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Il dry needlingè una tecnica di trattamento invasiva utilizzata dal fisioterapista (kinesiterapista) con l’obiettivo di trattare la sindrome miofasciale dolorosa. Questa è caratterizzata principalmente dalla presenza di punti trigger ed è uno dei disturbi più frequenti dell’apparato locomotore. Il punto trigger miofasciale, una struttura palpabile caratterizzata da una sensazione di dolore locale in un cordone muscolare e da un dolore irradiato mirato, è trattato utilizzando un ago da agopuntura per vascolarizzare la zona di contrazione. La tecnica di dry needlingdeve essere integrata in una gestione multimodale dei pazienti. Come per qualsiasi altro trattamento, la chiave del successo risiede in un buon ragionamento clinico, in un’anamnesi chiara e in una valutazione clinica mirata. I risultati del trattamento di dry needlingdevono essere verificati utilizzando parametri oggettivi e soggettivi. Migliaia di terapisti in tutto il mondo utilizzano questa tecnica invasiva e sicura che presenta un rischio modesto. L’interesse del mondo della ricerca nei confronti di questa tecnica è innegabile e gli effetti spesso sono spettacolari.

La punción seca (dry needling)es una técnica terapéutica invasiva utilizada por el fisioterapeuta (kinesiterapeuta) cuyo objetivo es el tratamiento del síndrome miofascial doloroso. Éste se caracteriza principalmente por la presencia de puntos gatillo y es uno de los motivos de consulta más frecuente del aparato locomotor. El punto gatillo miofascial (una estructura palpable que se caracteriza por una sensación de dolor local en un cordón muscular y un dolor localizado que se irradia) se trata con una aguja de acupuntura para vascularizar la zona de contracción. La técnica de punción seca debe integrarse en un tratamiento multimodal de los pacientes. Al igual que para cualquier otro tratamiento, la clave del éxito es un buen razonamiento clínico, una anamnesis clara y una evaluación clínica dirigida. Los resultados del tratamiento con punción seca deben verificarse con parámetros objetivos y subjetivos. Miles de terapeutas en todo el mundo utilizan esta técnica invasiva y segura, que presenta un riesgo bajo. Existe un interés innegable por esta técnica en el ámbito de la investigación y los efectos suelen ser espectaculares.

Aim: The hypothesis that patients with hyperglycaemia during admission, regardless of previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. The objective was to [...]

Background. The endothelial cell marker PAL-E is not reactive to vessels in the normal brain. The present study concerns the PAL-E reactivity in brain tumors in contrast to normal brain and nonneoplastic brain disease. Methods. A total of 122 specimens were examined: brain tumors (n = 94), nonneoplastic brain disease (n = 19), normal brain (n = 8), and fetal brain (n = 1). Standard immunohistochemical procedures using a panel of endothelial cell markers were applied to detect vessels reactive to PAL-E. Results. PAL-E reactivity to endothelial cells was found in all cases of glioblastoma multiforme, in 75% of the cases of anaplastic astrocytoma, and in 46% of the cases of astrocytoma. Furthermore, PAL-E reactivity was present in diseases with a developmental etiology, such as primitive tumors and congenital vascular malformations. The developing human brain (6-weeks' gestation age) and special sites of the mature brain, sites without blood-brain barrier, showed a strong reactivity, which indicates a relation with the status of blood-brain barrier development. Conclusions. PAL-E is the only marker out of a panel of endothelial cell markers that shows no reactivity to endothelial cells in the normal brain with an intact blood-brain barrier. In primary and metastatic brain tumors, PAL-E is reactive to endothelial cells, except for 25% of anaplastic astrocytoma and 54% of astrocytoma. PAL-E reactivity in brain tumors most likely is related to angiogenesis and to blood-tumor barrier properties not present in the normal blood-brain barrier.

In a series of 25 patients with head and neck cancer who had severe pain, the type and cause of the pain were analyzed. There were two types of pain: nociceptive and non-nociceptive. Nineteen (76%) patients had nociceptive pain that could be subdivided into actual nociceptive pain (9 patients), nociceptive nerve pain (8 patients), or referred pain (2 patients). The cause of nociceptive pain was secondary to tumor recurrence in 16 patients and secondary to benign inflammation in 3 patients. Of the six (23%) cases of non-nociceptive pain, all were diagnosed as neuropathic pain secondary to the sequels of neck dissection. World Health Organization guidelines were applied for the treatment of symptomatic pain of nociceptive pain; if necessary, nerve blocks were used after this treatment. Non-nociceptive pain was usually treated with amitriptyline or carbamazepine. If tumor recurrence was the cause of the pain, antitumor-directed therapy was applied, when possible. Relief was achieved in 52% of the patients after two attempts to treat pain, in 64% after three attempts, and in up to 72% after four attempts. Pain could not be controlled in 28% of the patients. Patients with tumor recurrence had a short median survival time of 3 months, regardless of pain control. Patients with neuropathic pain had a survival time of 16 months or more (median not reached). The authors conclude that the type and cause of the pain in cancer of the head and neck can be determined; this can lead to the administration of proper symptomatic therapy or treatment directed at the underlying cause. In most cases, several successive attempts to treat pain were made before relief was achieved. Cancer 1992; 70:178-184.

