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Within the management of urban disasters, geo-information systems (GIS) are used in any of the phases of mitigation, preparedness, response and recovery as most of the required data have a spatial component. Examples of GIS-based decision support systems on mitigation are found in simulation models of floods and earthquakes. In the preparation phase all kinds of spatial observations and models can be used to predict which areas will be threatened. To prepare for adequately responding in case of an actual disaster, these systems are capable of developing realistic scenarios that are used within training and virtual reality (VR) systems. During the actual response phase geo-information is used intensively: for getting an impression of the environment, for routing, for obtaining up-to-date information about the actual situation, etc. In the recovery phase, there is often a high public and political interest to judge the situation - comparing the pre- and post-disaster situation - and to set priorities for the rebuilding. Despite this potential of GIS-based support for urban disaster management, the use of these systems or even the utilisation of geo-information itself is still very limited in countries in Africa, Asia and Latin America. The emergency management is usually done with paper maps that are seldom up-to-date. Useful systems to support decision makers in any of the phases of disaster management are nearly completely lacking. To improve the work of decision makers and rescue teams, different premises have to be archived in relation to: meta-information to provide insight on the availability and usefulness of the geo-information itself, the technical equipment of the rescue teams (i.e. communication devices and field computers), and the up-to-date information from the affected areas (images, observations, reports). This paper suggests a framework for “urban and urgent” disaster management to facilitate the work of police forces, fire departments, ambulances and government coordinators in disaster situations by extending and improving the utilisation of geo-information. Within a pre-disaster situation, geo-information support management further can assist planning for prevention and mitigation.

A young child was admitted to hospital with haemolytic-uraemic syndrome caused by infection with a Shiga toxin 2-producing strain of Escherichia coli (STEC) O157. Five days before he became ill, the child had visited a small petting zoo. STEC O157 strains were isolated from faecal samples from goats and sheep housed on the farm. The human and the animal isolates were indistinguishable by molecular subtyping. The petting zoo voluntarily closed temporarily to prevent further cases of infection. Two out of 11 other, randomly selected petting zoos (including one deer park) visited subsequently, tested positive. Furthermore, during the study period there was one more notification of STEC O157 infection possibly linked with a farm visit. Although STEC O157 was indeed found in the petting zoo associated with this patient, transmission through animal contact could not be confirmed because the human isolate was not available for subtyping. The case study and the results of the other on-farm investigations highlight the risk of acquiring severe zoonotic infections during visits to petting zoos.

This paper presents a series of five models that were formulated for describing the neural control of the lower urinary tract in humans. A parsimonious formulation of the effect of the sympathetic system, the pre-optic area, and urethral afferents on the simulated behavior are included. In spite of the relative simplicity of the five models studied, behavior that resembles normal lower urinary tract behavior as seen during an urodynamic investigation could be simulated. The models were tested by studying their response to disturbances of the afferent signal from the bladder. It was found that the inhibiting reflex that results from including the sympathetic system or the pre-optic area (PrOA) only counteracts the disturbance in the storage phase. Once micturition has started, these inhibiting reflexes are suppressed. A detrusor contraction that does not result in complete micturition similar to an unstable detrusor contraction could be simulated in a model including urethral afferents. Owing to the number of uncertainties in these models, so far no unambiguous explanation of normal and pathological lower urinary tract behavior can be given. However, these models can be used as an additional tool in studies of the mechanisms of the involved neural control. Neurourol. Urodynam. 19:289–310, 2000. © 2000 Wiley-Liss, Inc.

The amplitude of a surface electromyogram is dependent on the number of active motor units, their size and the relative position of the recording electrode. It is not possible to interpret the surface electromyogram quantitatively without disentangling these different aspects. In this study the decline of different components of the motor unit potential with increasing radial distance from the motor unit is quantified. Fifty‐two motor units in the biceps brachii muscle were studied using 36‐channel surface electromyography combined with intramuscular scanning electromyography. Scanning electromyography was used to locate precisely the motor unit. The dependence of the surface motor unit potential magnitude on the radial distance between the motor unit and the recording electrodes can be described fairly well by an inverse power function. The steepness of this function depends on the chosen motor unit potential parameter and the interelectrode distance, but also varies between motor units. The change of the negative peak amplitude of the motor unit potential over the skin surface can be used to give a fairly accurate estimate of the location of the motor unit under the skin surface. We found that for all practical purposes the depth of a motor unit in the biceps brachii muscle can be estimated as 20% of the distance over the skin surface where motor unit potentials can be recorded with higher amplitudes than 50% of the maximal amplitude recorded at the skin surface caused by activity of the same motor unit.

