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ObjectiveIt is difficult to predict the presence of histological risk factors for lymph node metastasis (LNM) before endoscopic treatment of T1 colorectal cancer (CRC). Therefore, endoscopic therapy is propagated to obtain adequate histological staging. We examined whether secondary surgery following endoscopic resection of high-risk T1 CRC does not have a negative effect on patients' outcomes compared with primary surgery.DesignPatients with T1 CRC with one or more histological risk factors for LNM (high risk) and treated with primary or secondary surgery between 2000 and 2014 in 13 hospitals were identified in the Netherlands Cancer Registry. Additional data were collected from hospital records, endoscopy, radiology and pathology reports. A propensity score analysis was performed using inverse probability weighting (IPW) to correct for confounding by indication.Results602 patients were eligible for analysis (263 primary; 339 secondary surgery). Overall, 34 recurrences were observed (5.6%). After adjusting with IPW, no differences were observed between primary and secondary surgery for the presence of LNM (OR 0.97; 95% CI 0.49 to 1.93; p=0.940) and recurrence during follow-up (HR 0.97; 95% CI 0.41 to 2.34; p=0.954). Further adjusting for lymphovascular invasion, depth of invasion and number of retrieved lymph nodes did not alter this outcome.ConclusionsOur data do not support an increased risk of LNM or recurrence after secondary surgery compared with primary surgery. Therefore, an attempt for an en-bloc resection of a possible T1 CRC without evident signs of deep invasion seems justified in order to prevent surgery of low-risk T1 CRC in a significant proportion of patients.

Objectives:The decision to perform secondary surgery after endoscopic resection of T1 colorectal cancer (CRC) depends on the risk of lymph node metastasis and the risk of incomplete resection. We aimed to examine the incidence and risk factors for incomplete endoscopic resection of T1 CRC after a macroscopic radical endoscopic resection.Methods:Data from patients treated between 2000 and 2014 with macroscopic complete endoscopic resection of T1 CRC were collected from 13 hospitals. Incomplete resection was defined as local recurrence at the polypectomy site during follow-up or malignant tissue in the surgically resected specimen in case secondary surgery was performed. Multivariate regression analysis was performed to analyze factors associated with incomplete resection.Results:In total, 877 patients with a median follow-up time of 36.5 months (interquartile range 16.0–68.3) were included, in whom secondary surgery was performed in 358 patients (40.8%). Incomplete resection was observed in 30 patients (3.4%; 95% confidence interval (CI) 2.3–4.6%). Incomplete resection rate was 0.7% (95% CI 0–2.1%) in low-risk T1 CRC vs. 4.4% (95% CI 2.7–6.5%) in high-risk T1 CRC (P=0.04). Overall adverse outcome rate (incomplete resection or metastasis) was 2.1% (95% CI 0–5.0%) in low-risk T1 CRC vs. 11.7% (95% CI 8.8–14.6%) in high-risk T1 CRC (P=0.001). Piecemeal resection (adjusted odds ratio 2.60; 95% CI 1.20–5.61, P=0.02) and non-pedunculated morphology (adjusted odds ratio 2.18; 95% CI 1.01–4.70, P=0.05) were independent risk factors for incomplete resection. Among patients in whom no additional surgery was performed, who developed recurrent cancer, 41.7% (95% CI 20.8–62.5%) died as a result of recurrent cancer.Conclusions:In the absence of histological high-risk factors, a ‘wait-and-see’ policy with limited follow-up is justified. Piecemeal resection and non-pedunculated morphology are independent risk factors for incomplete endoscopic resection of T1 CRC.

Adsorption equilibria of butane isomers and SF6 on Kureha activated carbon were investigated using the volumetric method and the tapered element oscillating microbalance (TEOM) technique. The isotherm data of the butane isomers measured by the TEOM technique are in good agreement with those determined by the volumetric method. Single-component adsorption isotherms are reported at temperatures in the range from 298 to 393 K and at pressures up to 120 kPa. SF6 molecules are mainly adsorbed in the larger micropores, resulting in a lower adsorption capacity. The amount adsorbed for n-butane is slightly higher than that for isobutane in the whole range investigated. This is attributed to the fact that the linear n-butane molecule can adsorb in the smaller micropores. The Tóth model appropriately describes the equilibrium data of the butane isomers, while the isotherm data of SF6 can be fitted by the Langmuir model. The isosteric heats associated with adsorption for these three adsorptives show different loading dependences. The present study indicates that the activated carbon can be well characterized by the probe molecules having different molecular sizes.