Convergence and subduction started in the Late Paleocene, to the east of New Caledonia in the South Loyalty Basin/Loyalty Basin, leading to the formation of the Subduction–Obduction Complex of Grande Terre. Convergence during the Eocene consumed the oceanic South Loyalty Basin and the northeasternmost margin of Zealandia (the Norfolk Ridge). The attempted subduction of the Norfolk Ridge eventually led to the end-Eocene obduction. Intra-oceanic subduction started in the South Loyalty Basin, as indicated by high-temperature amphibolite (56 Ma), boninite and adakite series dykes (55–50 Ma) and changes in the sedimentation regime (55 Ma). The South Loyalty Basin and its margin were dragged to a maximum depth of 70 km, forming the high-pressure–low-temperature Pouébo Terrane and the Diahot–Panié Metamorphic Complex, before being exhumed at 38–34 Ma. The obduction complex was formed by the stacking from NE to SW of several allochthonous units over autochthonous Zealandia, including the Montagnes Blanches Nappe (Norfolk Ridge crust), the Poya Terrane (the crust of the South Loyalty Basin) and the Peridotite Nappe (the mantle lithosphere of the Loyalty Basin). A model of continental subduction accepted by most researchers is proposed and discussed. Offshore continuations and comparable units in Papua New Guinea and New Zealand are presented.

Contrary to acute pain, chronic pain does not serve as a warning signal and must be considered as a disease per se. This pathology presents a sensory and psychological dimension at the origin of affective and cognitive disorders. Being largely refractory to current pharmacotherapies, identification of endogenous systems involved in persistent and chronic pain is crucial. The amygdala is a key brain region linking pain sensation with negative emotions. Here, we show that activation of a specific intrinsic neuromodulatory system within the amygdala associated with type 4 metabotropic glutamate receptors (mGlu4) abolishes sensory and affective symptoms of persistent pain such as hypersensitivity to pain, anxiety- and depression-related behaviors, and fear extinction impairment. Interestingly, neuroanatomical and synaptic analysis of the amygdala circuitry suggests that the effects of mGlu4activation occur outside the central nucleus via modulation of multisensory thalamic inputs to lateral amygdala principal neurons and dorso-medial intercalated cells. Furthermore, we developed optogluram, a small diffusible photoswitchable positive allosteric modulator of mGlu4. This ligand allows the control of endogenous mGlu4activity with light. Using this photopharmacological approach, we rapidly and reversibly inhibited behavioral symptoms associated with persistent pain through optical control of optogluram in the amygdala of freely behaving animals. Altogether, our data identify amygdala mGlu4signaling as a mechanism that bypasses central sensitization processes to dynamically modulate persistent pain symptoms. Our findings help to define novel and more precise therapeutic interventions for chronic pain, and exemplify the potential of optopharmacology to study the dynamic activity of endogenous neuromodulatory mechanisms in vivo.

•The paper presents the most comprehensive study on equid mobility in Iberia so far.•The strontium data suggests that equids were sourced from mainly local areas, but probably included different locations.•Equids diet was carefully managed, most notably in winter.

Based on new structural and petrological investigations, we present two crustal-scale cross-sections of the Kyrgyz South Tien Shan, and correlations of main faults and units between Kyrgyzstan and China. The overall structure corresponds to a doubly-vergent mountain belt. The Kyrgyz and Chinese areas exhibit identical structural and metamorphic histories. To the west, the Atbashi Range comprises high-pressure oceanic and continental units stacked by north-verging thrusts above a low metamorphic accretionary prism. High-pressure (HP) gneisses are bound to their south by a south-dipping detachment exhibiting mantle relicts. The high-pressure oceanic and continental units underwent similar pressure–temperature (P–T) paths with peak conditions of around 500 °C–20 kbar, followed by rapid exhumation. The overall south-dipping structure and kinematics indicate a south-dipping subduction of the Central Tien Shan Ocean at 320–310 Ma, ending with the docking of the Tarim block to the Kazakh continent. To the east, the Pobeda Massif shows a narrow push-up structure. A major north-vergent thrust exhumes deep-crustal-level granulites, constituting the highest summits, which were thrust towards the north onto low-grade Devonian–Carboniferous schists. The southern part of South Tien Shan is made up of a south-verging thrust stack that formed later during ongoing convergence, reactivated throughout post-30 Ma phases.

