located in the periphery of tumors. Tumors expressed AFP and did not express PD-L1.Conclusion: Woodchucks chronically infected with WHV developed diverse hepatic tumor types with diagnostic imaging, pathology, and immune patterns comparable to that in humans. This unique animal model may provide a valuable tool for translation and validation of novel image-guided and immune-therapeutic investigations.Keywords: carcinoma, hepatocellular, radiology, interventional oncology, immunotherapy, models, animal, tumor microenvironment

© 2020 British Journal of AnaesthesiaBackground: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP.

The main objective of the breakwaters is to protect the port, the beach or the beach facilities from strong waves and storms, as they help to establish calm inside the port and thus achieve safety for ships, and ease of operation. This research aims to present study unconventional alternatives to vertical breakwater. In this study, two different models of vertical wave barriers implemented were chosen for their study and evaluation of the hydrodynamic performance. The first model is a vertical wall with circular slots and the second model is a vertical wall with square slots. A comparison was made between the two models it was found that the square slots reduce the transmission of waves more than circular slots by 5 to 20%. The use of two circular slotted walls decreases wave transmission by up to 30% and increases wave energy dissipation by up to 40% as compared to a single wall. With increasing relative length (h/L), the horizontal wave force rises. The relative wave forces (F/Fo), at porosity ( ) =0.25, was greater than at porosity ( ) = 0.50 by 10 to 30%. At the openings, the wave velocity is high, and the wave energy dissipation factor was also high; the higher the wave amplitude, the greater the wave energy dissipation factor.

Background: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP. © 2020 British Journal of Anaesthesia

The expanding international wildlife trade, combined with a lack of surveillance for key animal diseases in most countries, represents a potential pathway for transboundary disease movement. While the international wildlife trade represents over US $300 billion per year industry involving exchange of billions of individual animals, animal products, and plants as traditional medicines, meat from wild animals, trophies, live exotic pets, commercial products and food, surveillance and reporting of OIE‐Listed diseases in wildlife are often opportunistic. We reviewed peer‐reviewed literature for reports of 73 OIE‐Listed terrestrial animal diseases in wild animals and found 528 possible wild animal hosts using our methodology. Not all host–pathogen relationships indicate that a particular species serves an epidemiologically significant role in the transmission of disease, but improved reporting of infections in wild animals along with clinical and pathological findings would contribute to improved One Health risk assessments.

Rationale and objectives: A current clinical trial is testing a drug inhibitor for glutaminase 1 (GLS1), the enzyme responsible for glutamine's conversion into glutamate, for cancer therapy. However, the results indicated that monotherapy is not ideal. While metabolic profiling of tumors after treatment with a GLS1 inhibitor revealed numerous upregulated pathways which could explain the resistance, the specific pathways involved were not identified. In this study, using stable isotope-resolved metabolomics, we aim to detail the specific mechanism by which cancer cells are capable of circumventing GLS1 inhibition and compensating for glutamate production. Measurement and Methods: Patient-derived pancreatic tumors were implanted through orthotopic model in the pancreas of mice. After using our innovative delivery method through nanoparticle encapsulation of a selective GLS1 inhibitor, BPTES, we then injected 13C5, 15N2-glutamine via intraperitoneal administration, 3 times, 15 minutes apart. Tumors were harvested 2 hours post first glutamine injection. Metabolites were then extracted from tumors, and analyzed using Agilent 6520 Q-TOF mass spectrometer and 1H-NMR. Metabolite intensities were later normalized to protein concentration following analysis. Results: Our results showed that total glutamate levels were lower in BPTES-NP treated tumors as compared to vehicle control ones. Interestingly, we found an increase in (m+5) labeled glutamate (mass of the parent ions (m) and 5 more mass units due to 13C415N1-glutamate or 13C5-glutamate labelling) in BPTES-NP treated tumors as compared to the vehicle control tumors. Moreover, we found that (m+5) glutamate is a product of (m+7) glutamine being converted to (m+5) alpha-ketoglutaramate (KGM) via glutamine-pyruvate transaminase and further on into alpha-ketoglutarate (aKG) by omega-amidase, which can finally produce the identified (m+5) glutamate through glutamate dehydrogenase. Further analysis using 1H-NMR detailed a significant increase in overall KGM intermediate intensity in treatment groups compared to the control groups, confirming the upregulation of compensatory pathway (glutamine-KGM- aKG-glutamate) to produce glutamate upon treatment of GLS1 inhibitor. Conclusion: These results explain the reasons behind the limited clinical outcomes for single therapy with a GLS1 inhibitor, and provide potential therapeutic targets: glutamine-pyruvate transaminase, for combination treatments with GLS1 inhibitors to prevent the compensation for glutamate production amid GLS1 inhibition. Citation Format: Karim B. Nabi, Jimmy Kirsch, Tu Nguyen, Addison Quinones, Jessica Tan, Felipe Camelo, Marjorie Antonio, Jin Jung, Anne Le. Identification of compensatory pathway for glutamate production upon glutaminase 1 inhibition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5473.

