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INTRODUCTION Emergency medicine (EM) is a 24-7, on-demand, high-pressure discipline that provides care for a wide spectrum of illness and the sickest of patients, yet it includes very little opportunities [...], Objective: The organization of emergency medical care limits the ability of emergency physicians to know the outcomes of most of their patients after the patients leave the emergency department. This lack of outcome feedback may hinder the practice of emergency medicine (EM) by preventing 'calibration' of the decision tools of practitioners. We sought to determine what is currently known about outcome feedback in EM, including its incidence, impact and modifiers. Data source: We searched the following databases: PreMEDLINE, MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, DARE, Health Technology Assessment Database and AMED. We performed manual searches on abstract databases, reference lists, various health information and research websites, and nonindexed journals. Study selection: Selection entailed a 2-step screening process to exclude articles not pertaining to outcome feedback in EM. Data extraction: Our search yielded 1128 bibliographic records, from which screening identified 7 relevant reports: 5 surveys, 1 system level evaluation and 1 intervention trial. Data synthesis: All studies were found to have 'inadequate' or 'unable to assess' reporting and study quality. Systems for outcome feedback to EM residents have been increasingly available since 1984, though they are perceived to be inadequate. Commonly used mechanisms for outcome feedback include automatic routing of discharge summaries, case conferences for admitted patients and telephone calls to patients or families for discharged patients. With respect to attending emergency physicians, no conclusions or clinical recommendations can be made given the level of available evidence. Conclusion: The potential importance of outcome feedback remains, at this time, underevaluated. We propose a research framework, and hypothesize that increasing outcome feedback would increase emergency physician diagnostic accuracy, therapeutic outcomes, clinical efficiency and job satisfaction. Future research in this area should include surveys and focus groups, as well as simulated or real-world intervention trials. Keywords: treatment outcome, quality of health care, emergency medicine, decision support techniques, outcome feedback RESUME Objectif : L'organisation des soins medicaux d'urgence limite la capacite des medecins d'urgence de connaitre le devenir de la plupart de leurs patients apres leur passage a l'urgence. Le manque d'information sur les resultats peut nuire a la pratique de la medecine d'urgence en empechant << l'etalonnage >> des outils de prise de decisions qu'utilisent les praticiens. Nous avons cherche a determiner ce que l'on sait actuellement de l'information sur les resultats en medecine d'urgence, y compris son incidence, son impact et ses modificateurs. Source des donnees : Nous avons interroge les bases de donnees suivantes : PreMEDLINE, MEDLINE, EMBASE, CINAHL, CENTRALE, PsycINFO, DARE, Health Technology Assessment Databaseet AMED. Nous avons aussi realise des recherches manuelles de bases de donnees de resumes, de listes de reference, de divers sites Web d'information sur la sante et de sites de recherche et de revues non indexees. Selection pour l'etude : La selection s'est deroulee en deux etapes visant a exclure les articles ne traitant pas d'information sur les resultats en medecine d'urgence. Extraction des donnees : Notre recherche a produit 1128 dos siers bibliographiques, pour lesquels une selection a permis de retenir 7 rapports pertinents : 5 enquetes, 1 etude d'evaluation du systeme et 1 essai interventionnel. Synthese des donnees : Nous avons conclu que la clarte et la qualite de toutes les etudes etaient << inadequates >> ou << ne pouvaient etre evaluees >>. Depuis 1984, des systemes d'information sur les resultats a l'intention des residents en medecine d'urgence sont de plus en plus disponibles, meme s'ils sont percus comme etant inadequats. Des mecanismes d'obtention d'information sur les resultats couramment utilises comprennent le routage automatique des resumes de conge, les conferences de cas pour les patients hospitalises et les appels telephoniques aux patients ayant obtenu leur conge ou a leurs familles. En ce qui concerne les medecins d'urgence traitants, on ne peut formuler aucune conclusion ou recommandation clinique, compte tenu du niveau de preuves disponibles. Conclusion : L'importance eventuelle de l'information sur les resultats concernant le devenir des patients demeure, a ce moment, sous-evaluee. Nous proposons un cadre de recherche et avancons l'hypothese qu'une plus grande communication de telles informations accroitrait la precision du diagnostic des medecins d'urgence, les resultats therapeutiques, l'efficacite clinique et la satisfaction professionnelle. La recherche future dans ce domaine devrait comprendre des enquetes et des groupes de discussion, ainsi que les essais interventionnels simules ou reels.