This paper is focused on petrological and geochemical data obtained on a series of Middle and Upper Eocene magmatic rocks from the Lesser Caucasus of Armenia in order to elucidate magma sources and geodynamic processes. Middle–Upper Eocene magmatism is present in two main zones: the Amasia–Sevan–Hakari suture zone (ASHSZ) and the so-called South Armenian Microplate (SAM). Volcanic rocks from both places range from basalt to rhyolite and mostly display a calc-alkaline character. Trace element patterns from the SAM and ASHSZ samples show mobile-elements enrichment (Rb, Ba, Th) together with strong negative high field strength elements (Nb, Ta, Hf, Zr) anomalies. The (La/Sm)Nratio yields very close values for both areas. Conversely, the (La/Yb)Nratio is, on average, significantly higher for SAM than for ASHSZ, suggesting the presence of residual garnet at the source of the SAM volcanic rocks. Nevertheless, trace elements suggest partial melting from phlogopite- and amphibole-bearing spinel lherzolitic mantle sources.Neodymium and strontium isotopes yield εNd(40Ma)and 87Sr/86Sr(40Ma)ratios ranging, respectively, from –0.3 to +6.6 and from 0.70314 to 0.70531 for SAM samples, and from +3.4 to +6.8 and from 0.70393 to 0.70433 for ASHSZ samples. Initial Pb/Pb isotopic ratios yield close values for both areas but with slightly higher and more homogeneous 207Pb/204Pb and 208Pb/204Pb ratios for SAM samples. Such features concur with a more pronounced slab-component contribution in the frontal part of the volcanic belt, that is, in the SAM domain. No significant crustal contamination has been detected in the studied Eocene magmatic rocks from both the ASHSZ and SAM.Considering geodynamic and geochemical constraints, we propose that this magmatism is connected with a north-dipping Southern Neotethys subduction, in an extensional (back-arc) environment of orogenic belts. The Arabia–Eurasia collision and the closure of the Neotethys Ocean may have occurred after this magmatic event.

We present time-series of lead concentration and isotopic ratio in sediments from two French alpine lakes: Lac du Bourget, a suburban lake, and Lac d'Anterne, a mountain lake nearby the Mont-Blanc Range. This approach aims at differentiating “local” from “regional” inputs by comparing distant sedimentary records. 210Pb and 137Cs dating methods were validated by historical events recognition [1-2] providing confident age-depth models spanning the last 250 years. In both lakes the sediment is lead-enriched compared to upper continental crust over the whole records. The human impact reached its maximum around 1970 AD, and then presents a rapid decline. Lead concentration and isotopic composition are correlated. When compared to data from a Mont Blanc ice core [3], Lac d'Anternetime-series yields excellent correlation over the last 250 years, confirming the accuracy of both dating process and record of atmospheric lead fall-out. Record from Lac du Bourgetpresents a similar pattern until 1985 AD when the signal from the high elevation sites ones, both in concentrations and isotopic ratio. Our data confirm the date of 1970 as the maximum of atmospheric lead fall-out over Western Europe. Today, Lac d'Anterne still records a weak airborne contamination, while Lac du Bourgetis mostly influenced by local sources.

In response to the current organ shortage—and in an effort to increase the number of registered donors—the present campaign employed a direct‐mail marketing strategy that registered 6908 individuals in the state's First‐Person Consent Registry (FPCR). In evaluating the most effective of three mailers, 18‐year‐old individuals (N = 139356) were randomly assigned to receive: (a) a letter from the Secretary of State (SoS); (b) a brochure from the SoS or (c) both. As hypothesized, the results revealed that exposure to the SoS letter only resulted in a greater registration rate than exposure to the SoS brochure only. Results also revealed that exposure to both the SoS letter and SoS brochure resulted in a greater registration rate than exposure to the SoS brochure only. No difference in registration rate emerged between exposure to the SoS letter and SoS brochure compared to exposure to the SoS letter only. Our results speak to the effectiveness of utilizing personalized direct‐mail marketing strategies to promote organ donation with an emphasis on the practical implications of our findings for organ donation practitioners.

Further studies on the quality of runoff from tillage and cropping systems in the southeastern USA are needed to refine current risk assessment tools for nutrient contamination. Our objective was to quantify and compare effects of constant (Ic) and variable (Iv) rainfall intensity patterns on inorganic nitrogen (N) and phosphorus (P) losses from a Tifton loamy sand (Plinthic Kandiudult) cropped to cotton (Gossypium hirsutumL.) and managed under conventional (CT) or strip‐till (ST) systems. We simulated rainfall at a constant intensity and a variable intensity pattern (57 mm h−1) and collected runoff continuously at 5‐min intervals for 70 min. For cumulative runoff at 50 min, the Iv pattern lost significantly greater amounts (p< 0.05) of total Kjeldahl N (TKN) and P (TKP) (849 g N ha−1and 266 g P ha−1for Iv; 623 g N ha−1and 192 g P ha−1for Ic) than did the Ic pattern. However, at 70 min, no significant differences in total losses were evident for TKN or TKP from either rainfall intensity pattern. In contrast, total cumulative losses of dissolved reactive P (DRP) and NO3–N were greatest for ST‐Ic, followed by ST‐Iv, CT‐Ic, and CT‐Iv in diminishing order (69 g DRP ha−1and 361 g NO3–N ha−1; 37 g DRP ha−1and 133 g NO3–N ha−1; 3 g DRP ha−1and 58 g NO3–N ha−1; 1 g DRP ha−1and 49 g NO3–N ha−1). Results indicate that constant‐rate rainfall simulations may overestimate the amount of dissolved nutrients lost to the environment in overland flow from cropping systems in loamy sand soils. We also found that CT treatments lost significantly greater amounts of TKN and TKP than ST treatments and in contrast, ST treatments lost significantly greater amounts of DRP and NO3–N than CT treatments. These results indicate that ST systems may be losing more soluble fractions than CT systems, but only a fraction the total N (33%) and total P (11%) lost through overland flow from CT systems.

