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The Asthma Impairment and Risk Questionnaire (AIRQ®) is a composite control assessment. Scores of 0-1 indicate well-controlled (WC), 2-4 not well-controlled (NWC), and 5-10 very poorly controlled (VPC) asthma. Asthma Checklist is a tool to facilitate implementation of guideline and expert report recommendations. We assessed the impact of implementing AIRQ and Asthma Checklist with patients in a coaching program provided by certified asthma educators (AE-C).

Explains that electric vehicles need to achieve safety standards in a very short time in comparison with conventional gas vehicles, which have had 80 years to achieve present levels of safety. Lucas Batteries Ltd.'s program to design-engineer safety from the start; Difficulty of forecasting safety problems; Speed of gas dispersion under various conditions; Rate at which gas is generated when regenerative braking is used with a battery near the fully charged state; Need for very thorough ventilation of the battery compartment; Handling of battery packs.

Lung cancer is the leading cause of cancer death worldwide. Sex differences in lung cancer incidence and survival are known. Female sex is an independent good prognostic factor. Estrogens appear to play a key role in lung cancer outcomes. Accordingly, antiestrogen use may also influence survival in female non-small cell lung cancer (NSCLC) patients. In this study, we compared survival among antiestrogen users and nonusers. We performed a retrospective population-based study. Using the Manitoba Cancer Registry (MCR), we identified all women diagnosed with NSCLC from 2000 to 2007. The population-based Drug Program Information Network was accessed to establish which patients received antiestrogens. Demographic data (e.g., smoking patterns, stage, histology) were gathered from the MCR and by chart review. Survival differences between antiestrogen-exposed and not exposed groups were compared using multivariable Cox regression. Two thousand three hundred twenty women fit our patient criteria, of which 156 had received antiestrogens. Exposure to antiestrogens was associated with a significantly decreased mortality in those exposed both before and after the diagnosis of NSCLC (adjusted hazard ratio, 0.42, p= 0.0006). This association remained consistent across age and stage groups. Antiestrogen use before and after the diagnosis of NSCLC is associated with decreased mortality. This supports previous evidence that estrogens may play a key role in the biology and outcomes of NSCLC and suggests a potential therapeutic use for these agents in this disease.

A description is given of the principle of operation, design and technical realization of a Compton spectrometer. In contrast to many other devices that have been discussed in the literature, the Compton spectrometer described here combines an electron-impact x-ray source with a room-temperature semiconductor detector. It is shown that the momentum resolution of the Compton spectrometer for the K characteristic lines emitted by the tube anode is adequate to resolve the Doppler broadening originating in electron momentum distributions of low atomic number elements, such as carbon, nitrogen and oxygen. Experimental Compton-broadened spectra from a range of common materials are presented. Methods to extract Compton profiles from the experimental spectra, by accounting for the continuous component of the x-ray tube emission and the multiplet nature of the characteristic lines, are illustrated. The application of this Compton spectrometer to material characterization is briefly discussed.

Determination of auditory function is a fundamental part of a complete neurologic examination. Disability from permanent hearing loss is common in the general population. Current bedside auditory tests are unreliable and cumbersome. We evaluated the calibrated finger rub auditory screening test (CALFRAST) as a routine diagnostic tool.

To derive a visual-evoked potential (VEP) technique for identifying visual field defects in children with epilepsy treated with vigabatrin and unable to perform perimetry.

We describe the preparation of IEF tube gels inside a nonwetting microporous plastic tubing. The gel in the tube need not be extruded after the first dimension separation. Instead, the porous structure of the tubes is made wettable, and the proteins are electrophoresed “through-the-wall” into the second dimension PAGE gel. Commercial ampholytes and reagents are suitable for the procedure. A useful pI range of 4.5−9.5 can be obtained when pI 3−10 ampholyte mixtures are used. Because of the high surface area of the porous material, precautions must be exercised to reduce oxygen inhibition during polymerization and dehydration of the gel during storage and use. A sheath device is described that satisfies these requirements. The plastic tubes can be disposed of by incineration and pose no biohazard. Keywords: microporous tube • IEF • 2-D PAGE

Transcription of genes coding for metazoan spliceosomal snRNAs by RNA polymerase II (U1, U2, U4, U5) or RNA polymerase III (U6) is dependent upon a unique, positionally conserved regulatory element referred to as the proximal sequence element (PSE). Previous studies in the organism Drosophila melanogaster indicated that as few as three nucleotide differences in the sequences of the U1 and U6 PSEs can play a decisive role in recruiting the different RNA polymerases to transcribe the U1 and U6 snRNA genes in vitro. Those studies utilized constructs that contained only the minimal promoter elements of the U1 and U6 genes in an artificial context. To overcome the limitations of those earlier studies, we have now performed experiments that demonstrate that the Drosophila U1 and U6 PSEs have functionally distinct properties even in the environment of the natural U1 and U6 gene 5'-flanking DNAs. Moreover, assays in cells and in transgenic flies indicate that expression of genes from promoters that contain the "incorrect" PSE is suppressed in vivo. The Drosophila U6 PSE is incapable of recruiting RNA polymerase II to initiate transcription from the U1 promoter region, and the U1 PSE is unable to recruit RNA polymerase III to transcribe the U6 gene.