Practising emergency medicine is a bit like flying a plane at low altitude ... through the Rocky Mountains ... blindfolded. You can try to avoid the danger, but the outcomes [...]

INTRODUCTION Emergency medicine (EM) is a quixotic profession: emergency physicians (EPs) deliver one-time, episodic care to random patients during unpredictable health crises at all hours of the day; and then, [...], Objective: Emergency physicians (EPs) rarely find out what happens to patients after the patients leave their care, a process we call 'outcome feedback.' Some suggest this hinders the practice of emergency medicine (EM); however, evidence is lacking. We sought to evaluate EPs' perception of the current and potential role of outcome feedback in EM. Methods: We surveyed practising French- and English-speaking EPs from emergency departments within 100 km of Ottawa, Ont., in the provinces of Ontario and Quebec. The main outcomes included the prevalence, role and effect of outcome feedback. Results: Of the 297 physicians surveyed, 231 (77.8%) respond ed. The sample contained good representation of language groups, practice settings, sexes and age groups. All participants indicated that knowing outcomes is 'essential' (62.6%) or 'beneficial' (37.4%) to gaining experience in EM. Participants reported currently receiving passive outcome feedback in 10.0% of all cases, and seeking out (active) outcome feedback in 7.5% of all cases. The great majority of participants (97.3%) stated that they would like to receive more outcome feedback and believed that this would improve diagnostic accuracy (97.3%), clinical efficiency (85.5%), treatment outcomes (95.6%) and job satisfaction (95.1%). When asked to indicate 'any possible negative effects that might arise from increased outcome feedback,' 62.1% indicated none. However, 17.9% hypothesized negative emotional effects and 11.5% suggested increased time requirements. Conclusion: The overwhelming majority of EPs receive very little outcome feedback. Most would like more outcome feedback and believe it would improve the practice of EM. Keywords: treatment outcome, quality of health care, emergency medicine, decision support techniques, outcome feedback Objectif : Les medecins d'urgence savent rarement ce qu'il advient de leurs patients apres leur passage a l'urgence. Il y a ce qu'on appelle un manque <>. Certains suggerent que cela entrave la pratique de la medecine d'urgence. Il n'y a toutefois pas suffisamment de preuves a l'appui de cette hypothese. Nous avons cherche a evaluer la perception des medecins d'urgence quant au role actuel et potentiel de l'information sur les resultats en medecine d'urgence. Methodes : Nous avons interroge des medecins d'urgence francophones et anglophones travaillant dans les services d'urgence, en Ontario et au Quebec, dans un perimetre de 100 kilometres autour d'Ottawa (Ont.). Les principaux criteres d'evaluation etaient la prevalence, le role et l'effet de l'information sur les resultats. Resultats : Des 297 medecins interroges, 231 (77,8 %) ont repondu. L'echantillon offrait une bonne representation des groupes linguistiques, des milieux de pratique, des sexes et des groupes d'age. Tous les participants ont indique qu'il etait <> (62,6 %) ou << benefique >> (37,4 %) de recevoir de l'information sur le devenir de leurs patients pour acquerir des competences en medecine d'urgence. Les repondants ont signifie qu'ils recevaient actuellement de l'information passive sur leurs patients dans 10,0 % des cas, et qu'ils faisaient activement des demarches pour obtenir de l'information sur leurs patients dans 7,5 % des cas. La grande majorite (97,3 %) des repondants ont dit vouloir recevoir davantage d'information sur les resultats et pense que cela ameliorerait la precision du diagnostic (97,3 %), l'efficacite clinique (85,5 %), les resultats therapeutiques (95,6 %) et la satisfaction professionnelle (95,1 %). Lorsqu'on a demande aux repondants de reperer les << effets negatifs eventuels que pourrait entrainer une augmentation de la communication d'information sur les resultats >>, 62,1 % n'ont rien indique. Toutefois, 17,9 % ont suppose que cela pourrait engendrer des effets emotionnels negatifs et 11,5 % ont suggere comme effet eventuel la hausse d'exigences en matiere de temps. Conclusion : La grande majorite des medecins d'urgence recoivent tres peu d'information sur les resultats. La plupart aimeraient en recevoir davantage et estiment que cela ameliorerait la qualite de la pratique de medecine d'urgence.