Patients with advanced Parkinsons disease are often disabled by response fluctuations and dyskinesias despite optimal pharmacological treatment. Bilateral deep brain stimulation of the subthalamic nucleus or the internal part of the globus pallidus can lead to a substantial reduction of these motor symptoms and thereby improve functioning in activities of daily living. This article aims to review some general aspects of Parkinson's disease, the history of surgery for Parkinsons disease, and the effects, adverse events, indications and contraindications of deep brain stimulation in advanced Parkinsons disease.

Conservation tillage has significant potential as a water management tool for cotton production on sandy, drought-prone soils. Plant residue remaining at the soil surface from prior crops serves as a vapor barrier against water loss, reduces raindrop impact energy, slows surface runoff, and often increases infiltration. By increasing infiltration, the potential for greater plant-available water can be enhanced and irrigation requirements reduced. Five years of data were collected to quantify the hydrologic differences between strip till and conventional till production systems. Surface runoff and lateral subsurface flow were measured on six 0.2 ha plots in South Georgia in order to quantify the water-related effects of conservation tillage. Significant differences in surface and subsurface water losses were observed between the conventional and strip tilled plots. Surface runoff from the conventionally tilled plots exceeded that from the strip tilled plots, while subsurface losses were reversed. Surface runoff losses from the conventionally tilled plots exceeded those from the strip tilled plots by 81% (129 mm/year). Shallow lateral subsurface losses from the strip tilled plots exceeded those from the conventionally tilled plots by 73% (69 mm/year). Overall, a net annual gain of 60 mm of water was observed for the strip tilled plots. [ABSTRACT FROM AUTHOR]

Summary Objective: Postoperative radiotherapy is standard treatment for patients with a glioblastoma multiforme (GBM). However, a GBM is radioresistant and almost always recurs, even after a high dose of radiation. A GBM is characterized by its extensive neo-angiogenesis, which can be attributed to the high levels of vascular endothelial growth factor (VEGF). The scope of this study is to investigate the VEGF secretion by GBM cells with different radiosensitivity after irradiation. Methods:Three human GBM cell lines (U251, U251-NG2 and U87) were irradiated with single doses of 0, 5, 10 and 20 Gy of γ-rays from a 137Cs source. VEGF levels in medium were measured by ELISA at 24, 48 and 72 h after radiation. Cell survival was measured by the XTT assay 7 days after irradiation. Results:Following single dose radiation, the VEGF levels showed a dose dependent increase in U251, U251-NG2 and U87 glioma cells. Both base-line and radiation-enhanced VEGF levels were about 10-fold higher in U87 compared to U251 and U251-NG2 cells. In addition, in the XTT assay, the U87 was more radioresistant than both U251 and U251-NG2 cell lines (dose modifying factor (DMF) = 1.6 and 1.7 resp). Conclusion:Irradiation enhanced VEGF secretion in all three tested glioma cell lines (up to eight times basal levels). It is tempting to associate the radiation-enhanced VEGF secretion with an increased angiogenic potential of the tumor, which may be a factor in radioresistance.

The Better Assessment Science Integrating point and Nonpoint Sources (BASINS) system was developed by the U.S. Environmental Protection Agency to facilitate developing total maximum daily loads (TMDLs). The Soil Water Assessment Tool (SWAT) is one of the watershed-scale simulation models within BASINS. Because of the critical nature of the TMDL process, it is imperative that BASINS and SWAT be adequately validated for regions on which they are being applied. BASINS and SWAT were tested using six years of hydrologic data from a 22 km² subwatershed of the Little River in Georgia. Comparisons were made between water balance results obtained using high and low spatial resolution data as well as those obtained using default initial parameters versus those modified for existing groundwater conditions. In general, all scenarios simulated general trends in the observed flow data. However, for the years with lower precipitation, the total water yields simulated with the low spatial resolution data and the default initial conditions were overpredicted by up to 27% of the annual precipitation input. Total water yields simulated using the high spatial resolution input data were within 20% of the observed yields for each year of the assessment. Nash-Sutcliffe model efficiencies (E) for monthly total water yields were 0.80 using the high spatial resolution data with the modified initial conditions and 0.64 using the low spatial resolution data with the default initial conditions. While the model simulated general streamflow trends, discrepancies were observed between observed and simulated hydrograph peaks, time to peak, and hydrograph durations. A one-day time lag between the simulated and observed time to peak was the primary cause of large errors in daily flow simulations. Model modification and more extensive calibration may be necessary to increase the accuracy of the daily flow estimates for TMDL development. [ABSTRACT FROM AUTHOR]

: Single N -methyl amino acid-containing peptides related to the central hydrophobic region β 16-20 (Lys-Leu-Val-Phe-Phe) of the β -amyloid protein are able to reduce the cytotoxicity of natural β 1-42 in PC12 cell cultures. N -methyl phenylalanine analogs yield statistically significant increments in cell viability (Student's t -test &lt; 0.01%) and are nontoxic in the same assay. These promising results indicate that these peptide molecules could be a starting point for the development of potential therapeutic compounds for the treatment of Alzheimer's disease.