Wild birds play a major role in the evolution, maintenance, and spread of avian influenza viruses. However, surveillance for these viruses in wild birds is sporadic, geographically biased, and often limited to the last outbreak virus. To identify opportunities to optimize wild bird surveillance for understanding viral diversity, we reviewed responses to a World Organisation for Animal Health–administered survey, government reports to this organization, articles on Web of Knowledge, and the Influenza Research Database. At least 119 countries conducted avian influenza virus surveillance in wild birds during 2008–2013, but coordination and standardization was lacking among surveillance efforts, and most focused on limited subsets of influenza viruses. Given high financial and public health burdens of recent avian influenza outbreaks, we call for sustained, cost-effective investments in locations with high avian influenza diversity in wild birds and efforts to promote standardized sampling, testing, and reporting methods, including full-genome sequencing and sharing of isolates with the scientific community.

Summary This paper describes key travel traits of non-resident visitors to British Columbia's wine tourism destinations. It identifies Genera-list and Immersionist as being important segments of this market that merit particular attention in future destination management planning and marketing initiatives. It uses an importance-performance analysis framework to determine the key areas for management activity that need to be addressed in order to meet the travel product needs of each of these segments. The paper concludes by recommending a range of strategic initiatives that should be used by the wine industry and its tourism partners to elevate the appeal of BC wine destinations in the international marketplace. While specific to the

As interest in the varying applications of Internet technology has expanded in recent years, so have discussions concerning the relative merits of this medium as a credible means for conducting market survey research. Proponents of this form of on-line surveying claim that as the Internet becomes more universally accepted as a means of communication, its utility for survey purposes will be largely related to its ability to conduct some forms of research faster, better, and more conclusively than other more traditional methods of interviewing. Other supporters highlight the approach's potential research advantages with respect to gaining access to especially difficult-to-find populations, its cost effectiveness from a data collection perspective, and its speed of interaction with respondent populations. Conversely, other researchers express more cautionary perspectives and emphasize that Internet survey methods tend to suffer many of the same shortcomings as those associated with more traditional ...

While the importance of managing the structure and behavior of distribution channels has been clearly identified in general marketing literature, it has received relatively limited research attention in the context of tourism businesses. This situation is typified in the ski industry where knowledge of the range of channel options and the potential influence of using varying distribution channels on the effectiveness of destination marketing programs is limited. This paper describes the structure of British Columbia's existing ski area distribution channels, and outlines key market features which discriminate direct and indirect channel users from each other. It then details the distinctive characteristics of an indirect channel group-club channelers-in order to illustrate some of the management implications associated with understanding the behavioral characteristics of specific channel users. The paper is written as a contribution to the emerging academic tourism literature on channels of distr...

Many of the criticisms of on-site surveys relate to contextual concerns. This is particularly the case for outdoor on-site surveys where the contextual effects of weather conditions are so intuitively apparent. In such circumstances, research is needed to suggest a priori which contextual weather factors have positive outcomes and which have negative effects. It was thought that some of the differences in reported satisfaction levels at winter resorts might be caused specifically by contextual weather conditions at the time of the assessment. To probe this perspective, this study compared the attribute satisfaction ratings of participants at Canadian winter resorts with prevailing weather conditions on the day of the survey. This article suggests that on-site weather conditions may be associated with the overall attribute evaluation scores reported by participants at Canadian winter resort destinations. This relationship appears to be particularly clear with respect to low attribute ratings occurring during windy weather conditions.