Project managers can avail of scheduling software, communication software and project management software to enhance their capabilities. Managers must realize however, that sound management practices are more important than the tools as well as sound decision-making processes. These tools however, increase the chances of a project's success.

The future market of palmtop computers is expected to be successful if training and acculturation issues behind it are given importance. The handheld computer market is classified into three parts namely, personal digital assistants (PDAs), personal companions and PC companions. Marketing of handheld computers are affected by several factors, particularly by information technology infrastructure, considering that the usage of palmtop computers may cause a great impact on network communications.

Extranets can provide market advantages to organizations by providing them with a fast means of communicating with customers, suppliers, and partners. The system enables firms to serve customers better since feedback from users about products can instantly be accessed by engineers, hastening product development. Customary issues such as security remain a legitimate concern for firms but can be addressed by multilevel approaches that include firewalls, passwords protection, and encryption codes that would prevent intruders from accessing or transmitting classified information.

Integrated messaging, which is the integration of e-mail, fax and voice mail on a system, is useful to companies whose mobile executives rely on up-to-date messages and information to do business. While the utility of integrated messaging cannot be dismissed in current business competitiveness, its benefits must be weighed against the investments in technology to bring systems up to date with user requirements.

Venereal warts caused by human papillomavirus (HPV) infection may be destroyed by photosensitizing therapy. Researchers treated 24 patients with vulvar warts with photodynamic therapy including either a 2.5% 5-aminolevulinic acid ointment or a 20% 5-aminolevulinic acid cream. After application of the drug, fluorescence was initiated by use of an ultraviolet lamp placed 50 cm in front of the vulva. Drug levels were found to be higher with the 2.5% ointment than with the 20% cream 90 minutes after application. None of the women using the 2.5% ointment reported discomfort, while nine using the 20% cream did. The drug cleared the basal skin layer by 24 hours after application, so photodynamic therapy should be performed before this to eradicate HPV from basal skin. The drug is not well absorbed in normal, surrounding skin, and usually does not damage it.

Spending money to prevent defects is always a good investment. By using quality as a strategic weapon, Japanese companies have changed the face of competition forever. With help from quality [...]

Quality enhancement is a very successful method of cost reduction and product differentiation, but current accounting and financing practices do not provide adequate data to justify investment in capital equipment [...]

Purpose: Information sharing is vital to organizational operations, yet employees are often reluctant to share negative information. This paper aims to gain insight into which employees will be reluctant to share negative information and when by drawing from the proactive motivation literature examining effects of proactive personality and motivational states on individuals’ willingness to share negative information. Design/methodology/approach: A cross-sectional design was used, with data collected from a final sample of 393 individuals via an online survey. Hypotheses were tested using correlation and hierarchical multiple regression analyses. Findings: Interactive effects indicate proactive individuals with accompanying high levels of role breadth self-efficacy (“can do”) or high levels of felt responsibility for constructive change (“reason to”) were less likely to be reluctant to share negative information. However, findings also suggest proactive individuals with lower levels of proactive motivation avoid sharing negative information. Originality/value: The findings extend what is known about personality factors and employee willingness to share information to highlight which employees may be likely to avoid sharing negative information. The authors also examine the moderating influence of proactive motivational states on the relationships between proactive personality and reluctance to share negative information.

Your May/June 2017 article 'Michigan Odawa in World War I,' including reference to Pvt. Pontiac Williams, Co. K, 125th Infantry Regiment, especially caught my attention. I recognized the 125th as [...]

Silver clusters were assembled in helium droplets of different sizes ranging from 104to 1011atoms. The clusters were heated upon laser irradiation at 355 nm, and evaporation dynamics of He atoms were studied by quadrupole mass spectroscopy using signals from He+, He2+, and He4+splitter ions. We found that for droplets containing less than 107atoms the laser irradiation leads to evaporation of He atoms. However, the laser irradiation leads to the breakup of the large droplets into smaller ones.