Lead concentrations and isotopic ratios were measured along two well-dated sediment cores from two distant lakes: Anterne 2100 m a.s.l. and Le Bourget 270 m a.s.l., submitted to low and high direct human impact and covering the last 250 and 600 years, respectively. The measurement of lead in old sediment samples >3000 BP permits, in using mixing-models, the determination of lead concentration, flux and isotopic composition of purely anthropogenic origin. We thus show that since ca.1800 AD the regional increase in lead contamination was mostly driven by coal consumption 206Pb207Pb ∼ 1.17–1.19; 206Pb204Pb ∼ 18.3–18.6, which peaks around 1915 AD. The increasing usage of leaded gasoline, introduced in the 1920s, was recorded in both lakes by increasing Pb concentrations and decreasing Pb isotope ratios. A peak around 1970 206Pb207Pb ∼ 1.13–1.16; 206Pb204Pb ∼ 17.6–18.0 corresponds to the worldwide recorded leaded gasoline maximum of consumption. The 1973 oil crisis is characterised by a drastic drop of lead fluxes in both lakes from ∼35 to <20 mg cm−2yr−1. In the late 1980s, environmental policies made the Lake Anterne flux drop to pre-1900 values <10 mg cm−2yr−1 while Lake Le Bourget is always submitted to an important flux ∼25 mg cm−2yr−1. The good match of our distant records, together and with a previously established series in an ice core from Mont Blanc,1provides confidence in the use of sediments as archives of lead contamination. The integration of the Mont Blanc ice core results from Rosman et al.1with our data highlights, from 1990 onward, a decoupling in lead sources between the high elevation sites Lake Anterne and Mont Blanc ice core, submitted to a mixture of long-distance and regional contamination and the low elevation site Lake Le Bourget, where regional contamination is predominant.

Lead concentrations and isotopic ratios were measured along two well-dated sediment cores from two distant lakes: Anterne (2100 m a.s.l.) and Le Bourget (270 m a.s.l.), submitted to low and high direct human impact and covering the last 250 and 600 years, respectively. The measurement of lead in old sediment samples (>3000 BP) permits, in using mixing-models, the determination of lead concentration, flux and isotopic composition of purely anthropogenic origin. We thus show that since ca. 1800 AD the regional increase in lead contamination was mostly driven by coal consumption (206Pb/207Pb ~ 1.17–1.19; 206Pb/204Pb ~ 18.3–18.6), which peaks around 1915 AD. The increasing usage of leaded gasoline, introduced in the 1920s, was recorded in both lakes by increasing Pb concentrations and decreasing Pb isotope ratios. A peak around 1970 (206Pb/207Pb ~ 1.13–1.16; 206Pb/204Pb ~ 17.6–18.0) corresponds to the worldwide recorded leaded gasoline maximum of consumption. The 1973 oil crisis is characterised by a drastic drop of lead fluxes in both lakes (from ~35 to &lt;20 mg cm−2 yr−1). In the late 1980s, environmental policies made the Lake Anterne flux drop to pre-1900 values (&lt;10 mg cm−2 yr−1) while Lake Le Bourget is always submitted to an important flux (~25 mg cm−2 yr−1). The good match of our distant records, together and with a previously established series in an ice core from Mont Blanc,1 provides confidence in the use of sediments as archives of lead contamination. The integration of the Mont Blanc ice core results from Rosman et al.1 with our data highlights, from 1990 onward, a decoupling in lead sources between the high elevation sites (Lake Anterne and Mont Blanc ice core), submitted to a mixture of long-distance and regional contamination and the low elevation site (Lake Le Bourget), where regional contamination is predominant.

We describe the design and implementation of L2W – a Problem Solving Environment (PSE) for landuse change analysis. L2W organizes and unifies the diverse collection of software typically associated with ecosystem models (hydrological, economic and biological). It provides a web-based interface for potential watershed managers and other users to explore meaningful alternative land development and management scenarios and view their hydrological, ecological, and economic impacts. A prototype implementation for the Upper Roanoke River Watershed in Southwest Virginia, USA is described.