The desorption kinetics of n-butane and isobutane in Kureha carbon has been investigated by means of the TEOM technique. The model used to describe the desorption profiles is based on the nonlinear Tóth type adsorption isotherm and the overall rate of desorption controlled by both mass transfer across the gas film surrounding each particle and micropore diffusion. The strong concentration-dependent micropore diffusion in Kureha carbon could be well described by the structural approach proposed by Do (Chem. Eng. Sci. 1996, 51, 4145−4158), in which the diffusivity at zero coverage appeared to be independent of loading. The concentration dependence of micropore diffusivities in the structural approach is stronger than the so-called Darken correction; for n-butane it is stronger than that for isobutane. Under similar conditions, the diffusivities of n-butane in Kureha carbon are slightly larger than those of isobutane. The diffusivity activation energy at zero loading for n-butane is larger than that for isobutane because of the penetration of n-butane molecules in the smaller micropores of Kureha carbon, in which there are stronger interactions between adsorptive and adsorbent.

Seasonal fluctuations in hepatitis A have been observed in the Netherlands related to Turkish and Moroccan children after visiting their home countries. This study determined the prevalence and associated factors of hepatitis A virus (HAV) antibodies in Turkish and Moroccan children in Rotterdam. A random sample was taken of children in Rotterdam, aged 5–16 years, of Turkish and Moroccan origin, together with a random sample of native Dutch children aged 5–7 and 14–16 years. Blood was collected by finger prick on filter paper. IgG and IgM anti‐HAV was detected by an enzyme‐linked immunoassay (EIA). The 319 Turkish, 329 Moroccan, and 248 native Dutch children participated in the study. In Turkish children, IgG anti‐HAV increased from 2.2% to 22.2% over the age groups. In Moroccan children, IgG anti‐HAV increased from 10.2% to 57.7%. In native Dutch children, 0.8% had IgG anti‐HAV in the youngest and 3.1% in the oldest age group. The percentage IgG‐positive also having IgM anti‐HAV was 21% in Turkish, and 41% in Moroccan children. No IgG‐positive native Dutch children had IgM anti‐HAV. The prevalence of IgG anti‐HAV was associated with increased age, being Moroccan, longer stay in the country of origin before migrating to the Netherlands, and known contact to HAV. The majority of Turkish and Moroccan children aged 4–16 years in Rotterdam are not protected against HAV, but do have a high risk of becoming infected while visiting their native country. Active vaccination against HAV of these children is indicated, with as primary aim their own protection. Prevention of HAV‐transmission in the general community should be seen as a secondary benefit. In addition, possible Dutch contacts of nonvaccinated Turkish and Moroccan children, such as day care workers and teachers, should also be vaccinated against HAV. J. Med. Virol. 72:197–202, 2004. © 2004 Wiley‐Liss, Inc.

Twenty-eight percent of patients with the Guillain–Barré syndrome remain able to walk unaided. Studying patients with the mild form of Guillain–Barré syndrome can further contribute to knowledge of the spectrum of the syndrome and explore whether this subgroup may need treatment with IV immunoglobulin.

ABSTRACTThe kinetics of dengue virus (DEN)-specific serum immunoglobulin classes (immunoglobulin M [IgM] and IgA) and subclasses (IgG1 to IgG4) were studied in patients suffering from dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Serum samples from non-DEN febrile patients were included as controls. IgM, IgG1, and IgG3 serum antibodies were the predominant immunoglobulins throughout the course of illness in all three patient groups. In contrast, IgA antibodies were significantly higher in the acute phase in DSS patients compared to those in DF patients (P< 0.05). The levels of IgG1 differed significantly between patients with DF and those with DHF and DSS (P< 0.05). A significant difference was also found in IgG3 levels between DF patients and DHF patients (P< 0.05) but not between DF patients and DSS patients. Finally, levels of IgG4 antibodies differed significantly between DF patients and DSS patients (P< 0.05). Collectively, these data show that increased levels of DEN-specific IgA, IgG1, and IgG4 serum antibodies are risk markers for the development of DHF and DSS and that their measurement may provide valuable guidance for early therapeutic intervention.