The aim of this study was to determine the objective tumour response rate and duration of response and toxicity of linomide (Roquinimex) treatment in patients with disseminated renal cell carcinoma, pretreated or not pretreated with immunotherapy. From March 1991 to July 1992, 72 patients with metastatic and progressive renal cell cancer were entered of whom 9 (12%) were not evaluable for response. Linomide was given orally, twice weekly, 5 mg during the first week with dose escalation to 10 mg during the second week and 15 mg thereafter. Treatment was continued until disease progression or unacceptable toxicity. No haematological toxicity but slight anaemia was observed. A significant WBC (white blood cell count) increase ( P < 0.0001 , paired T-test) was found during treatment. The most often reported non-haematological side-effects were: flu-like syndrome (54%, grade III-IV 7%), nausea/vomiting (41% and 3%, respectively) and neurotoxicity (34% and 2%). Most side-effects were of mild or moderate intensity (WHO grade 1 or 2). The objective overall response rate was 4%: 1 CR and 2 PRs. Stable disease was reported for 28 patients (40%). The duration of response was 17, 22 and 30 (CR) months. Median time to progression was 5 months. Linomide at the given dose and schedule is well tolerated, but has limited antitumour activity in metastatic renal cell carcinoma.

The background of the bioelectric activity of muscle recorded from the surface of the skin (surface electromyography) in terms of the representation of single motor units of the underlying muscle(s) is not very well documented or understood. An insight into the composition of an electromyogram is essential for the proper interpretation of one of the most widely applied electrophysiological techniques. In the present paper, a study of the contribution of single motor unit potentials to the surface electromyogram is presented. To this end, the decline of different components of the motor unit potential with depth of the motor unit is quantified. Experimentally, the action potentials from motor units at several positions in the muscle were recorded by 30 skin surface electrodes. Simultaneous use of scanning electromyography provided information about the actual position and size of the motor unit. Observed linear log–log relationships between motor unit potential magnitudes and distance indicated the usefulness of a power function to describe the motor unit potential's dependence on recording distance. It is shown that different specific surface motor unit potential characteristics fall off differently with depth. The magnitude–distance relationship is shown to be dependent on the recording configuration (unipolar vs. bipolar recording, including the inter‐electrode distance) and the chosen motor unit potential parameter (negative peak amplitude, positive peak amplitude and area).

AbstractVon Hippel-Lindau (VHL) disease is an autosomal dominant inherited disorder with a predisposition to develop a wide variety of lesions: retinal, cerebellar, spinal and medullar hemangioblastomas, renal cell carcinomas, phaeochromocytomas, and renal, pancreatic and epididymal cysts are the most frequent manifestations of the disease. The prevalence of VHL disease has been estimated to be 1 per 36.000 persons.We report the case of a 68-year-old woman with Von Hipple-Lindau disease who developed high fever with pulmonary and hepatic lesions proven to be Hodgkin's disease on biopsy.To our knowledge, this is the first report of Hodgkin's disease in a patient with Von Hippel-Lindau.

Following a previous EORTC GU-Group study, in which linomide showed some activity in poor prognosis patients, this study was initiated to determine the effect of linomide in more favourable patients. 35 patients with metastatic renal cell carcinoma with good prognostic factors, i.e. good performance status, prior nephrectomy, no prior systemic therapy, and no liver, bone or brain metastases, were treated with linomide, a quinoline derivative with immunomodulating properties, at a dose of 10 mg daily, after an initial dose escalation during the first 4 weeks of treatment. In 29 evaluable patients, no responses were observed (95% confidence interval 0-10%). Best overall response was no change in 9 patients, for a median duration of 4 months. Linomide in this schedule was poorly tolerated, with 17% (6 patients) of patients being withdrawn and 23% (8 patients) having dose reductions due to adverse events, mostly influenza-like symptoms of myalgia, arthralgia and fatigue. Several cases of pericarditis and neuropathy were observed. In spite of selection of favourable prognosis patients and an optimal daily dosing schedule, linomide was not an effective treatment in renal cell carcinoma. In view of toxicity and lack of efficacy, there is no rationale in further testing the drug in this disease.