Brain edema and swelling often complicate surgery for brain tumors. Its pathophysiology is unclear, as is the relationship with brain tissue oxygenation. Our hypothesis was that brain edema around tumor is cytotoxic type caused by impaired local tissue oxygenation due to increased local tissue pressure. Therefore, we monitored brain tissue oxygen pressure (ptiO2) and carbon dioxide pressure (ptiCO2) in 19 patients undergoing craniotomy for removal of a brain tumor and specifically studied the effect of decompression by dura opening and by tumor removal with respect to the presence of brain swelling. Before craniotomy, multiparameter sensors were inserted into the peritumoral brain tissue guided by MRI-based stereotaxy. In eight patients who had severe brain swelling upon opening of the dura mater, ptiO2immediately rose from 7 ± 8 mm Hg to 24 ± 15 mm Hg (P< 0.05), whereas in patients who did not have swelling, ptiO2went from 16 ± 9 to 18 ± 10 mm Hg after opening of the dura. The mean ptiO2of all patients at the start of resection of the tumor was 18 ± 11 mm Hg, and increased to 30 ± 15 mm Hg after resection was completed (P< 0.05). The effect on ptiO2of raising the FiO2to 1.0 was limited in this group of patients, as an increase greater than 50 was found in only six of twelve patients. Notably, in six patients, sensor malfunctions or associated hardware problems occurred, prohibiting useful data acquisition. We conclude that brain tissue oxygenation is reduced in the peritumoral area and improves after local tissue pressure relief, especially in patients with brain swelling. Thus, ischemic processes may contribute to brain edema around tumors. Intraoperative ptiO2monitoring may enhance the safety of neuroanesthesia, but the high incidence of failures with this type of sensor remains a matter of concern.

The role of the motor thalamus as surgical target in stereotactic neurosurgery for different kinds of tremor is discussed. For tremor in Parkinson's disease, the subthalamic nucleus becomes more and more often the surgical target, because this target also gives relief of other and more incapacitating symptoms (hypokinesia, rigidity). Stimulation is as effective in tremor suppression as coagulation but has less adverse events and permits bilateral surgery. In selected cases, thalamotomy can still be indicated. © 2002 Movement Disorder Society

To study the frequency of morbidity and mortality associated with pallidotomy.

Serial analysis of gene expression (SAGE) was used to identify a gene named GOA (gene overexpressed in astrocytoma), which codes for a novel Ring finger B-box coiled-coil (RBCC) protein. Northern blot hybridization showed overexpression of GOA in 9 of 10 astrocytomas. Except for kidney, in which high expression was found, expression levels in normal tissues were low and comparable to normal brain. Immunohistochemistry demonstrated presence of GOA, with prominent nuclear staining, in astrocytoma tumor cells and astrocytes of fetal brain, but virtual absence in mature astrocytes. Overexpression was not due to amplification, since amplification of GOA was only found in one of 65 astrocytomas. GOA was localized to 17q24–25, a region that is frequently gained or amplified in a number of other tumor types. GOA contains two LXXLL motifs, which are thought to be important for nuclear receptor binding. Our data suggest an important role of GOA in the process of dedifferentiation that is associated with astrocytoma tumorigenesis and possibly with that of other tumor types as well.

Plants are regarded as a promising system for the production of heterologous proteins. However, little is known about the influence of plant development and growth conditions on N-linked glycosylation. To investigate this, transgenic tobacco (Nicotiana tabacum cv Samsun NN) plants expressing a mouse immunoglobulin G antibody (MGR48) were grown in climate rooms under four different climate conditions, i.e. at 15 degrees C and 25 degrees C and at either low or high light conditions. N-glycans on plantibodies and soluble endogenous proteins were analyzed with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS). Antibodies isolated from young leaves have a relatively high amount of high- mannose glycans compared with antibodies from older leaves, which contain more terminal N-acetylglucosamine. Senescence was shown to affect the glycosylation profile of endogenous proteins. The relative amount of N-glycans without terminal N-acetylglucosamine increased with leaf age. Major differences were observed between glycan structures on endogenous proteins versus those on antibodies, probably to be attributed to their subcellular localization. The relatively high percentage of antibody N-glycan lacking both xylose and fucose is interesting.

Plants are regarded as a promising system for the production of heterologous proteins. However, little is known about the influence of plant physiology and plant development on the yield and quality of the heterologous proteins produced in plants. To investigate this, tobacco (Nicotiana tabacum cv Samsun NN) was transformed with a single construct that contained behind constitutive promotors the light- and heavy-chain genes of a mouse antibody. The in planta stability of the antibody was analyzed in transgenic plants that were grown under high and low irradiation at 15 degrees C and 25 degrees C. High-light conditions favored the production of biomass, of total soluble protein, and of antibody. The plants grown at 25 degrees C developed faster and contained less antibody per amount of leaf tissue than the plants grown at 15 degrees C. Both endogenous protein and antibody content showed a strong decline during leaf development. The heavy chains of the antibody underwent in planta degradation via relatively stable fragments. In vitro incubations of purified plantibody with leaf extracts of wild-type tobacco indicated the involvement of acidic proteases. It is interesting that the same antibody produced by mouse hybridoma cells exhibited higher stability in this in vitro assay. This may be explained by the assumption that the plant type of N-glycosylation contributes less to the stability of the antibody than the mouse-type of N-glycosylation. The results of this study indicate that proteolytic degradation during plant development can be an important factor affecting yield and homogeneity of heterologous protein produced by transgenic plants.