Objectives. The aim of the present paper was to review the published literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of the efficacy of strontium and potassium toothpastes in the treatment of dentine hypersensitivity (DH). Methods. Following a review of 94 relevant papers both from searching electronic databases (PUBMED) and hand searching of relevant written journals, 13 studies were identified, and 7 papers (1 for strontium-based toothpastes and 6 for potassium-based toothpastes) were finally accepted for inclusion. The main outcome measures were the methodology and assessment used by Investigators in studies designed to evaluate DH. Results. The results of the present paper would indicate that the reported efficacy of both strontium- and potassium-based toothpastes in relieving DH is questionable. Conclusions. The results from the present paper would appear to support the conclusions of previous investigators that there is only minimal evidence for the efficacy of both strontium- and potassium-based toothpastes in relieving symptoms of DH.

This research provides insights into the nature of the Mexican health spa tourism market. The overriding research hypothesis is that a comparatively strong long-haul pleasure market for health spa-related tourism exists in Mexico, and that this market can be differentiated from other more generic Mexican long-haul travel groups. Using information derived from the Tourism Canada-United States Travel and Tourism Administration (USTTA) long-haul market data sets, the paper begins by outlining the health spa affinity of travellers from several European, Asian and Latin American countries on their long-haul pleasure travel vacations. The research then describes the characteristics of Mexican health spa travellers. Using a long-haul market segmentation framework developed by Tourism Canada and the USTTA, it identifies how Mexican long-haul health spa visitors differ from other travellers to that destination in terms of their socio-demographic, attitudinal and behavioural traits. The paper then describes tivo distinct groups of Mexican health spa users that offer a particular opportunity for tourism businesses interested in attracting Mexican long-haul pleasure travellers. In the process of describing these Mexican health spa travellers, the paper also suggests an effective step-wise method for identifying high potential long-haul niche travel markets.

Objective To describe a patient with hereditary head and neck paraganglioma (HNPGL) and to review the literature on these rare tumors. Methods We review the English-language literature regarding SDH mutations, HNPGL, hereditary paraganglioma-pheochromocytoma syndrome, and the role of functional imaging in the follow-up of these tumors. We also describe the clinical findings, imaging results, and follow-up of a man who initially presented with HNPGL and subsequently developed metastatic pheochromocytoma 20 years later. Results A 66-year-old man presented with a history of hypertension, palpitations, sweating, and elevated urinary norepinephrine. Iodine-123-metaiodobenzylguanidine (123I-MIBG) scan demonstrated a left suprarenal mass and multiple avid lesions in the abdomen, chest, and posterior cranial fossa. Histologic examination confirmed aSubmitted for publication February 25, 2012 Accepted for publication May 14, 2012 To purchase reprints of this article, please visit: www.aace.com/reprints. Copyright © 2012 AACE. metastatic pheochromocytoma, and molecular genetic testing revealed a mutation in the SDHD gene. The patient had had surgery 20 years earlier for HNPGL. Although most HNPGLs arise sporadically, susceptibility genes have been identified in approximately one-third of cases. Optimal follow-up remains controversial. We reiterate a need for longterm follow-up of patients with a mutation in an SDH gene. 123I-MIBG, highly specific for identifying ectopic neuroendocrine tissue, may have a role in long-term follow-up. Conclusions Although HNPGLs rarely metastasize, their malignant potential is difficult to predict. Routine surveillance for at-risk patients is recommended. Patients with a mutation in an SDH gene should therefore undergo regular surveillance. (Endocr Pract. 2012;18:e130-e134)

