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La rupture traumatique des corps caverneux est une urgence qui s’inscrit dans le cadre des affections rares du pénis. Elle peut avoir une lourde conséquence sur la fonction sexuelle ultérieure des patients souvent jeunes. L’objectif de notre étude était d’évaluer l’impact du traitement chirurgical de la fracture des corps caverneux sur la fonction sexuelle masculine.

Background: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe.Methods: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14).Results: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries.Conclusion: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.

A special course on Marriage, the Family and Human Sexuality was established at Kenrick-Glennon Seminary in St. Louis so as to assist the seminarians in their better understanding of the Church’s teaching relative to natural methods of family planning and women’s health care. This article compares the response at the beginning of this three-credit semester course to the same seven-item questionnaire given at the conclusion of the course. The pre- and postcourse scores were calculated for each of the questions. The scores obtained after the course were all significantly higher than they were before the course with pvalues ranging from 0.01 to <0.0001. Four of the items showed marked improvement including an understanding of the church’s teaching related to natural methods, current methods of natural family planning, the impact of a natural method on a couple’s marriage, and also the impact of a natural method on family life. Statistically significant improvement was also seen in their understanding of the topic of natural family planning and the Creighton Model System and its relevance toward the seminarian’s vocation, the use of the methods to either achieve or avoid pregnancy, and how contraception and abortion are linked. In these last three items, the level of statistical significance was quite high, although not as high as the other four items. There were 104 seminarians over an eight-year period of time, who provided answers to these questions, both before and after the course. This course was modeled after a course that was initiated at the Pope Paul VI Institute for the Study of Human Reproduction, which was for priests, seminarians, and Catholic leaders, titled Love & Life Unlimited.Nontechnical Summary: This is an evaluation of a ten-point, seven-question questionnaire that was utilized at the beginning of a course at Kenrick Seminary in Marriage, Sexuality, Creighton Model and NaProTECHNOLOGY. The same questionnaire was given to the students at the beginning of the course and then two to three months later at the conclusion of the three-credit course. The results show that there is a significant improvement in the seminarians’ knowledge and general attitude about natural methods of family planning and suggests that such courses would be beneficial to establish in seminaries throughout the country.

A special course on Marriage, the Family and Human Sexuality was established at Kenrick-Glennon Seminary in St. Louis so as to assist the seminarians in their better understanding of the Church's teaching relative to natural methods of family planning and women's health care. This article compares the response at the beginning of this three-credit semester course to the same seven-item questionnaire given at the conclusion of the course. The pre- and postcourse scores were calculated for each of the questions. The scores obtained after the course were all significantly higher than they were before the course with p values ranging from 0.01 to < 0.0001. Four of the items showed marked improvement including an understanding of the church's teaching related to natural methods, current methods of natural family planning, the impact of a natural method on a couple's marriage, and also the impact of a natural method on family life. Statistically significant improvement was also seen in their understanding of the topic of natural family planning and the Creighton Model System and its relevance toward the seminarian's vocation, the use of the methods to either achieve or avoid pregnancy, and how contraception and abortion are linked. In these last three items, the level of statistical significance was quite high, although not as high as the other four items. There were 104 seminarians over an eight-year period of time, who provided answers to these questions, both before and after the course. This course was modeled after a course that was initiated at the Pope Paul VI Institute for the Study of Human Reproduction, which was for priests, seminarians, and Catholic leaders, titled Love & Life Unlimited. Nontechnical Summary: This is an evaluation of a ten-point, seven-question questionnaire that was utilized at the beginning of a course at Kenrick Seminary in Marriage, Sexuality, Creighton Model and NaProTECHNOLOGY. The same questionnaire was given to the students at the beginning of the course and then two to three months later at the conclusion of the three-credit course. The results show that there is a significant improvement in the seminarians' knowledge and general attitude about natural methods of family planning and suggests that such courses would be beneficial to establish in seminaries throughout the country. [ABSTRACT FROM AUTHOR]