Mycobacterium branderi, a potential human pathogen first characterized in 1995, has been isolated from respiratory tract specimens. We report here a case in which M. branderi was the only organism isolated upon culture from a hand infection. This isolate, along with a second isolate from a bronchial specimen, was subjected to conventional identification tests for mycobacterial species. Further analysis by high-performance liquid chromatography (HPLC) of mycolic acids and 16S rRNA gene sequencing was performed, and the antibiotic susceptibility profile was determined for both strains. Biochemical tests and the HPLC pattern were consistent with that of M. branderi and M. celatum, which are very similar. The 16S rRNA gene sequence of both strains corresponded to that of M. branderi and enabled us to confidently differentiate this organism from other closely related species such as M. celatum. This contributes to a further understanding of the status of this species as a potential human pathogen as well as illustrating the need for molecular diagnostics as a complementary method for the identification of rare mycobacterial species.

To separate the retinal electrophysiologic markers associated with vigabatrin-attributed visual field loss (VGB-VFL) from those associated with current vigabatrin therapy.

We determined the validity of using external devices for urine specimen collection from 24 elderly incontinent men residing in a nursing home by collecting three sequential specimens, two with external devices and then one by catheterization. The positive predictive value of organisms isolated in quantitative counts of greater than or equal to 10(5) CFU/ml in external devices for bladder bacteriuria was 86% for either sterile or clean collecting devices and 93% for the same organism in two consecutive specimens. The negative predictive value for organisms present in quantitative counts of less than 10(5) CFU/ml was 90% for both sterile and clean devices and 86% when the organism was present in both specimens. Contamination in external collection devices was not influenced by whether the device was clean or sterile, circumcision of the resident, or duration of time between device application and specimen collection. These data suggest that urine specimens collected by ward nursing staff with external devices are reliable for the diagnosis of bacteriuria in this patient population.

A current-flow and current-source-density analysis of the sensory evoked response (SER) and the direct cortical response (DCR) in the somatosensory cortex of rats was performed to determine the origin of these potentials. The SER was found to originate in layers II and III, as in cats, with a single excitatory neuronal circuit component. The DCR, on the other hand, has five components, three inhibitory and two excitatory. The activation and magnitude of these components vary with stimulus strength and frequency. During the second and fourth ms of the response, two inhibitory currents flow in layers V and VI; 2 ms later, excitatory current flows in layers II and III. This excitatory current appears to be the same one involved in the SER. Five ms later, the superficial excitatory current is replaced by an inhibitory one in the neighborhood of the DCR's negative peak. At strong stimulus strengths, this is followed by an excitatory current in layer V. The early inhibitory and excitatory components step up through layers upper-VI, V and III over time, implying that inhibition followed by excitation moves upward through cortex. The currents associated with the DCR in somatosensory cortex are compared with those for the DCR in motor and association cortex.

The in vitro activities of penicillin, clindamycin, chloramphenicol, metronidazole, piperacillin, piperacillin-tazobactam, ticarcillin, ticarcillin-clavulanate, ampicillin-sulbactam, cefoxitin, ceftizoxime, cefotetan, moxalactam, and imipenem against 348 Bacteroides fragilis group isolates collected from six Canadian cities during 1990 were determined by the National Committee for Clinical Laboratory Standards (NCCLS) agar dilution technique. All isolates were susceptible to chloramphenicol, metronidazole, piperacillin-tazobactam, and imipenem. For the other antibiotics tested, the following resistance rates were observed: penicillin, 97%; clindamycin, 9%; piperacillin, 19%; ticarcillin, 31%; ticarcillin-clavulanate, 0.28%; ampicillin-sulbactam, 0.85%; cefoxitin, 26%; ceftizoxime, 15%; cefotetan, 53%; and moxalactam, 17%. Susceptibility profiles to beta-lactam antibiotics varied among the different species tested: B. fragilis and Bacteroides vulgatus demonstrated lower resistance rates than Bacteroides distasonis and indole-positive Bacteroides thetaiotaomicron and Bacteroides ovatus. Ceftizoxime results should be interpreted cautiously, because the MICs obtained with the recommended NCCLS control strain were lower than expected.

Thirty women were randomized in a double-blind, placebo-controlled study to receive either norfloxacin, 200 mg orally daily at bedtime, or placebo for the prevention of recurrent bladder infection. Subjects were followed monthly to monitor compliance and symptoms, for urine culture and periurethral and anal canal swabs to monitor colonization, and for blood specimens for hematologic and biochemical studies to monitor safety. During 1 year of follow-up, 10 of 15 placebo subjects and none of 15 norfloxacin subjects developed infection (P less than 0.001). Adverse effects occurred with equal frequencies in the two groups. For norfloxacin subjects, only 2 (1.6%) of 129 periurethral and 4 (3.1%) of 129 anal canal swabs showed colonization with aerobic gram-negative organisms, while 16 (22%) of 73 periurethral and 47 (64%) of 73 anal canal swabs from placebo subjects showed colonization. Daily therapy with norfloxacin at bedtime is effective in preventing recurrent cystitis. During 1 year of norfloxacin therapy, colonization was infrequent and superinfection with norfloxacin-resistant organisms did not occur.