IT professionals are now beginning to realize the applicability of browser technology in the development of a client/server model. Web-based applications help in solving significant problems encountered in legacy systems, including their rigid user interface. However, there remain some limitations that will have to be addressed by proponents of browser-based technology, such as slow application response and a lack of security features.

'L' MONTY BODY SHOP INC., a family-owned collision repair facility in El Monte, Calif., recently experienced a very exciting event. I'm a third-generation collision repair specialist and the current owner/president [...]

An evaluation was conducted on the use of geothermal energy in wastewater treatment in the Canadian Prairie Provinces. The assessment included an analysis of geothermal energy costs, an examination of the effects of using elevated temperatures in wastewater treatment, a selection of suitable uses of the lowgrade energy in wastewater treatment, and a preliminary assessment of costs and benefits. By heating the wastewater influent to 30° C on a yearround basis, performance as measured by BOD removal of an activated sludge plant might be increased by 10–15%. There may be much less benefit in the case of longdetention aerated lagoons. The benefit may be significant approximately 30% for trickling filter plants, but such systems are generally not considered for use in the harsh western Canadian climate. The economics of using geothermal energy to improve wastewater treatmentplant efficiency is not particularly attractive. An additional investment of 33–50% of the cost of the treatment plant is generally required for the installation of a geothermal energy system so that any enhanced efficiency of the treatment plant is obtained.

Olfactory learning assays in Drosophila have revealed that distinct brain structures known as mushroom bodies (MBs) are critical for the associative learning and memory of olfactory stimuli. However, the precise roles of the different neurons comprising the MBs are still under debate. The confusion surrounding the roles of the different neurons may be due, in part, to the use of different odors as conditioned stimuli in previous studies. We investigated the requirements for the different MB neurons, specifically the alpha/beta versus the gamma neurons, and whether olfactory learning is supported by different subsets of MB neurons irrespective of the odors used as conditioned stimuli. We expressed the rutabaga (rut)-encoded adenylyl cyclase in either the gamma or alpha/beta neurons and examined the effects on restoring olfactory associative learning and memory of rut mutant flies. We also expressed a temperature-sensitive shibire (shi) transgene in these neuron sets and examined the effects of disrupting synaptic vesicle recycling on Drosophila olfactory learning. Our results indicate that although we did not detect odor-pair-specific learning using GAL4 drivers that primarily express in gamma neurons, expression of the transgenes in a subset of alpha/beta neurons resulted in both odor-pair-specific rescue of the rut defect as well as odor-pair-specific disruption of learning using shi(ts1).

Forty-nine compounds currently used as additives in foods were tested in combination with three biocontrol agents, the yeasts Rhodotorula glutinis, Cryptococcus laurentii, and the yeastlike fungus Aureobasidium pullulans, to increase their antagonistic activity against Penicillium expansum, the causal agent of blue mold on apples. Twelve additives dramatically improved the antagonistic activity of one or more of the tested biocontrol agents. In a two-way factorial experiment with these selected additives the percentage of P. expansumrots on apples was significantly influenced by the antagonist and the additive as well as by their interaction. The combination of the biocontrol agents and some additives resulted in a significantly higher activity with respect to the single treatments applied separately, producing additive or synergistic effects. Some of the selected additives combined with a low yeast concentration (106cells per ml) had comparable or higher efficacy than the biocontrol agents applied alone at a 100-fold higher concentration (108cells per ml). Some organic and inorganic calcium salts, natural gums, and some antioxidants displayed the best results. In general, the effect of each additive was specific to the biocontrol isolate used in the experiments. Possible mechanisms involved in the activity of these beneficial additives and their potential application in effective formulations of postharvest biofungicides are discussed.

Offers guidelines in golf course renovation. Things to be observed when contractors are digging lakes or creating mounds; Factors to consider when renovation includes irrigation work; Actions that should be taken before any sprigging or seeding takes place; Plans which would serve as backup in case problems occur.

Despite repeated attempts to eliminate statelessness and to provide for the protection of stateless persons, international law has not been able to provide an adequate response to these problems. In the Middle East the problem has continued to grow as social and political change pushes people into becoming stateless and fails to provide those who are stateless with adequate protection. The treaties that have attempted to prevent this practice have failed. At the same time the lex specialis aimed at protecting people from the consequences of statelessness have also failed. The result has been a lacuna in the protection of stateless persons. This article suggests that a step towards filling this gap might be made by applying general international human rights law to protect stateless persons.