The West Florida Shelf (WFS) is a source of uncertainty for the Gulf of Mexico carbon budget. Data from the synthesis of approximately 135,000 pCO2values from 97 cruises from the WFS show that the shelf waters fluctuate between being a weak source to a weak sink of carbon. Overall, the shelf acts as a weak source of CO2at 0.32 ± 1.5 mol m−2yr−1. Subregions, however, reveal slightly different trends, where surface waters associated with 40–200‐m isobath in the northern and southern WFS are generally weak sinks all year, except for summer when they act as sources of CO2. Conversely, nearshore waters (<40 m) are a source of CO2, particularly the southern shallow waters, which are a source all year round. The pCO2of seawater has been increasing at a rate of approximately 4.37 μatm/year as compared to atmospheric pCO2which has increased at a rate of about 1.7 μatm per year from 1996 to 2016. The annual CO2flux has increased from −0.78 to 0.92 mol m−2yr−1on the shelf from 1996–2016. The WFS is emitting 9.23 Tg C/year, with the southern nearshore region emitting the most at 9.01 Tg C/year and the northern region acting as a sink of −1.96 Tg C/year. Aragonite saturation state on the WFS shows seasonal and geographic trends with values ranging from 2 to 5. Lowest values are found in winter associated with subregion <40‐m isobath. The West Florida Shelf (WFS) is a source of uncertainty for determining the Gulf of Mexico carbon budget and how surface waters are being affected by increasing atmospheric carbon dioxide (CO2) levels. Little is known about the WFS trends of the seawater partial pressure of carbon dioxide (pCO2) over the last decades; much of the uncertainty stems from lack of data. In order to address some of this uncertainty, approximately 135,000 pCO2values collected on 97 research cruises between 1996 and 2016 were analyzed and show that the shelf waters have changed from being a weak sink to weak source of CO2to the atmosphere. Further, data was divided into four geographical subregions. Offshore surface waters absorb CO2, whereas nearshore surface waters emit CO2to the atmosphere. Importantly, pCO2of the nearshore seawater has been increasing at a rate approximately 2.5 times faster than atmospheric pCO2over the past 20 years. These data indicate that factors in addition to the atmosphere CO2are influencing increases in nearshore seawater. Additionally, WFS aragonite saturation state, often used to monitor ocean acidification conditions, shows seasonal and geographic trends, with year‐round supersaturated values ranging from 2 to 5. WFS surface water shows a change from carbon sink to source from 1996 to 2016The WFS emits 9.23 Tg C/year, with the south nearshore emitting the most at 9.01 Tg C/year and the north acting as a sink of −1.96 Tg C/yearShelf water (<40‐m isobath) pCO2has increased at a rate approximately 2.6 times faster than the atmospheric rate in the past 20 years

The National Organ Transplant Act stipulates that deceased donor organs should be justly and wisely allocated based on sound medical criteria. Allocation schemes are consistent across the country, and specific policies are publicly vetted. Patient selection criteria are largely in the hands of individual organ transplant programs, and consistent standards are less evident. This has been particularly apparent for patients with developmental disabilities (DDs). In response to concerns regarding the fairness of transplant evaluations for patients with DDs, we developed a transplant centerwide policy using a multidisciplinary, community‐based approach. This publication details the particular policy of our center. All patients should receive individualized assessments using consistent standards; disability should be neither a relative nor an absolute contraindication to transplantation. External review can increase trust in the selection process. Patients in persistent vegetative states should not be listed for transplantation. The authors present the Pediatric Transplant Center at Boston Children's Hospital's policy addressing developmental disability as a patient selection criterion for deceased donor solid organ transplantation.