Enterotoxigenic Bacteroides fragilis (ETBF) causes diarrhea and is implicated in inflammatory bowel diseases and colorectal cancer. The only known ETBF virulence factor is the Bacteroides fragilis toxin (BFT), which induces E-cadherin cleavage, interleukin-8 secretion, and epithelial cell proliferation. A murine model for ETBF has not been characterized. Specific pathogen-free (SPF) C57BL/6J or germfree 129S6/SvEv mice were orally inoculated with wild-type ETBF (WT-ETBF) strains, a nontoxigenic WT strain of B. fragilis (WT-NTBF), WT-NTBF overexpressing bft (rETBF), or WT-NTBF overexpressing a biologically inactive mutated bft (rNTBF). In SPF and germfree mice, ETBF caused colitis but was lethal only in germfree mice. Colonic histopathology demonstrated mucosal thickening with inflammatory cell infiltration, crypt abscesses, and epithelial cell exfoliation, erosion, and ulceration. SPF mice colonized with rETBF mimicked WT-ETBF, whereas rNTBF caused no histopathology. Intestinal epithelial E-cadherin was rapidly cleaved in vivo in WT-ETBF-colonized mice and in vitro in intestinal tissues cultured with purified BFT. ETBF mice colonized for 16 months exhibited persistent colitis. BFT did not directly induce lymphocyte proliferation, dendritic cell stimulation, or Toll-like receptor activation. In conclusion, WT-ETBF induced acute then persistent colitis in SPF mice and rapidly lethal colitis in WT germfree mice. Our data support the hypothesis that chronic colonization with the human commensal ETBF can induce persistent, subclinical colitis in humans.

Polygonum minus (kesom) was steam distilled to produce an oil in 0.3% yield. The chemical composition of the oil was examined in detail using a combination of GC/MS. Results obtained from the chemical analysis in combination with some preliminary plant propagation studies indicate that it is possible to obtain kesom oil which possesses a total aldehyde content > 87%. This can be achieved only when the plants are grown under controlled conditions. In total 28 compounds were identified in the oil.

Objectives This study compared the efficacy and safety profile of electrohydraulic (EH) and electromagnetic (EM) lithotriptors in the treatment of 10- to 20-mm renal and proximal ureteric stones at a single center and by a single operator. Methods Between January 2001 and December 2006, we sequentially treated patients meeting study inclusion criteria with MPL 9000 Dornier EH for the first 3 years, followed by the EM Siemens Modularis shockwave lithotripsy (SWL) unit. A single operator performed all SWL treatments under the supervision of an admitting urologist. We analyzed the demographic features and stone- and treatment-related parameters including complications for both groups. In each group, the stone-free rate and efficiency quotient was determined at 1-3 months. Results Of 274 patients, we sequentially treated 112 using the EH lithotriptor, and 162 the EM lithotriptor. The pre-SWL patients and stone-related parameters were similar in the two groups, except for diagnostic imaging modalities. The mean number of SWL sessions, need for ancillary procedure, retreatment rate, stone location, stone-free rate, and efficiency quotient were not significantly different between groups. The mean number of shockwaves required for complete fragmentation was 2977 and 6044 (P Conclusions Single center, single operator experience with two types of lithotriptor indicated that both are equally efficacious, with similar safety profiles. The only significant difference was that the EH lithotriptor required fewer shockwaves for fragmentation.

Forty-one compounds have been identified in the essential oil of Ruta angustifolia. Besides the already known compounds, seven derivatives possessing the 3,4-methylenedioxyphenyl moiety were identified, including piperonyl acetone and a novel olefinic derivative 8-(3,4-methylenedioxyphenyl)-1-octene.

The effects of seat belts and the use of alcohol and drugs have been studied as etiological factors in facial trauma to occupants of motor vehicle accidents (MVAs). During a 15-month period, 461 patients were admitted to a regional trauma center as a result of injuries sustained in MVAs. Two hundred thirty-seven (51%) of these patients had facial trauma. Facial trauma was the single most common injury in these patients. One hundred eighty-five patients (78%) had major soft tissue injury, and 52 patients (22%) had facial bone fractures. Forty-two of 237 patients (18%) with facial trauma were wearing seat belts compared with 74 of 224 patients (33%) without facial trauma who were wearing seat belts at the time of the accident. Large numbers of patients who were wearing seat belts at the time of the accident had minor injuries and were never admitted to the hospital. Sixty-five of 224 patients (24%) without facial trauma and 121 of 237 patients (51%) with facial trauma tested positive for alcohol or drugs. The majority of the patients who tested positive for alcohol had blood alcohol levels of more than 100 mg/dL. Head injuries and blunt chest trauma were most commonly associated injuries in these patients. This study suggests that use of alcohol and drugs in occupants of the motor vehicle had a major effect on the etiology of facial trauma. Also it supports the data that suggests that the use of seat belts prevents a wide range of injuries including facial trauma in MVAs.