In the current study, the authors describe and compare two different strategies of brachytherapy for the treatment of patients with primary glioblastoma multiforme (GBM). The study was comprised of 84 patients. Forty-five patients were implanted with permanent or temporary low activity iodine-125 (¹²⁵I) seeds in Cologne and 21 patients were implanted with temporary iridium-192 (¹⁹²Ir) wires in Amsterdam. Both groups received external beam radiation therapy (EBRT); the ¹²⁵I group received 10–30 grays (Gy) with the implant in situ and the ¹⁹²Ir group received 60 Gy before implantation. In Cologne, implantation was performed after a diagnostic stereotactic biopsy whereas in Amsterdam implantation took place after cytoreductive diagnostic surgery. In addition, 18 patients in Amsterdam served as a control group. This group received only EBRT after cytoreductive surgery. In both groups the mean age of the patients was between 50–55 years, with 80% of the patients age > 45 years. The mean implantation volume encompassed by the referenced isodose was 23 cm³ for ¹²⁵I and 48 cm³ for ¹⁹²Ir. Initial dose rates were 2.5–2.9 centigrays (cGy)/hour for permanent ¹²⁵I, 4.6 cGy/hour for temporary ¹²⁵I, and 44–100 cGy/hour (mean, 61 cGy) for ¹⁹²Ir. A total dose of 50–60 Gy, 60–80 Gy, and 40 Gy, respectively, was administered at the outer margins of the tumor. The median survival was approximately 16 months for both the ¹²⁵I group and the ¹⁹²Ir group. This was 6 months longer than the median survival in the control group. Reoperations were performed in 4 patients in the ¹²⁵I group (9%) versus 7 patients in the ¹⁹²Ir group (33%). No complications or late reactions were reported in the ¹²⁵I group, whereas one case of hemorrhage and three cases of delayed stroke were observed in the ¹⁹²Ir group. The equal median survival times in these two brachytherapy groups with such different dose rate radiation schedules support the hypothesis that dose rate does not play a major role in the survival of patients with primary GBM. Cancer 2000;88:2796–802. © 2000 American Cancer Society.

Soils with differences in argillic and kandic horizon clay content (12–28% clay), thickness of overlying sandy eluvial horizons (ranging from <0.50 to >1.0 m), and degree of structural development occur in upland Kandiudult soils in the Upper Coastal Plain of Georgia. Interest in agricultural site‐specific management necessitates more adequate characterization of solute transport properties between and within these soils. Undisturbed columns (15‐cm diam., n=34) were collected by horizon for three pedons typifying the extremes of the clay content in the argillic horizon. Breakthrough curves (BTCs) were conducted using a Br−tracer and were evaluated by fitting the single‐ and two‐region adaption of the convection–dispersion equation (CDE) to outflow measurements. Saturated hydraulic conductivity (Ks) measurements and methylene blue dye staining of conducting voids were also performed on the cores. Dye staining indicated differences in preferential flow occurred between surface (Ap), eluvial (E), and argillic and kandic (Bt) horizons. Retardation factors (R) were positively correlated with clay quantities, and horizons possessing relatively less clay (A and E horizons) possessed the highest α values (quickest solute exchange rates between mobile and immobile regions). Horizons with relatively higher clay quantities (Bts) had the lowest α and β (ratio of mobile water to the volumetric water content) values, but the highest effective dispersivity (λeff) values. Dye‐stained areas were correlated (r=0.65)with β, which suggested β may be an approximation of the degree of preferential flow for these soils. For the three pedons studied, significant differences in α existed between the extremes, and thus they are interpreted to behave differently from a solute transport standpoint. Pedotransfer functions (PTFs) were developed for grossly estimating hydraulic and transport parameters.

The results of several cohort studies suggest that patients with advanced Parkinson's disease would benefit from unilateral pallidotomy. We have assessed the efficacy of unilateral pallidotomy in a randomised, single-blind, multicentre trial.

Multiple etiological factors including gastroesophageal reflux, hyperfunctional voice use, and endotracheal intubation have been implicated in the development of posterior laryngeal ulcers and granulomas. The optimal approach to treatment of these lesions remains controversial. The mainstay of treatment at Vancouver General Hospital has been aggressive medical management of gastroesophageal reflux, with complimentary voice therapy offered to patients suspected of having significant hyperfunctional phonation. The authors reserve Botulinum toxin injection or surgical excision for patients who fail initial therapy. They conducted a retrospective analysis of their voice clinic records from 1985-1997 to examine the efficacy of this approach. They identified 76 patients with the diagnosis of contact ulcer or granuloma. Fifty-two patients had follow-up data available for review. Ninety-four percent of patients were treated nonsurgically: 35 patients were treated solely by dietary and medical therapy to control gastroesphageal reflux, 10 patients were treated by a combination of medical gastroesophageal reflux control and voice therapy, 3 patients had Botox injections, 2 patients had surgical excision of granuloma, 1 patient had a Kenalog injection, and 1 patient underwent laparoscopic fundoplication. Overall, 77% of patients had complete resolution, whereas 11% had partial resolution and another 11% had no significant improvement. The data supports control of gastroesophageal reflux as a central component in treatment of posterior laryngeal ulcers and granulomas.

The purpose of this article is to measure the absolute risk aversion coefficients (RACs) of irrigation fanners in the Winterton area if annual income and wealth are at stake. Decision makers became more risk averse when wealth instead of annual income is at stake. RACs measured at low, medium and high annual income and wealth levels, showed no change when annual income or wealth levels increased. The majority of irrigation farmers have risk neutral annual income and wealth risk preferences.