Identification of biomarkers that assess posttransplant risk is needed to improve long‐term outcomes following heart transplantation. The Clinical Trials in Organ Transplantation (CTOT)‐05 protocol was an observational, multicenter, cohort study of 200 heart transplant recipients followed for the first posttransplant year. The primary endpoint was a composite of death, graft loss/retransplantation, biopsy‐proven acute rejection (BPAR), and cardiac allograft vasculopathy (CAV) as defined by intravascular ultrasound (IVUS). We serially measured anti‐HLA‐ and auto‐antibodies, angiogenic proteins, peripheral blood allo‐reactivity, and peripheral blood gene expression patterns. We correlated assay results and clinical characteristics with the composite endpoint and its components. The composite endpoint was associated with older donor allografts (p < 0.03) and with recipient anti‐HLA antibody (p < 0.04). Recipient CMV‐negativity (regardless of donor status) was associated with BPAR (p < 0.001), and increases in plasma vascular endothelial growth factor‐C (OR 20; 95%CI:1.9–218) combined with decreases in endothelin‐1 (OR 0.14; 95%CI:0.02–0.97) associated with CAV. The remaining biomarkers showed no relationships with the study endpoints. While suboptimal endpoint definitions and lower than anticipated event rates were identified as potential study limitations, the results of this multicenter study do not yet support routine use of the selected assays as noninvasive approaches to detect BPAR and/or CAV following heart transplantation. In this observational, multicenter, cohort study of 200 heart transplant recipients, the investigators find that acute rejection and evidence of vasculopathy at 1 year posttransplant correlates with several epidemiological parameters, anti‐HLAantibodies and plasma angiogenesis‐related factors, but not with a panel of cellular and molecular biomarkers. See also Van Aelst et al on page 99.

To study temporal trends in crude and age standardised rates of cardiac catheterisation and percutaneous coronary intervention (PCI) in Ireland, 2004–2011.

In this paper we study grating-induced plasmon–plasmon coupling in photorefractive layered media using a weak-coupling approximation. The method used is applicable to general layered structures that support both plasmonic and optical modes, such as photorefractive liquid crystal cells. The approximate equations are accurate when compared to S matrix approaches and capture the plasmon propagation at the surface of the device along with the optical modes guided by the layered geometry underneath. Analysis of the resulting model provides insight into the effect of the control parameters in this device and the means to optimize the diffraction efficiency. For example, by considering the case in which the plasmon is spectrally separated from the guided modes it is possible to determine the optimum gold thickness and grating strength required to obtain the strongest possible diffraction.

ABSTRACTRecombinant clones of the carboxyl terminus of the major surface glycoprotein (MsgC) of Pneumocystis jiroveciiare useful for analyzing serologic responses in humans. However, there is no standardized set of antigens in general use, which could lead to conflicting results. We have previously shown that human immunodeficiency virus type 1 (HIV-1)-infected patients with prior Pneumocystispneumonia (PcP+) responded more frequently and more strongly to a clone of MsgC than did HIV-1-infected patients without PcP (PcP-). Here we test three new clones of MsgC to determine the effect of antigenic sequence variation on immune reactivity in blood donors and HIV-infected patients previously analyzed for reactivity to our original MsgC clone. In Western blot analyses, PcP+patients exhibited the highest frequency of reactivity to each MsgC clone, and the frequency of reactivity with all four MsgC clones together was significantly higher in sera from PcP+patients than in sera from the other patient groups. Furthermore, in an enzyme-linked immunosorbent assay we found that the PcP+population had the highest level of reactivity to two of the four clones tested. One of the new clones could distinguish between PcP+and PcP-populations, and two MsgC clones could distinguish blood donors from the other patient populations. The results show that inherent differences in MsgC amino acid sequence can affect recognition by antibodies independently of variations in protein length or patient population, and the utility of a clone depends on its sequence and on the populations tested.

Fat embolism occurs following fractures of a long bone or arthroplasty. We investigated whether paradoxical embolisation through a venous-to-arterial circulation shunt (v-a) could lead to cerebral embolisation during elective hip or knee arthroplasty.Transcranial Doppler ultrasound (TCD), following the intravenous injection of microbubble contrast, identified the presence of a shunt in 41 patients undergoing hip (n=20) or knee (n=21) arthroplasty. Intra-operative cerebral embolism was detected during continuous TCD monitoring. Of the 41 patients, 34 had a v-a shunt of whom 18 had an embolism and embolism only occurred in patients with a shunt (p = 0.012). Spontaneous and larger shunts were associated with a greater number of emboli (rs= 0.67 and rs= 0.71 respectively, p < 0.01). Observations in two patients with large spontaneous shunts revealed 368 and 203 emboli and unexplained post-operative confusion and pancreatitis.Paradoxical cerebral embolisation only occurred in patients with a shunt and may explain both postoperative confusion and fat embolism syndrome following surgery.