Several derivatives of aspartic acid were protected on Nas their NVOC derivatives, and on the side chain carboxylates as nitroveratryl esters. Following activation as the cyanomethyl esters, these fully protected aspartate derivatives were converted to the respective pdCpA esters. The protected aspartyl-pdCpA esters were then utilized as substrates for T4 RNA ligase in the presence of in vitro transcripts of tRNA lacking the pCpA dinucleotide normally found at the 3'-end. In this fashion, several misacylated tRNAs were prepared; following photolytic deprotection, these were employed successfully for incorporation into proteins at predetermined positions.Key words: aminoacylated nucleotides, amino acid protection, protein synthesis, tRNA activation.

This study evaluated the effects of polyethylene glycol-conjugated superoxide dismutase (PEG-SOD) in re-expansion pulmonary edema, a unilateral lung injury due in part to re-oxygenation of hypoxic, collapsed lung tissue. The hypothesis underlying this investigation was that extracellular superoxide contributed to the lung inflammation in this model, and that PEG-SOD could be used to test for extracellular superoxide involvement. The right lungs of 2—3 kg rabbits were collapsed for seven days by intrapleural air injections. Immediately prior to lung re-expansion, rabbits received intravenously 10,000 units/kg PEG-SOD (n = 6) or an equal volume of H2O2-inactivated PEG-SOD (n=6). Inactive PEG-SOD pretreated rabbits had a marked increase in re-expanded lungs’ lavage albumin concentration (right 1653 ± 230 µg/ml, left 404 ± 160 µg/ml; p < .01). Active PEG-SOD did not inhibit this permeability increase (right 1744 ± 242 µg/ml, left 180 ± 53 µg/ml; p < .01). However, active PEG-SOD significantly decreased both total number and percent neutrophils in alveolar lavage (right 24.8 ± 9.4%, left 4.2 ± 0.8%; p < .05) compared to inactive PEG-SOD pretreated rabbits (right 52.8 ± 5.8%, left 8.7 ± 2.4%; p < .01). Pretreatment with active PEG-SOD significantly increased lung tissue (20.4 ± 1.5 units/mg DNA), blood (400 ± 8 units/ml) and right lung lavage (30.0 ±3.1 units/ml) SOD activities compared to those from inactive PEG-SOD pretreated rabbits (respectively: 16.0 ± 1.0 units/mg DNA, 335 ± 14 units/ml and 10.8 ± 1.3 units/ml; p < .05 for each comparison). These data indicate that PEG-SOD pretreatment effectively: (1) increased lung tissue SOD activity; (2) decreased by >50% the accumulation of neutrophils within the re-expanded lung; but (3) did not decrease lung permeability following re-expansion.

In a 1902 American Journal of the Medical Sciences case report, Riesman described “albuminous expectoration” following thoracentesis, a phenomenon that is now recognized as re-expansion pulmonary edema (RPE). Both cellular and biochemical mechanisms that produce lung injury in RPE have been described recently. Pathophysiologically, this unilateral edematous lung injury resembles the adult respiratory distress syndrome (ARDS) because both are characterized by intra-alveolar-activated neutrophils and markedly increased lung capillary permeability. Biochemical mechanisms that operate in RPE are analogous to those in diverse re-oxygenation (reperfusion) injuries that have been described recently in the heart, kidney, brain, and intestine. Re-oxygenated lung tissue appears to produce excess superoxide and other cytotoxic oxygen metabolites, although lung xanthine oxidase, the commonly recognized source of these oxidants, is exceedingly low. Riesman’s critical analyses of the re-expansion edema fluid in his case provided an impetus for others to hypothesize that increased permeability pulmonary edema in RPE represented re-oxygenation injury of the lung microvasculature.

A canine lumbar laminotomy and discectomy model was used to evaluate the effects of a resorbable gel, ADCON-L (Gliatech Inc., Cleveland, OH), in reducing peridural scar formation and to assess the healing progress of immediately adjacent normal structures.