Seroprevalence of herpes simplex virus type 1 (HSV-1) and HSV-2 was determined in 1993 and 1998 in a randomly selected study group of 1024 and 654 attendees, respectively, at the sexually transmitted disease (STD) clinic of the University Hospital Rotterdam-Dijkzigt, The Netherlands. Correlations of HSV-1 and HSV-2 seropositivity were investigated. The relationship between HSV-1 and HSV-2 antibodies was also studied.

We previously described an automatic procedure for diagnosing and grading detrusor instability using a cystometric study. In our current study we applied a modified version of the program in patients with urge incontinence treated with sacral neuromodulation to test its capacity to detect changes after therapeutic intervention and understand the mode of action of neuromodulation.

The performance of six commercially available immunoassay systems for the detection of dengue virus-specific immunoglobulin M (IgM) and IgG antibodies in serum was evaluated. These included two IgM and IgG enzyme immunoassays (EIA) from MRL Laboratories and PanBio, a rapid immunochromatographic test (RIT) from PanBio, immunofluorescence assays (IFA) from Progen, a dot blot assay from Genelabs, and a dipstick EIA from Integrated Diagnostics (INDX). For this study a panel of 132 serum samples, including 90 serum samples from patients with suspected dengue virus infection and 42 serum samples from patients with other viral infections, was used. In addition, serial serum samples from two monkeys experimentally immunized and challenged with dengue virus type 2 were used. Results were considered conclusive when concordant results were obtained with four of the six antibody-specific assays. Based on this definition, the calculated overall agreement for the human serum samples for the respective IgM immunoassays was 97% (128 of 132), with 34% (45 of 132) positive serum samples, 63% (83 of 132) negative samples, and 3% of samples (4 of 132) showing discordant results. The calculated overall agreement for the IgG assays was 94% (124 of 132), with 49% (65 of 132) positive, 45% (59 of 132) negative, and 6% (8 of 132) discordant results, respectively. The sensitivities of the dengue virus-specific assays evaluated varied between 71 and 100% for IgM and between 52 and 100% for IgG, with specificities of 86 to 96% and 81 to 100%, respectively. The relative sensitivities of the respective IgM assays measured with the monkey serum samples were comparable with those obtained with 12 serial serum samples from humans. Overall performance, based on the sum of the agreement, sensitivity, specificity, and Kappa statistics of the IgM and IgG immunoassays, showed that the antibody detection systems from INDX and Genelabs and the MRL and PanBio EIA are useful and reliable assays for dengue virus serodiagnosis.

Detection of herpes simplex virus type 2 (HSV-2)-specific antibodies by a monoclonal antibody (MAb)-blocking enzyme-linked immunoassay (EIA) was compared with detection by a strip immunoblot assay (SIA) in a sexually transmitted disease (STD) clinic population. The study population consisted of 1,683 genitourinary medicine clinic attendees (582 women and 1,101 men). Sera were tested for the presence of HSV-2 antibody by use of the blocking EIA, in which binding of the MAb AP-1 to HSV-2 glycoprotein G-2 (gG-2) is blocked by HSV-2-specific antibody. The Chiron RIBA HSV-1 and -2 strip immunoassay (SIA) utilizes HSV-1- and HSV-2-specific or cross-reactive antigens immobilized on nitrocellulose strips (HSV gB-1 and HSV gG-1 peptide bands specific for HSV-1 antibody, HSV-2 gG-2 band specific for HSV-2 antibody, and HSV gD-2 band cross-reactive for HSV-1 and HSV-2 antibodies). A total of 1,612 sera were tested by MAb-blocking EIA for HSV-2 antibody and by SIA for HSV-1 and HSV-2 antibodies. By EIA, 541 (33.6%) sera were positive for HSV-2 antibody and 1,068 sera were negative for HSV-2 antibody; 3 sera gave equivocal results. HSV-2 antibody was detected in 555 (34.4%) sera by SIA; 144 (26%) of these sera possessed only HSV-2 antibody, and 411 (74%) sera contained both HSV-1 and HSV-2 antibodies. SIA detected HSV-1 antibody in 1,155 (71.6%) sera; 744 (64%) of these sera contained HSV-1 antibody alone. Sixteen sera contained antibody against HSV but could not be typed by SIA. A total of 512 sera were positive for HSV-2 antibody by both the EIA and SIA. We concluded that the blocking EIA and SIA showed a high level of agreement in detecting HSV-2 antibody in this population. In contrast to the SIA, the blocking EIA is a useful tool for large epidemiological studies, though the SIA proved to be slightly more sensitive once sera with discrepant results were further tested.