The Creighton Model system of natural family planning (NFP) is useful in achieving pregnancy, avoiding pregnancy, and detecting some gynecologic disorders. NFP practitioners support the client in using NFP. Because the effectiveness of NFP is related to the teaching process and to teacher expertise, clients choosing NFP may be best served by referral to a certified NFP practitioner for instruction.

The Creighton Model system of natural family planning (NFP) is useful in achieving pregnancy, avoiding pregnancy, and detecting some gynecologic disorders. NFP practitioners support the client in using NFP. Because the effectiveness of NFP is related to the teaching process and to teacher expertise, clients choosing NFP may be best served by referral to a certified NFP practitioner for instruction.

The surgical treatment of Perthes’ disease by femoral or innominate osteotomy is not as effective in those over the age of eight years as it is in the younger child. This has prompted the search for other types of management in those who are older. The preliminary results of the use of a lateral shelf acetabuloplasty for such cases have shown encouraging results at two years. The concern with such an operation is that it might interfere with the growth of the outer aspect of the acetabulum and so prejudice the long-term outcome. We describe a review at maturity of 26 children presenting with early disease after the age of eight years who were treated by lateral shelf acetabuloplasty. The results suggest that the outcome is improved; 22 of 27 hips were rated as Stulberg groups 1 to 3. Poor results occurred in children, particularly girls, presenting with Group-4 disease over the age of 11 years.

Hairy cell leukemia is a chronic lymphoproliferative disorder of B-cell lineage, whose malignant cells express the interleukin-2 (IL-2) receptor. A soluble form of the IL-2 receptor is released by these cells in culture, and the sera of patients with hairy cell leukemia contain elevated levels of this soluble receptor. Four hundred twenty- seven serum samples from 101 patients were analyzed for soluble IL-2 receptor (sIL-2R). The clinical status of patients appeared to be associated with the serum level of sIL-2R. The hairy cell index (a measure of tumor cell burden) was correlated with the square root of the serum sIL-2R level (r = .77). Improved clinical status was associated with decreasing serum sIL-2R levels, whereas disease relapse was associated with increasing levels. Notably, every patient who responded to therapy had a decline in serum sIL-2R level, and every patient with disease progression had an increase in serum sIL-2R level. This phenomenon was observed for several different treatments, including standard-dose interferon, low-dose interferon, and deoxycoformycin. The predictive reliability of this test is currently being prospectively evaluated.

Previous studies have demonstrated that significant hematologic improvement occurs in the majority of patients with hairy cell leukemia (HCL) treated with partially purified or recombinant interferon (IFN). Fifty-three patients received IFN alfa-2b for at least 3 months in a dose of 2 X 10(6) U/m2 subcutaneously thrice weekly. Of the 49 patients evaluable for response (at least 6 months of IFN therapy), there were ten complete responses and 29 partial responses for a total response rate of 80%. The peripheral blood counts and bone marrow continued to improve over the course of a full year of therapy. IFN was well tolerated, with no patients discontinuing therapy because of toxicity. Transient myelosuppression occurred in most patients during the first 1 to 2 months of therapy, occasionally precipitating a transfusion requirement. After IFN treatment was discontinued, there was a marked decrease in normal marrow elements and a relative increase in marrow hairy cells. This was associated with a transient increase in normal elements in the peripheral blood. Only one of 24 patients followed after receiving IFN for a median of 8.5 months (range, 3 to 16 months) has required further therapy. We conclude that low-dose IFN alfa-2b is highly effective in advanced HCL; responding patients should be treated for at least 1 year. The decision to initiate a second course of IFN therapy should be based primarily on peripheral blood counts and the clinical status of the patient rather than on the bone marrow.

An efficient numerical procedure is presented for calculation of the transfer function corresponding to a state-space description.