An expressed oil of the fruit of Pittosporum spp. was analyzed by GC and GC/MS. Fifteen compounds were identified in the oil, of which α-pinene (60.2%) was the major component. Chiral GC analysis revealed that α-pinene was made up of more than 99% (R)-enantiomer.

3 analogs bound to hGRPR cells with high affinity and each was rapidly internalized to the similar extent (40% in 7.5 rain). Similar internalization was seen in NIH H1299 lung cancer cells which possess hGRPR. Using an MTT assay CAMPTO-BN inhibited cell growth with a half-mammal dose of 200 nM in NCI H1299 cancer ceils and was 4 times more potent at inhibiting growth of hGRPR/BALB cells than untransfected BALB cells, whereas, no difference was seen with unconjugated camptothecin. CONCLUSIONS: We have successfully developed a high affinity GRPR agonist coupled to camptothecin in a varyingly labile fashion that ts cytotoxic for normal and cancer cells which have GRPR The availability of such an agent should be helpful for targeting cancer cells that possess GRPR and therefore useful as a more specific therapeutic agent for these cancers.

Background To determine factors influencing the clearance of fragments after extra-corporeal shock wave lithotripsy (ESWL) for lower pole calyceal (LPC) stones. Methods In the period between July 1998 and Oct 2001, 100 patients with isolated lower polar calyceal calculi ≤ 20 mm, in patients aged ≥ 14 years, were included in the study. Intravenous urograms (IVU) were reviewed to define the LPC anatomy (width of the infundibulum and pelvicalyceal angle). Study end points i.e. stone free status; number of shock waves used and number of sessions were correlated with variables like LPC anatomy, body mass index and stone size. Results At three months follow up the clearance for stone size ≤ 10 mm, 11–15 mm and 16–20 mm were 95, 96 and 90% respectively. Patients with acute LPC (90°) had stone clearance of 94 and 100% respectively. For the infundibular width of < 4 mm, the stone clearance was 93% were as for > 4 mm, it was 100%. For body mass index (BMI) less than and > 30 kg/m2, the stone clearance was 92 and 95% respectively. Conclusions There is a trend towards more ESWL sessions and shock wave requirement in patients with acute pelvi-calyceal angle and narrow infundibulum but it is not statistically significant. Size (≤ 20 mm) and BMI has no relation with stone clearance. With modern lithotripter, stones up to 20 mm could primarily be treated by ESWL, irrespective of an un-favorable lower polar calyceal anatomy and body habitus.

The wood oil of Cinnamomum parthenoxylon of Malaysian origin, which was produced in 1.0% yield, was found to contain methyl eugenol (45%) and safrole(20%).

The essential oil of Ruta graveolens produced in Malaysia was subjected to analysis by GC/MS. Thirty compounds representing ca. 82% of the oil were identified. The major compounds were 2-undecanone (30.73%), 2-nonanone (18.06%) and 2-nonyl acetate (11.03%). Psoralen (1.28%) and bergaptene or xanthotoxin (7.24%) also were identified in the oil.

Nonabsorbable radioactive material was used in treating malignant lesions by local injection. One hundred thirty-five Lewis Wistar rats were inoculated subcutaneously with tumor cells. After 7 days, the rats grew tumors of approximately 1 x 1 x 1 cm at the injection site. The rats then were divided into two groups; 50% were kept as a control group while the other 50% received single injections of 1 mCi yttrium 90 (/sup 90/Y) microspheres directly into the center of the tumor. This study shows a significant reduction of the tumor growth rate in treated animals. Tumor sizes after 4 days averaged 1.31 ml in the treated rats and 9.74 ml in the control group. Excluding animals that had complete regression of the tumor, treated rats lived an average of 30.8 days from the day of treatment compared with the control rats, which lived an average of 17.4 days. Pathology examinations showed no effects from injected radioactive materials in the liver, bone marrow or the kidney. Examination of the injected area after 6 months showed that microspheres remained locally and that the tumor was replaced with collagen tissue.