Abstract:  Considerations for applying LDA to bubbly flows with bubbles about 3 to 4 mm in diameter were investigated by means of detailed experiments in the model geometry of a train of bubbles. Both forward scatter and backscatter LDA were studied. The validity of phase discrimination via burst amplitude was tested and special attention was paid to the impact of bubble interface response to the laser beams. Forward and backscatter measurements can be compared well. In both configurations, predominantly the liquid phase is “seen” by LDA. A bubble itself only leads to a velocity realization in special conditions. In those cases the Doppler shift is determined by the motion of the bubble interface which consists of the motion of the center of gravity of the bubble as well as shape oscillations. In backscatter bubbles only give velocity realizations when their “cheeks” pass through the measuring volume virtually perpendicularly. It is shown that the bubble-caused velocity realization frequency is very low for bubbles of the size used. Phase discrimination on burst amplitude does not hold. In ambient cases such as bubble columns one can assume that only the liquid phase is being studied.

Until 1995, 39 cases of serologically confirmed hantavirusnephropathy in humans, caused by the Puumala type of Hantavirus, have been documented in the Netherlands. Thirty-two of these occurred in Twente, a small region in the eastern part of the country, in which the presence of Puumala-like Hantavirusin feral rodents has recently been demonstrated. Sixteen of the cases documented in humans occurred in 1993. Here we present an overview of clinical, histopathological and epidemiological findings of hantavirus infections. All the clinical and laboratory findings of the 39 documented cases were similar to those found in infections with the same virus in neighbouring countries. Complete recovery of renal function occurred in all patients. One patient developed a Guillain-Barré syndrome after having recovered from her renal failure. Histopathological examination of kidney biopsies collected from 13 of the patients in the acute stage, confirmed the presence of acute interstitial inflammation of differing severity in these individuals. A serological survey carried out amongst 4232 healthy blood donors in the endemic area showed a seroprevalence of 0.7%. This suggests that less severe or perhaps even subclinical infections occur.

Summary This report describes the first isolation and partial characterization of a herpesvirus from the harbor seal(Phoca vitulina). The virus was isolated during a disease outbreak in a group of young seals nursed in an seal orphanage in The Netherlands. Almost half of the seals died with symptoms of acute pneumonia and focal hepatitis and the virus was isolated of organs of most of the dead animals. Seven out of ten seals of which paired serum samples were obtained showed seroconversion in a virus neutralization test during this outbreak. The virus was tentatively characterized as a herpesvirus (seal herpesvirus: SeHV or phocid herpesvirus 1) on the basis of its characteristic morphology in electron microscopy, buoyant density in sucrose, sensitivity to ether and heat treatment and its antigenic relationship with other probable members of the Alphaherpesvirinae subfamily. The virus caused cytopathic changes within 24 hours after inoculation in seal kidney cells, consisting of a focal rounding of cells and syncytium formation. No cytopathic changes were observed in the cells of nine other mammalian species tested.

The decline of maternal respiratory syncytial virus (RSV) specific serum antibodies was studied in 45 children during the first 6 months of life, using a virus neutralization assay and competition ELISAs measring fusion protein and glycoprotein specific antibodies. In all children RSV neutralizing antibodies were demonstrated at birth, with titers ranging from 33 to 1382. The calculated mean half life of these antibodies was 26 days. Furthermore, in a group of 38 children with suspected RSV infection, all younger than 6 months of age on admission, the diagnostic value of serological assays was evaluated. In 32 children RSV infection was confirmed by virus isolation, direct immune fluorescence and RT‐PCR. In 7 patients of this group a significant titer rise in virus neutralization assay was demonstrated. Six additional RSV infected children could be identified by showing the presence of RSV‐specific IgM or IgA serum antibodies or by showing an increase in fusion protein or glycoprotein specific antibodies. All serological tests together identified 13 (41%) of the 32 RSV infected patients. It is concluded that in children of this age group, which represent the majority of patients hospitalized with RSV infections, serological assays not only have a limited diagnostic value but are of limited value for sero‐epidemiological studies. J. Med. Virol. 52:97–104, 1997. © 1997 Wiley‐Liss, Inc.