Sixty-one strains of bacteria capable of growth on 4-methyl benzoic acid (29 isolates) or naphthalene (32 isolates) as the sole source of carbon and energy were isolated from sediments and water samples from the River Tyne, UK. Random amplification of polymorphic DNA from genomic DNA extracted from the different strains demonstrated that 14 of the 4-methyl benzoate-degrading isolates were unique and the remainder fell into seven groups containing two or three isolates that produced identical banding patterns. Thirteen of the naphthalene-degrading isolates were unique and nine groups with two or three identical representatives encompassed all other isolates. Screening of the bacterial strains for the presence of genes homologous to xylE, nahC and bphC by polymerase chain reaction and dot blot hybridizationdemonstrated that most strains harboured xylE- and/or nahC-like genes and only asingle isolate was found that did not harbour any of these genes. None of the isolates harboured bphC-like genes. It was concluded that, while considerable diversity existed in host strainsisolated using a single simple enrichment procedure, the extradiol dioxygenase genes involved inaromatic ring cleavage, present in these strains, were conserved to a considerable degree.

We have used T-cell receptor beta-chain transgenic mice to determine the effects of a limited T-cell receptor repertoire on major histocompatibility complex class I-restricted epitope selection during the course of an influenza virus infection. Analysis of T-cell hybridomas generated from wild-type and transgenic mice demonstrated that the viral epitope recognized depended on the available T-cell receptor repertoire. Wild-type T-cell hybridomas recognized epitopes derived from the nucleoprotein and basic polymerase molecules, whereas hybridomas generated from transgenic mice recognized epitopes derived from the nonstructural protein and the matrix protein. There was no overlap in specificity between the two panels of hybridomas. This reciprocal pattern of specificity was also apparent in cytoxicity assays with brochoalveolar lavage cells isolated from the lungs of influenza virus-infected mice. T-cell receptor usage in the transgenic hybridomas was very restricted, with only one V alpha element used for ech of the two viral epitopes recognized. In the case of the hybridomas reactive to the nonstructural protein, sequence analysis showed that they all expressed V alpha 4J alpha 32 chains associated with the same junctional amino acids (Leu-Leu) that were encoded by five different nucleotide sequences, indicating a strong selection for T-cell receptor usage. Taken together, these data demonstrate that the available T-cell receptor repertoire can have a profound effect on the immunodominance of class I-restricted epitopes during a viral infection.

The consequences of severely limiting the T-cell receptor (TCR) repertoire available for the response to intranasal infection with an influenza A virus or with Sendai virus have been analyzed by using H-2k mice (TG8.1) transgenic for a TCR beta-chain gene (V beta 8.1D beta 2J beta 2.3C beta 2). Analyzing the prevalence of V beta 8.1+ CD8+ T cells in lymph node cultures from nontransgenic (non-TG) H-2k controls primed with either virus and then stimulated in vitro with the homologous virus or with anti-CD3 epsilon showed that this TCR is not normally selected from the CD8+ T-cell repertoire during these infections. However, the TG8.1 mice cleared both viruses and generated virus-specific effector cytotoxic T lymphocytes (CTL) and memory CTL precursors, though the responses were delayed compared with the non-TG controls. Depletion of the CD4+ T-cell subset had little effect on the course of influenza virus infection but substantially slowed the development of the Sendai virus-specific CTL response and virus elimination in both the TG8.1 and non-TG mice, indicating that CD4+ helpers are promoting the CD8+ T-cell response in the Sendai virus model. Even so, restricting the available T-cell repertoire to lymphocytes expressing a single TCR beta chain still allows sufficient TCR diversity for CD8+ T cells (acting in the presence or absence of the CD4+ subset) to limit infection with an influenza A virus and a parainfluenza type 1 virus.