Rockwell is working on the development of a micro-electro-mechanical optical scanner based on bimorph microactuators. This scanner is lightweight, is small, and has superior scanning performance. The scanner is a low-power (<1 W) device that has large scan angles (20 deg) and scan rates in the range of 100 to 2000 Hz. It works for all wavelengths and offers the potential for monolithic integration with both electronics and optics for on-chip signal processing and control. The optical scanner consists of two main components—actuator and mirror—which are fabricated on a silicon cantilever beam. The actuator is comprised of a bimorph layer covered with two metal layers, which function as top and bottom electrodes. The mirror can be as large as 12 mm2in area, is placed at the end of the cantilever beam, and is designed for maximum optical flatness. The optical efficiency of the device is very high and can exceed 90 on proper metallization of the mirror area. The scan angle is a function of beam thickness, power efficiency of the bimorph, and many other design criteria. Through many improvements in these design parameters, a scan angle greater than 20 deg is expected to be achieved with high yield. © 1997 Society of Photo-Optical Instrumentation Engineers.

The effects of portal hypertension on gastric motor function were investigated using the rat staged portal vein ligation model. Gastric emptying of liquids and solids was studied separately following meals labeled with51Cror99Tcby whole stomach scintillation counting. Portal hypertension was consistently established in experimental rats (splenic pulp pressure: mean±SEM, portal hypertension versus control, 16.8 ±0.7 vs 11.8 ±0.7 mm Hg, P <0.0001). Although liquids were emptied in an exponential manner and solids in a linear fashion, gastric emptying of both meals was more rapid in the experimental rats. Ten minutes after the liquid meal, more than 50% of the meal had emptied from the stomachs of portal hypertensive rats while only one third of the meal had cleared in the control group (P<0.02). Gastric emptying of the solid meal was significantly accelerated in experimental rats at 60 and 120 min (percent meal remaining: portal hypertension versus control, 41.9±4.0 vs 55.4±3.5 and21.5±4.9 vs 32.6±4.3, P<0.05). Stomachs of portal hypertensive animals were heavier (P<0.009) and histologic examination revealed submucosal edema. Thus, a possible mechanism of the disrupted gastric motor function in portal hypertension is decreased gastric wall compliance secondary to edema.

Reexpansion pulmonary edema (RPE) is an acute, unilateral lung injury initiated by cytotoxic oxygen metabolites and temporally associated with an influx of polymorphonuclear neutrophils (PMNs); these toxic oxygen products appear to result from reoxygenation of chronically collapsed lung. Lodoxamide tromethamine (U-42585E) reduces infarct size after reperfusion of ischemic myocardium. The possible protective effects of lodoxamide in RPE were examined. Right lungs of rabbits were collapsed for 7 days by injection of air into the pleural space. Reexpansion was accomplished by chest tube with negative pressure in spontaneously ventilating rabbits. Twelve pairs of animals received either lodoxamide (20 mg/kg/h intravenously (i.v.) from 30 min before reexpansion until they were killed) or an equivalent volume of sterile saline. After 2 h, animals were killed by i.v. pentobarbital. Right and left lungs of six pairs of animals were lavaged with 25 ml saline each; the remaining six pairs of animals were studied by measurement of lung wet/dry weight ratio. Albumin concentrations in lavage fluid (BAL) of lodoxamide-treated animals were 243 ± 165 μg/ml in right lung and 29 ± 15 μg/ml in left lung (p < 0.03); albumin concentration in right lung BAL of untreated animals was 1,180 ± 319 μg/ml (p < 0.02 vs. lodoxamide-treated animals). PMN percentages in right BAL (3.8 ± 3.1) and left BAL (2.9 ± 2.2) did not differ in lodoxamide-treated animals (p > 0.65); PMN percentage in right BAL of untreated animals was 18.7 ± 2.9 (p < 0.001 vs. lodoxamide-treated animals). Incubation of PMNs with lodoxamide (1, 10, and 100 μg/ml) resulted in a dose-dependent decrease in directed migration (p < 0.005) but did not affect PMN adherence. Wet/dry weight ratio was not affected by lodoxamide administration. Thus, lodoxamide prevents PMN influx and decreases the alveolar-capillary protein leak in RPE, primarily by inhibiting PMN chemotaxis.