The insertion reactions of the allenes propadiene and 1,2-heptadiene in the Pd−C bond of complexes (N&arcraise;N)Pd(R)X (N&arcraise;N = 8-PQ, p-An-BIAN, i-Pr-DAB, p-An-DAB, i-Pr-PyCa; R = Me, C(O)Me, C(O)Ph, C(O)i-Pr; X = Cl, Br) have been investigated. An X-ray crystal structure determination of (8-PQ)Pd{(1−3-η)-2-methylpropenyl}Cl exhibited the unexpected monodentate coordination of the nitrogen ligand. The monodentate coordination in apolar solvents and bidentate coordination in polar solvents was demonstrated by means of NOE NMR experiments. Kinetic measurements revealed that the reactions are first order in the palladium concentration and occur via an allene concentration independent and dependent pathway. Reactions of complexes containing flexible bidentate nitrogen ligands were retarded by additional free bidentate nitrogen ligand indicating that initial dissociation of a nitrogen donor is an important step in the reaction. We have strong indications that the migration of the R group to the precoordinated allene is the rate-determining step. Instead of mass-law retardation by excess X^- (X = Cl^-, Br^-), an enhancement of the reaction has been observed in case of the complexes (8-PQ)Pd(Me)Cl, (8-PQ)Pd(Me)Br, and (i-Pr-DAB)Pd(C(O)Me)Cl. Flexible bidentate nitrogen ligands greatly enhance the reaction, owing to the easy formation of an accessible site on the metal center. The insertion of allenes into the Pd−C bonds of complexes containing rigid bidentate nitrogen ligands probably proceeds via initial allene association followed by either halide or nitrogen dissociation and subsequent migration of the R group to the precoordinated allene.

The ionic [Pd(C7H8C(O)R)(Ar-BIAN)]X (R = Me, Et, iPr, Ph; X = Cl, Br, I; Ar = p-An, p-FC6H4, p-BrC6H4, p-Tol, Ph, o,o‘-Me2C6H3, o,o‘-iPr2C6H3) complexes (1b−12b), bearing the bidentate nitrogen ligand bis(arylimino)acenaphthene (Ar-BIAN), have been synthesized via reaction of the corresponding neutral acylpalladium complexes Pd(C(O)R)X(Ar-BIAN) (1a−12a) with norbornadiene (nbd). For the first time, an extensive kinetic study of this migratory alkene insertion into acyl−palladium bonds of neutral complexes containing α-diimine ligands has been carried out. It has been found that under pseudo-first-order circumstances these reactions follow the rate law kobsd = k1 + k2[nbd], which shows that these reactions proceed via a pathway independent of alkene concentration (k1 pathway) and a pathway dependent on alkene concentration (k2 pathway). The dramatic decrease of the rate constants k1 and k2 upon increasing the steric bulk of the BIAN ligand and the large negative entropy of activation and low enthalpy of activation for both pathways indicate that the k1 and k2 pathways are closely related and involve associative processes. From the influence of solvent, X and C(O)R ligand, steric and electronic properties of the BIAN ligand, the presence of free halide and free BIAN, and the parameters of activation, mechanisms have been proposed for both pathways. The k1 pathway may proceed via a rate-determining solvent-assisted halide or nitrogen dissociation, followed by alkene association and migratory insertion, while the k2 pathway may occur via a rate-determining migratory alkene insertion in a contact ion pair intermediate. This species may be formed via alkene association followed by either halide or nitrogen dissociation.