Metabolic utilization and toxicity of acetaldehyde were studied in flies lacking alcohol dehydrogenase (ADH), aldehyde oxidase (AO), or both functions. Prior to the experiments, mutant alleles Adhn4 and mal were transferred to the same genetic background by 10 successive backcrosses. By comparison with wild-type flies, various deleterious, pleiotropic effects could be attributed to the mal allele but not to Adhn4. Of the four genotypes studied (mal, Adhn4, mal Adhn4, and wild), all were able to use acetaldehyde as a resource in a similar way. In spite of its high toxicity, acetaldehyde appeared a better resource than ethanol. Flies treated with intermediate acetaldehyde concentrations (around 0.5%) exhibited a very high interindividual heterogeneity which could reflect a physiological adaptation occurring as a consequence of the aldehyde treatment. Toxicity tests showed that ADH-negative flies were more sensitive to acetaldehyde than wild type, but this is most likely explained by the transformation of the aldehyde into alcohol. Our results show that the aldehyde metabolizing enzyme (AME) system in Drosophila is neither ADH nor AO. The existence of an aldehyde dehydrogenase is plausible.

The response of Arabidopsis thaliana (L.) Heynh. (Cruciferae) to a gradient of chronic gamma-radiation was examined under field conditions. Plants that were initially introduced to the gamma field as dry seeds received exposures of 1·34 to 18 800 R/20 hour day from the time of seed germination. Regression analysis demonstrated a significant, but non-linear, response for three variables, number of seedlings emerging, number of plants flowering, and plant volume; the response of a fourth variable, number of leaves per plant, was not related to daily exposure. LD50 values ranged from 66 R/20 hour day for plant volume to 1231 R/20 hour day for seedling emergence. Flowering and plant volume were the most sensitive indicators of radiation exposure. The demonstration of a variable threshold at low levels of exposure indicates that in nature A. thaliana may be exposed to environmental radiation throughout its life-cycle without significant modification of growth or development.

In this paper algorithms far the computation of all four Luonbarger canonical forms are presented. The algorithms are based on an appropriate sequence of elementary similarity transformations and are well suited to digital computer implementation. They also provide considerable improvement over existing methods particularly when the transformation matrix as well as the canonical form is required.

Sixty-one strains of bacteria capable of growth on 4-methyl benzoic acid (29 isolates) or naphthalene (32 isolates) as the sole source of carbon and energy were isolated from sediments and water samples from the River Tyne, UK. Random amplification of polymorphic DNA from genomic DNA extracted from the different strains demonstrated that 14 of the 4-methyl benzoate-degrading isolates were unique and the remainder fell into seven groups containing two or three isolates that produced identical banding patterns. Thirteen of the naphthalene-degrading isolates were unique and nine groups with two or three identical representatives encompassed all other isolates. Screening of the bacterial strains for the presence of genes homologous to xylE, nahC and bphC by polymerase chain reaction and dot blot hybridization demonstrated that most strains harboured xylE- and/or nahC-like genes and only a single isolate was found that did not harbour any of these genes. None of the isolates harboured bphC-like genes. It was concluded that, while considerable diversity existed in host strains isolated using a single simple enrichment procedure, the extradiol dioxygenase genes involved in aromatic ring cleavage, present in these strains, were conserved to a considerable degree.

Nine patients with progressive hairy cell leukemia were treated with subcutaneous injections of recombinant alpha 2 interferon (2 to 10 X 10(6) U/m2) three times weekly. Eight patients completed at least eight weeks of treatment and were evaluable; one patient with refractory thrombocytopenia died of an intracerebral hemorrhage after two doses of interferon. Seven of eight patients responded, with responses occurring as early as two weeks. Four patients also had resolution of their monocytopenia. No complete responses were seen with up to 30 weeks of treatment. Bone marrow biopsies demonstrated improvement in all eight patients. No unforeseen toxicity occurred, but most patients had transient myelosuppression during the first few weeks of treatment. Recombinant alpha 2 interferon is effective in the treatment of hairy cell leukemia, with acceptable toxicity.

An algorithm is presented for converting a single-output time-varying linear system to phase-variable canonical form. The method uses a sequence of elementary equivalence transformations and requires considerably fewer function multiplications and differentiations than other techniques.