Reliable estimates of saturated hydraulic conductivity are a prerequisite for accurate estimations of water flow and chemical transport through soil profiles. While informative, mean estimates of flow and transport have been shown to be inadequate for modeling purposes. Distributions and variances along with mean predictions provide a better form of model input. The spatial variability of field‐measured saturated hydraulic conductivity (Kfs) was investigated on a transect across a 1‐ha field in west‐central Georgia. The field includes two soil types, a Pine Flat loamy sand (coarse‐loamy, siliceous, thermic Typic Paleudult) and a Troup sand (loamy, siliceous, thermic Grossarenic Kandiudult). Estimates of Kfswere calculated using data collected with a constant‐head permeameter. Mean, variance, and distribution data were determined for each soil and four selected horizons. Calculated values in the top 2 m of the soil profiles ranged from 0.07 to 117 mm h−1for the Pine Flat loamy sand and from 23 to 406 mm h−1for the Troup sand. Statistical differences between Kfsdata calculated for the lower soil profiles coincide with soil textural differences observed with depth and across the plot. Semivariances for ln Kfsdata were calculated and models fit to the semivariograms. Random behavior, with little spatial correlation, dominated the In Kfsdata for the upper 0.5 m of the Pine Flat soil and the 2.0‐m measurement for the Troup soil. Observed correlation ranges varied from 2 to 166 m. Large statistical differences in Kfswere observed for the adjacent soils.

The history of functional neurosurgery for the treatment of Parkinson's disease is reviewed. Two major stages may be distinguished: (1) open functional neurosurgery, which started in 1921 with bilateral cervical rhizotomy by Leriche. In 1937 Bucy performed the first motor cortectomy in a tremor patient, and subsequently introduced lesioning of the corticospinal tract at different levels. In 1939 Meyers started open transventricular surgery of the basal ganglia, which was abandoned in the 1940s because of high mortality. However, this operation drew attention to the basal ganglia and their efferent pathways as surgical targets for the relief of parkinsonian symptoms. (2) Stereotactic (closed) functional neurosurgery in patients was in 1947 for the first time performed by Spiegel and Wycis, soon followed by surgeons in various countries. Originally, the globus pallidus and the ansa lenticularis were the surgical targets but were replaced at the end of the 1950s by the ventrolateral thalamus. A few surgeons positioned their lesions in the subthalamic area. In both targets favorable results were reported for the treatment of tremor and rigidity with acceptable adverse events. In selected patients, bilateral surgery was performed. In 1969 the results of more than 37,000 stereotactic operations had been published. Criteria for the surgical technique and selection of patients were described, and various stereotaxic atlases became available. At that time, L‐dopa became generally available and the number of stereotactic operations declined dramatically. However, as a result of the shortcomings of the L‐dopa therapy in the long‐term treatment of Parkinson's disease, the thalamotomy gradually regained its place. New developments were the reintroduction of the pallidotomy by Laitinen in 1992 and the thalamic stimulation for pharmacotherapy‐resistant tremor by Benabid and collaborators in 1991. New insights in the pathophysiology of Parkinson's disease supported the revival of the functional stereotactic neurosurgery and recently caused the introduction of the subthalamic nucleus as a surgical target in the treatment of Parkinson's disease.

The results of thalamotomy for the various kinds of tremor are described. The nomenclature of the ventrolateral thalamic nuclei is discussed. Long‐term thalamic stimulation seems a promising addition to or alternative for the thalamotomy, but this has still to be proven by a prospective trial that includes a cost‐effectiveness analysis.

To identify export and sorting information in outer membrane protein PhoE of Escherichia coli K-12, a set of deletions was created, resulting in the removal of N-terminal amino acids of the mature protein. Pulse-chase experiments revealed that some mutant proteins were slowly or not at all processed, but there was not correlation between processing rate and the extent of the deletions. The unprocessed precursors were accessible to trypsin in the periplasm showing that processing by leader peptidase rather than translocation is affected by these deletions. The results show that no specific sequences in the N-terminal part of the mature PhoE protein are required for translocation through the inner membrane. The capability of the processed mutant proteins to assemble into the outer membrane was correlated to the exten of the deletions. Thus, mutants which lack up to amino acid residue 14 are normally incorporated into the outer membrane. Larger deletions which removed the first postulated membrane-spanning fragment of the protein affected the efficiency of assembly: in addition to trimers of the protein in the outer membrane, also monomers were detected in the periplasm. If the deletions extended C-terminally to residue 48, only monomeric forms of the proteins were found in the periplasm.

Summary The techniques of stereotactic biopsy of mass lesions of the brain are described, and the indications discussed. Since computerized axial tomography has become available the decision to perform a stereotactic biopsy is made more frequently than previously. Stereotactic techniques in neuro-oncology are a continuously expanding field of largely diagnostic and sometimes therapeutic procedures. It now seems likely that most centres concerned with brain tumour patients will make use of stereotactic biopsies in the future.