Recently morbilliviruses were isolated from harbour seals (Phoca vitulina) in North West Europe (phocid distemper virus-1: PDV-1) and from Baikal seals (Phoca sibirica) in Siberia (phocid distemper virus-2:PDV-2) during outbreaks of severe disease which resembled distemper in dogs. PDV-1 and PDV-2 were passaged in SPF dogs, in which they caused distemper-like disease symptoms, and were subsequently passaged in Vero cells in which they caused cytopathic changes. PDV-1, PDV-2, and canine distemper virus (CDV) were compared with respect to their biological, morphological, physical, protein chemical, and antigenic properties. It was concluded that PDV-1 should be considered a newly recognized member of the genusMorbillivirus, whereas PDV-2 proved to be quite similar if not identical to CDV.

This study concerns the prevalence of current and lifetime Posttraumatic Stress Disorder (PTSD) in various groups of officially recognized Veterans of the Dutch civilian Resistance against the Nazi occupation during World War II. In total, 1046 Resistance veterans living in The Netherlands and 52 who emmigrated to the United States after the war were examined. Between four and five decades after the end of WW 11, between 25 and 50% were suffering from current PTSD. The life-time prevalence is estimated to be substantially higher. The course of PTSD proved highly variable. There had often been a delay of several decades between the end of the war and reoccurrence or first onset of posttraumatic symptoms. The prevalence of PTSD in Resistance veterans who emigrated to the United States was hardly different from that of the veterans still living in The Netherlands.

The author presents a study of the personality structure, youth development and the role of interhuman conflicts in the work situation and the family, in the causation and course of Menière's disease, the somatopsychic reactions of the patients to the illness, and the principles of a form of psychotherapy which was combined with the regular E.N.T. check-ups and treatment. The results confirm and extend previous work by other researchers. A testable hypothesis about the specific psychosomatic etiology of Menière's disease is formulated and presented.

Male Dutch Resistance veterans from World War II who reported on chronic diseases were compared with subjects from a population survey. Resistance veterans in general reported significantly more disease. Veterans with symptoms of posttraumatic stress disorder reported more disease than those who had none. Furthermore, 13 specific disease categories were more prevalent in the Resistance veterans than in the general population. In the Resistance veterans total number of reported diseases was significantly correlated with anxiety, depression, and posttraumatic stress disorder. In Resistance veterans weekly tobacco use was comparable to that of the control subjects, but alcohol consumption was significantly less.

The parameters Pisv(active isovolumetric detrusor pressure) and vmax(maximum shortening velocity), which characterize the contractility of the detrusor muscle, were determined in guinea pigs. To this end it was necessary to develop a method of measuring flow rates in these small animals. The values found were used to calculate the contractility parameter Wmax. Thirteen animals were used. The results found for Pisvand vmaxwere 43.0 ± 3.7cm. H20 and 20.2 ± 3.7mm. per second, respectively. The latter corresponded to about 0.38 muscle lengths per second, which is similar to values reported for bladder strips from other species. Previous work showed that in vitro Pisvdecreased with increasing bladder volume over a wide range of volumes. In vivo Pisvseemed to be independent of bladder volume. This suggests that neurogenic stimulation intensifies as volume increases. vmaxalso was independent of volume. Wmaxappeared to be suitable for detecting differences in the contractility of the bladders of different animals. Values were not significantly different in isovolumetric and nonisovolumetric contractions. Normalized to the size of the bladder, the Wmaxvalues indicated that the power generated by the guinea pig bladder is similar to the power generated by the human bladder.

To study the relative importance of neurogenic factors in detrusor contractility, active bladder wall stress values were compared in situ and in vitro. Eight male guinea pigs were used. The active stress in the bladder wall in spontaneous micturition contractions was calculated from the results of urodynamic examinations and compared with the active stress developed in response to optimum electrical stimulation in full-thickness bladder wall strips taken from the same bladders. The results indicated that, in normal micturition, the detrusor muscle is not fully stimulated, and the rate of pressure development is not determined by mechanical factors. To identify topological variations of detrusor contractility, the strips were taken from three different locations. It was found that strips from the posterior wall contracted more forcefully than those from the anterior wall.