Several biologically important examples of posttranscriptionally regulated genes have recently been described (T. Gerster, D. Picard, and W. Schaffner, Cell 45:45-52, 1986; R. Reeves, T.S. Elton, M.S. Nissen, D. Lehn, and K.R. Johnson, Proc. Natl. Acad. Sci. USA 84:6531-6535, 1987; H.A. Young, L. Varesio, and P. Hwu, Mol. Cell. Biol. 6:2253-2256, 1986). Little is known, however, regarding sequences that mediate posttranscriptional RNA stability. Characterization in our laboratory of a mutant murine B lymphoma, M12.C3, revealed a posttranscriptional defect affecting the synthesis of a major histocompatibility complex class II gene (A beta d) whose product normally controls both the specificity and magnitude of the immune response. Molecular studies revealed that the mutation responsible for diminished A beta d gene expression was an intronic deletion of 10 base pairs (bp) located 99 bp 5' of the third exon. This deletion lies in a region not known to be critical for accurate and efficient splicing. Furthermore, sequence analysis of amplified A beta-specific cDNA demonstrated that the small number of A beta d transcripts produced in the mutant cells was correctly spliced. It appears that the mechanism by which this intronic 10-bp deletion acts to decrease RNA stability is unlikely to be at the level of RNA splicing.

We reviewed 26 consecutive men of mean age 28 years who had had wedge bone grafting and Herbert screw fixation for symptomatic established nonunion of the waist of the scaphoid. The period between injury and operation averaged 30 months (10 to 96), and 11 of the 26 patients had had previous operations, seven with bone grafts.At a mean follow-up of 14 months (6 to 42) 25 fractures (95%) had united at a median time of four months. Symptoms were improved in all patients. The outcome was not related to the time between injury and surgery or to pre-existing degenerative changes. Previous surgery carried a worse prognosis.The technique is difficult but can achieve union even when previous surgery and bone grafting have failed. The usual result is improved function and some relief of pain.

We report a postal survey of 59 families of children with osteogenesis imperfecta. From the 51 replies we collected data on developmental milestones and walking ability and related them to the Sillence and the Shapiro classifications of osteogenesis imperfecta. Twenty-four of the patients had been treated by intramedullary rodding.Both classifications helped to predict eventual walking ability. We found that independent sitting by the age of ten months was a predictor for the use of walking as the main means of mobility with 76% attaining this. Of the patients who did not achieve sitting by ten months, walking became the main means of mobility in only 18%. The developmental pattern of mobility was similar in the rodded and non-rodded patients.

The authors compared parental reports with medical records for 157 children enrolled in a prospective study of chronic otitis media with effusion between 1987 and 1991. Parents completed a questionnaire about the child's past health history, and the research nurse abstracted history information from the clinic's medical record. Previous insertion of a tympanostomy tube (kappa = 0.96) and premature birth (kappa = 0.68) were accurately reported, but there was a substantial proportion of missing data for age at first episode of otitis media, occurrence of otitis media the previous summer, and number of episodes in the previous 18 months. Data were significantly more likely to be missing for male children, children with siblings, and those with more episodes. Parents who reported six or more previous episodes for their child overestimated the number compared with the medical record (8.7 vs. 7.4, respectively; p = 0.01), while those who reported fewer episodes underestimated the number (3.1 vs. 4.6, respectively; p = 0.01). Episodes of otitis media during the 3 months between study visits were also accurately reported (kappa = 0.94). The accuracy and completeness of parental report of the child's health history was influenced by the chronicity of otitis media, the duration of recall, and the seriousness of the event being recalled.

Microwave properties of high-temperature films deposited on LaAlO3 substrate are presented. The films are grownin situ using a high-pressure single-source sputtering technique. Microwave resonators and filters are fabricated and tested. The maximum measuredQ values are 1400; the surface resistances were less than 360µO between 4.2 and 50 K. The filter performance was 18 dB better than a similar filter fabricated in Ag.

High-quality superconducting films of erbium-barium-copper-oxide have been produced in a multisource sputtering system on a variety of substrates, including buffered sapphire and silicon wafers as well as various single-crystal materials. Fine-grained polycrystalline films with narrow (<4 K) resistive transitions have been grown on a number of different substrates. The use of erbium in the 12–3 compound leads to improved film morphology and to more forgiving conditions for establishing of the superconducting phase. Sputtered neutral mass spectroscopy (SNMS) yields useful information about the compositional profile of the films.