Tests were conducted to determine the moisture absorption/desorption characteristics of representative indoor building materials and furnishings. The experiments consisted of weighing several iteras while they were being subjected to humidity step changes. The quantities of moisture absorbed and released and the associated time constants were noted. The results showed that for a step change in humidity ratio, common indoor materials exhibited significant moisture uptake (release) relative to the change in moisture content of the air space. Of the materials tested, carpet was the most reactive, followed by unpainted spruce lumber, and then by latex-painted gypsum wallboard.

Fuel consumption is calculated using a modelling procedure for automobiles travelling on three alternative street patterns designed for a subdivision in Kingston Township, Ontario. The modelling procedure is described. The results indicate that grid and solar superblock street patterns, compared to the existing street pattern, offer small fuel savings to a tripmaker in the portion of the work trip travelled in the subdivision.

A novel transition metal complex, Venus flytrap cluster (VFC), is described for the preparation of radio-labeled antibodies. VFC contained 57Co, which was held tightly between the faces of two covalently bridged carborane ligands by cluster bonding of the metal with appropriate ligand orbitals. Anti-carcinoembryonic antigen monoclonal antibody T84.66 was conjugated to 57Co-VFC with full retention of immunological activity. Biodistribution studies in nude mice bearing carcinoembryonic antigen-producing tumors showed excellent tumor localization of 57Co-VFC-T84.66. The accumulation of radionuclide in normal liver was low and independent of dose, which may reflect the stability of the radionuclide complex. These results presage the use of VFC systems for binding transition metals that are clinically useful for radioimmunodiagnosis and radioimmunotherapy.

The purpose of this study was to determine the effects of portal hypertension on gastrointestinal transit. Portal hypertension was induced in a group of 15 rats by the staged portal vein ligation technique. A control group of 15 rats underwent a sham operation. Ten days later, a 51Cr-labeled Krebs' buffer solution was instilled into the duodenum and the distribution or radioactivity along the length of the small intestine was determined after 15, 30, and 60 minutes. Portal hypertension was consistently established in the study group; splenic pulp pressure (mm Hg, mean ± SD, portal hypertensive vs. control) was 20.0 ± 3.9 vs. 12.7 ± 3.9, P< 0.002. Various measures of intestinal transit revealed delayed transit in the portal hypertensive group. Retention of radioactivity in the most proximal quartile of the intestine was greater [percentage retained (portal hypertensive vs. control) was 57.9 ± 17.3 vs. 31.2 ± 15.3, P< 0.02, 49.1 ± 15.5 vs. 28.3 ± 4.8, P= 0.03, and 42.4 ± 17.6 vs. 29.0 ± 8.8, P= 0.08, at 15, 30, and 60 minutes, respectively] and the geometric mean of transit was located more proximally (P< 0.02) at each study interval in the portal hypertension group. It was concluded that portal hypertension is associated with delayed intestinal transit. This abnormality could predispose to bacterial overgrowth and contribute to altered digestion and absorption.

Cellobiohydrolase I from Trichoderma reeseicatalyzes the hydrolysis of methyl β-D-cellotrioside ( Km= 48μM, kcat= 0.7 min −1) with release of the β-cellobiose (retention of configuration). The same enzyme catalyzes the ( trans-hydration of cellobial ( Km= 116 μM, Kcat= 1.16 min −1) and lactal ( Km= 135 μM, kcat= 1.35 min −1), presumably with glycosyi oxo-carbonium ion mediation. Protonation of the double bond is from the direction opposite that assumed for methyl β-cellotrioside, but products formed from these prochiral substrates are again of β configuration. Cellobiohydrolase II from the same microrganism hydrolyzes methyl β-D-cellotetraoside ( Km= 4 μM, kcat= 112 min −1) with inversion of configuration to produce α-cellobiose. The other reaction product, methyl β-cellobioside, is in turn partly hydrolysed by Cellobiohydrolase II to form methyl β-D-glucoside and D-glucose, presumably the α-anomer. Reaction with cellobial is too slow to permit unequivocal determination of product configuration, but clear evidence is obtained that protonation occurs from the si-direction, again opposite that assumed for protonating glycosidic substrates. These results add substantially to the growing evidence that individual glycosidases create the anomeric configuration of their reaction products by means that are independent of substrate configuration.