Lyme borreliosis (LymeB), Hemorrhagic fever with renal syndrome (HemoFRS), Lymphocytic choriomeningitis (LymphoCM), Tick-borne encephalitis (TickBE), Q Fever (QFever), and Weil's leptospirosis (Lepto) are known to be occupational diseases for rural outdoor workers. We investigated the occupational infection risks for these diseases in greater detail. Antibodies to these agents were assessed in 312 forestry workers and muskrat catchers, and in 356 matched office workers. Three levels of occupational exposure were distinguished: high for active forestry workers, low for supervisory forestry staff and muskrat catchers and zero for office workers. At high exposure the prevalence odds ratios (with 95% CI between brackets) were: LymeB 15 (5.5–42), HemoFRS 11 (1.3–501), LymphoCM 5.4 (1.0–50), TickBE 1.0 (0.3–3.0), QFever 1.0 (0.4–2.1), and Lepto 0 (0.0–33). No significant risk of infection was found at low exposure. Part of the present group had also been studied in 1989 and 1990. Within this cohort the conversion rates to Borrelia burgdorferi have been estimated for the periods 1989–1990 and 1990–1993 as 0.23 and 0.066 year-1, respectively, and the reversion rate as 0.44 year-1. The corresponding values for HemoFRS were 0.031, 0.018 and 1.42 year-1. Active forestry workers in the Netherlands are at high risk of infection by LymeB, HemoFRS and LymphoCM. Prevalence of antibodies to LymeB and HemoFRS appeared to reflect the levels of these infection hazards in recent history.

The course of micturition depends on bladder contractility and urethral resistance. The former is determined by geometrical, muscular and neurogenic factors. The muscular aspects of bladder contractility can be characterized by the parameters P"i"s"v, the isovolumetric detrusor pressure, and v"m"a"x, the maximum (unloaded) shortening velocity of the detrusor muscle. The neurogenic control system of the urinary tract modulates bladder contractility, which might effectively change the values of P"i"s"v and v sub max. These parameters also depend on the instantaneous bladder volume. In previous work the dependence of P"i"s"v on the intensity of stimulation and bladder volume was measured in guinea pig bladders in vivo and in vitro. In the present work v"m"a"x was derived in 5 guinea pig bladders in vitro, using electrical stimulation and the stop-flow technique. This technique implies that pressure values measured at a certain shortening velocity of the bladder circumference and in an isovolumetric contraction at the same volume are used to derive v"m"a"x mathematically from the Hill equation. v sub max was independent of the bladder volume in the range of 0.6 to 6.1 ml., but it was significantly different for the two intensities of stimulation used. Therefore, it is concluded that the maximum shortening velocity of the guinea pig detrusor muscle depends on the intensity of stimulation. During submaximal stimulation the detrusor not only generates lower pressures, it also contracts more slowly. A possible explanation for this phenomenon is that the bladder is not uniformly stimulated. The isovolumetric pressure measured in the stop-flow test was compared with the isovolumetric pressure measured at the same bladder volume some minutes later. It was observed that shortening had a depressant effect of approximately 33% on the isovolumetric pressure. This implies that the clinically employed stop-flow test might underestimate detrusor contraction strength.

Propadiene, 3-methyl-1,2-butadiene (DMA), and 2,4-dimethyl-2,3-pentadiene (TMA) reacted via migratory insertion with both neutral and ionic Pd(R)X(p-An-BIAN) (R = Me (1), C(O)Me (2); X = Cl (a), SO3CF3 (b)) complexes, containing the rigid nitrogen ligand bis(p-anisylimino)acenaphthene (p-An-BIAN), resulting in the novel and stable allylpalladium complexes Pd(η³-C3H4R)X(p-An-BIAN) (R = Me (3), C(O)Me (6)), Pd(η³-C5H8R)X(p-An-BIAN) (R = Me (4), C(O)Me (7)), and Pd(η³-C7H12R)X(p-An-BIAN) (R = Me (5), C(O)Me (8)), respectively (X = Cl (a), SO3CF3 (b)). The neutral complexes 6a and 7a reacted with carbon monoxide to form the acylpalladium complexes Pd(C(O)C3H4C(O)Me)Cl(p-An-BIAN) (9) and Pd(C(O)C5H8C(O)Me)Cl(p-An-BIAN) (10), respectively, while the analogous trifluoromethanesulfonate complexes 6b and 7b were completely inert toward CO. Complexes 9 and 10 reacted again with propadiene and DMA, respectively, to yield the allylpalladium complexes Pd(η³-C3H4C(O)C3H4C(O)Me)Cl(p-An-BIAN) (11) and Pd(η³-C5H8C(O)C5H8C(O)Me)Cl(p-An-BIAN) (12), respectively. Also insertion of norbornadiene in complex 10 was possible, yielding the ionic complex [Pd(C7H8C(O)C5H8C(O)Me)(p-An-BIAN)]Cl (13a), which reacted with AgSO3CF3 to give [Pd(C7H8C(O)C5H8C(O)Me)(p-An-BIAN)]SO3CF3 (13b). The novel complexes 9−12 are the first isolated and fully characterized complexes formed by successive insertion reactions of carbon monoxide and allenes, while 13a is the first isolated complex containing a metal-bonded ter-oligomer of carbon monoxide, an allene, and norbornadiene. The X-ray crystal structure of 7a has been determined and shows a distorted square pyramidal geometry in which the BIAN ligand is bonded to the palladium center in an unusual asymmetric fashion (Pd−N(1) = 2.144(7) Å; Pd−N(2) = 2.600(8) Å).