Sera from 20 anemic patients with chronic renal failure (CFR) were studied for their effect on bone marrow in vitro erythroid colony formation (CFUE) and the observations correlated with parathyroid hormone (PTH) and ionized calcium levels in the patients' sera. Results demonstrated that 17 out of 20 patients' sera significantly inhibited in vitro erythropoiesis by 47% to 97%. No significant elevation in ionized calcium was found in 16 of the patients tested. Furthermore, assay of PTH levels in these patients revealed that 9 out of 20 had elevated levels of PTH. No correlation was found between PTH serum levels and the degree of in vitro inhibition of erythropoiesis (CFUE) by the patients' sera. Addition of up to 2,000 pg/mL (far above the patients' levels) of exogenous N-terminal or C-terminal PTH with in vitro bone marrow cultures resulted in no inhibitory effect on CFUE. It is concluded that the circulating inhibitor of erythropoiesis which has been shown to exist in the sera of this particular group of patients with CRF, is not PTH.

Pseudoobstruction of the large bowel occurs as acute distention of the colon, usually in a high risk and seriously ill patient without any mechanical obstruction. Massive distention of the colon results in perforation of the cecum and fecal peritonitis and is associated with a very high mortality rate. Laparotomy with cecostomy is the recommended surgical therapy for this problem which carries a mortality rate of over 20 percent. We have used the colonoscope to decompress the distended colon, and especially the cecum, in 10 patients with Ogilvie's syndrome, with a 90 percent success rate and no deaths or complications. The surgeon should follow the several technical guidelines mentioned herein for successful and safe performance of the procedure. These guidelines include a tap water enema of about 1,000 ml before the procedure, avoidance of the liberal use of air insufflation during the procedure, and blind insertion of the colonoscope. This procedure is not indicated in any patient with signs of peritonitis and perforation.

A new technique has been added to the Hartmann procedure to suture the rectal stump to the presacral fascia using black silk sutures at the time of the initial resection and closure of rectal stump. This will prevent contraction of the rectal stump behind the bladder or vagina deep in the pelvis and makes reanastomosis of the proximal colon to the rectal stump very easy. Also discussed are the advantages of the modified Hartmann procedure in cases of emergency sigmoid colectomy as opposed to the conventional three stage procedure.

• To find a way to decrease the incidence of laparotomies negative for appendicitis, we studied 108 female patients between the ages of 15 and 45 years who had undergone appendectomy with the diagnosis of acute appendicitis. Of these 108 patients, 56 had acute appendicitis and 52 had normal appendixes. The patients between the ages of 15 and 25 years had a 59% incidence of negative laparotomies, in comparison with those patients between 36 and 45 years old, who had an incidence of 22%. In patients with normal appendixes, 18 had no intra-abdominal pathologic findings. Twenty had pelvic inflammatory disease, and nine had ovarian abnormalities. There were no differences in the clinical symptoms, vital signs, roentgenographic findings, or other laboratory studies between the two groups. There were no in-hospital perforated appendixes in the patients who were operated on within 48 hours of admission. To decrease the incidence of negative appendectomies, we recommend in-house observation and simultaneous examination of the patient by the surgeon and a gynecologist. ( Arch Surg 1986;121:1053-1055)

In few other areas of activity are the generation, gathering, processing, application and communication of information as important for business as they are in the travel and tourism industry. Ski area executives need to understand their markets in order to effectively interact with them. For this, managers have to be able to generate enough timely information about the market to support their decision making processes. This study develops a prototype ski executive information system for the Canadian ski industry. It is designed to provide ski industry executives with a readily accessible source of product and marketing intelligence to assist in strategic decision making. The icon and menu based grapical interfaces developed in this prototype combine to provide a user friendly information retrieval system whose efficiencies could eventually provide a botter use of various tourism data bases by decision makers.