A new method for obtaining the (m-1/m) Padé approximation for a linear system in state space form is presented. Using elementary equivalence transformations the state matrix is progressively tridiagonalized, generating approximations of increasing order. The technique is equally applicable to series of Markov parameters, time moments of mixtures of these two.

Membrane sensors are key components employed by bacteria to respond to environmental changes such as alterations in chemical composition or nutrient availability. However, membrane-associated carbohydrate sensing in bacteria has remained unexplored. We have shown that dietary supplementation of piglet feed with the sweetener neohesperidin dihydrochalchone (NHDC), a flavonoid compound with the attached sugar moiety, neohesperidose (a disaccharide composed of L-rhamnose and D-glucose), specifically enhances the population abundance of a single phylotype, designated Lactobacillus (LB)4228, a member of the probiotic bacterium family, Lactobacillaceae. To understand the molecular basis of the sweetener effect, we isolated LB4228 from pig caecal contents and analysed its growth characteristics in the presence of NHDC. We demonstrated that NHDC significantly reduces the lag phase of growth and enhances expression of LB sugar transporters. Furthermore, we determined that NHDC is not transported, degraded or metabolised by LB4228. The experimental evidence suggested that sensing of NHDC by a plasma membrane receptor underlies sweetener-induced growth of this probiotic bacterium1. To determine the binding specificity of this putative bacterial receptor, we have recently synthesized a range of metabolites of NHDC, hesperetin dihydrochalcone-4′-β-D-glucoside hesperetin dihydrochalcone and 3-(3-hydroxy-4-methoxyphenyl)propionic acid. However, analysis of the effect of these metabolites on LB4228 indicated that neither the backbone structure of this flavonoid nor the attached monosaccharide glucoside moiety are recognised by the receptor. Interestingly the presence of neohesperidose the disaccharide moiety of NHDC, in culture media, was effective in enhancing sugar transporter expression in LB4228, leading to the conclusion that the putative plasma membrane sweet sensor of LB4228 detects disaccharides. Understanding of the underlying mechanism allows for the identification of this receptor and its use as a nutritional target for enhancing probiotic, health promoting gut bacteria.1Daly et al. (2015) Bacterial sensing underlies artificial sweetener-induced growth of gut Lactobacillus. Environ Microbiol 18, 2159–2171.

The transition from normality to malignancy in colorectal cancer is characterized by alterations in the expression of genes associated with the maintenance of tissue homoeostasis. Butyrate, a product of microbial fermentation of dietary fibre in the colon, is known to regulate a number of genes associated with the processes of proliferation, differentiation and apoptosis of colonic epithelial cells, and, hence, homoeostasis of colonic tissue. We have shown previously that the transport of butyrate into colonocytes is of fundamental importance to butyrate's regulatory ability, and therefore sought to assess the expression profile of butyrate-responsive genes in colon cancer tissue, where the expression of the colonic luminal-membrane butyrate transporter, MCT1 (monocarboxylate transporter 1), is significantly down-regulated. In the present paper, we first employed microarray analysis to assess global changes in butyrate-responsive genes using HT29 human colon carcinoma cells treated with butyrate. There was consistency in the butyrate response of selected genes in two other human colonic cell lines (HCT116 and AA/C1) using quantitative real-time PCR. Furthermore, we report that expression levels of selected butyrate-responsive genes involved in the processes of proliferation, differentiation and apoptosis, are deregulated in colon cancer tissue, correlating with decreased expression of MCT1. These findings support our hypothesis that a reduction in MCT1 expression, and hence butyrate transport, can lead to a reduction in the intracellular butyrate levels required to regulate gene expression. Collectively, our results highlight the important contribution of butyrate transport to the maintenance of tissue homoeostasis and disease prevention.

We report two cases of children with multiple hereditary osteochondromatosis (MHO) in whom painful restriction of hip movement developed due to intraacetabular osteochondromata. Excision of the lesions relieved pain and restored joint movement after 14 and 3 months' follow-up, respectively. Long-term follow-up of these patients is essential.