Detrusor instability and hyperreflexia are characterized by involuntary detrusor contractions in the filling phase of the voiding cycle. The diagnosis is made when urodynamic evaluation reveals such contractions. To compare patients and evaluate treatment a method is needed to quantify the degree of instability. We developed an instability parameter based on the area under the curve of involuntary detrusor contractions on conventional filling cystometry.

The resistance offered to urinary flow by the urethra is one of the factors determining the course of micturition. It was the aim of the present work to study the dependence of urethral resistance on the degree of relaxation of the urethra.

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection and quantification of IgM and IgG serum antibodies to mouse polyomavirus (MPV). To evaluate the potential of this ELISA for the screening of laboratory rodents, serum samples from specific pathogen free (SPF) BALB/c RIVM mice, collected after experimental intraperitoneal infection with MPV, were tested by this assay. The results were compared with those obtained from the same sera in an immunofluorescence assay (IFA) and a haemagglutination inhibition assay (HIA). The ELISA proved to be the most sensitive of the 3 assays, allowing the detection of seropositive animals within 7 days post-infection and giving antibody titres that were about 4 to 8 times higher than those found in the IFA and HIA respectively. More than 5000 serum samples from non-infected specific pathogen free laboratory mice and 90 from 10 SPF N:NIH/RIVM mice experimentally infected with K-papovavirus, were negative in this assay, thus confirming the specificity of the ELISA

The course of micturition depends on bladder contractility and urethral resistance. The former is determined by geometrical, muscular and neurogenic factors. The muscular aspects of bladder contractility can be characterized by the parameters P isv, the isovolumetric detrusor pressure, and v max, the maximum (unloaded) shortening velocity of the detrusor muscle. The neurogenic control system of the urinary tract modulates bladder contractility, which might effectively change the values of P isvand v sub max. These parameters also depend on the instantaneous bladder volume. In previous work the dependence of P isvon the intensity of stimulation and bladder volume was measured in guinea pig bladders in vivo and in vitro. In the present work v maxwas derived in 5 guinea pig bladders in vitro, using electrical stimulation and the stop-flow technique. This technique implies that pressure values measured at a certain shortening velocity of the bladder circumference and in an isovolumetric contraction at the same volume are used to derive v maxmathematically from the Hill equation. v sub max was independent of the bladder volume in the range of 0.6 to 6.1 ml., but it was significantly different for the two intensities of stimulation used. Therefore, it is concluded that the maximum shortening velocity of the guinea pig detrusor muscle depends on the intensity of stimulation. During submaximal stimulation the detrusor not only generates lower pressures, it also contracts more slowly. A possible explanation for this phenomenon is that the bladder is not uniformly stimulated.

In this study, 680 male and 144 female Dutch Resistance veterans of World War II were evaluated on Posttraumatic Stress Disorder, trait anxiety, and depression. Approximately 27% of these men and 20% of these women showed current Posttraumatic Stress Disorder. Resistance veterans, as a group, appeared comparable to the controls from Dutch validation studies on trait anxiety and depression. Gender differences were not observed. Veterans with current PTSD symptoms scored higher on trait anxiety and depression than the remaining veterans and were comparable on trait anxiety and depression to psychiatric patients. Correlational analyses showed that there was a strong association between trait anxiety and depression. Posttraumatic Stress Disorder correlated highly with trait anxiety and depression.