This paper describes a procedure, using logit analysis, to model the mode choice decision of work trip commuters residing in a small municipality, Kingston Township, in the Province of Ontario, Canada. Particular emphasis is given to assessing the appropriateness of including perceptual variables as mode choice determinants in the modelling procedure. Results indicate that a carefully designed survey procedure using a small data base, and the inclusion of perceptual and non-perceptual variables in the demand model contribute to the goodness-of-fit of the the model to the sample data. It is concluded that the modelling procedure may offer potential for evaluating transportation policies designed to ameliorate work trip related problems confronting Kingston Township commuters.

The purpose of this study was to determine whetherin vivofluorescence detection of protoporphyrin IX (PpIX) could be used to identify intraperitoneal micrometastases of epithelial ovarian carcinoma after application of 5-aminolevulinic acid (ALA). ALA was applied intraperitoneal at different concentrations (25, 50, and 100 mg/kg) and iv (100 mg/kg) to immunocompetent Fischer 344 rats bearing a syngeneic epithelial ovarian carcinoma. At different time intervals after ALA administration (1.5, 3, and 6 hr) the peritoneal cavity was illuminated with ultraviolet (uv) light.In vivofluorescence of PpIX initially was determined by direct visualization. Subsequentlyex vivomeasurements were made with a slow-scan, thermoelectrically cooled CCD camera. Redin vivofluorescence was observed in ovarian micrometastases smaller than 0.5 mm in 100% of the ALA-administered animals independent of time interval, drug concentration, or route of administration. The intensity of the fluorescence was concentration dependent as strong fluorescence was consistently found only above 25 mg/kg ALA.Ex vivotumor to peritoneum fluorescence yield peaked 3 hr after administration of a 100 mg/kg intraperitoneal dose. Direct visualization ofin vivofluorescence after ALA application may improve the detection of intraperitoneal ovarian cancer micrometastases.

The first description of bilateral cortical necrosis of the kidneys is accredited to Juhel-Rénoy,1 of France (1886). The condition is rare, the literature containing reports of about 70 cases. Reviews of the literature have been made by Scriver and Oertel2 (1930), Ash3 (1933) and Evans and Gilbert4 (1936).Bilateral cortical necrosis of the kidneys is so named because at autopsy both kidneys show more or less extensive necrosis of the cortex. Grossly the necrotic cortex is reddish yellow and soft, closely resembling a fresh infarct in appearance and consistency. However, the involved area does not have the shape of an infarct but has the shape of the cortex even to the point of involving the columns of Bertin. Only a thin layer of cortex adjacent to the capsule and the pyramids is spared. The necrosis is more or less patchy. The cortical vessels also are necrotic

This study was undertaken to determine the capacity of infected kidneys to excrete hexamethylenamin. We had just had a small series of unilateral kidney infections in which large doses of hexamethylenamin had failed to be of any benefit. The frequent clinical failure of the drug it was felt might depend on its inability to pass through such impaired organs. At the outset, full credence was placed in the generally current valuation set on hexamethylenamin, i. e., when taken by mouth, it is excreted in the urine, bile, pancreatic, synovial and cerebrospinal fluids in sufficient quantities to be of marked bactericidal value. This confidence, however, was not strengthened by a rather thorough review of its extensive literature, and personal experimental results which quickly developed gave still greater uncertainty. Ever since Nicolaier introduced it into medicine, nearly twenty years ago, the efficiency of the drug has been ascribed to its decomposition

This paper is based on the study of 173 cases of Hodgkin's disease, treated at the Howard A. Kelly Hospital between October, 1913, and November, 1925.My original intention to cover both Hodgkin's disease and lymphosarcoma was abandoned on account of the immensely greater material and the difficulty in analyzing it, and also from the fact that the two diseases are histologically and, in many ways, clinically quite distinct. The first is an infection, in all likelihood, and the second a neoplasm. I believe that a large number of cases which have been treated and which showed the general distribution in the glands, the fever and the other clinical signs of Hodgkin's disease, may have been Hodgkin's disease. The tissue examinations, however, showed only a lymphoid hyperplasia and, as a consequence, these cases have been classified as pseudoleukemia, or lymphosarcoma.The term Hodgkin's disease, first employed by Samuel Wilks, 1