In a prospective, randomized, multicenter study, the efficacy and safety of cefoperazone and the combination ampicillin-tobramycin as initial therapy for patients with severe acute biliary tract infections were compared. Of 77 patients initially entered in the study, definite severe biliary tract infection was confirmed in 67. Sixty-four patients completed treatment. At the end of treatment, 35 of 36 (97%) patients given cefoperazone and 23 of 28 (82%) given ampicillin-tobramycin were cured of their infection (P = 0.07). Pathogens were recovered from the bile in 32 patients; microbiological cures were observed in 18 of 19 (94%) patients receiving cefoperazone and 8 of 13 (62%) receiving ampicillin-tobramycin (P = 0.03). Thirteen patients had septicemia. None (0%) of the eight septicemic patients from the cefoperazone group, but two of five (40%) from the ampicillin-tobramycin group, were clinical failures. Of the isolated pathogens, 51% were resistant to ampicillin, while the resistance rate was 4% for tobramycin and 1% for cefoperazone (P less than 0.001). Biliary concentrations of cefoperazone were maintained at high levels--236 +/- 87 micrograms/ml up to 12 h after administration. Even in the presence of severe obstruction, cefoperazone levels in the bile and gallbladder wall were above MICs for most pathogens. Cefoperazone may be considered as an excellent alternative in the therapy of severe biliary tract infections.

1. The laminar and temporal distribution of synaptic activity supplied by forward and feedback connections between different areas of rat visual cortex was determined with the use of current source density (CSD) analysis in in vitro slices. In forward connections, synaptic potentials were evoked by electrically stimulating area 17 and recording in the extrastriate area LM (lateromedial), that ranks at the second hierarchical level, one step above primary visual cortex. For activating feedback connections, the location of stimulating and recording electrodes was reversed. 2. The synaptic interactions in reciprocal intracortical circuits are excitatory, and they are mediated through glutamate receptors that are blocked by kynurenic acid. 3. Forward connections from area 17 to area LM provide input to all layers including a strong input to layer 4. In contrast, feedback input to layer 4 is weak and is mainly directed to superficial and deep layers. This laminar distribution closely resembles that seen anatomically. 4. Both forward and feedback connections evoke distinct temporal patterns of synaptic activation in different layers. Although onset and peak latencies are slightly shorter in the forward than in the feedback pathway, the difference is not statistically significant. 5. The spatiotemporal distribution of synaptic activation by forward connections resembles the pattern evoked by geniculocortical inputs. Feedback connections show greater similarities to long-range connections within area 17, although they are not identical. Our results support the notion derived from anatomic and in vivo physiological studies that forward and feedback pathways belong to functionally distinct cortical circuits.

X-ray scattering, including coherent, incoherent, and resonance (fluorescent) phenomena, is of fundamental importance in contemporary science as a tool to probe the structure of matter at an atomic level. This elevated status is in sharp contrast to the role of x-ray scatter in medical and industrial radiography, where it is generally regarded as an unmitigated nuisance to be corrected for or, preferably, eliminated. We introduce a novel x-radiographic technique [x-ray diffraction computed tomography (CT)] based on measurement of coherent scatter. The physical background to coherent scattering is described in a simple, classical way, and its importance in conventional radiography is demonstrated by using Monte Carlo analysis. Some diffraction patterns of plastics and animal tissues are presented to illustrate the relevance of coherent scattering to material characterization and diagnosis in industrial and medical radiology. An experimental first-generation (single-pencil-beam) CT system has been constructed to demonstrate the feasiblity of x-ray diffraction CT. Some diffraction CT and coherent scatter projection images of simple objects are presented. Possibilities for improving the ratio of image contrast to noise and increasing the momentum resolution of the technique are illustrated.

Ninety-one patients with forgetfulness, confusion and depression were referred for visual evoked potential and electroencephalographic investigation. The patients were subdivided, on clinical symptoms alone, into a group of 41 with evidence of dementia and a patient control group of 50 with affective disorders. A second control group of 30 normal volunteers of equivalent age was used.

There has been much recent conjecture over the apparent source location of the visually evoked potential, particularly in considering the lateralization found in half-field pattern reversal stimulation.

Albinism is a congenital condition in which hypopigmentation occurs. In addition to this abnormality there is a misrouting of the optic nerve fibers, with some fibers from the temporal retina following a crossed route at the chiasma and terminating in the contralateral cortical hemisphere. This contralateral preponderance of fibers from each eye should be recognizable from recording the visual evoked cortical potential over each hemisphere on monocular stimulation. Such a technique should produce evidence of responses of either increased amplitude or shorter latency over the contralateral hemisphere. Twenty-five human albinos (twenty-three oculocutaneous, two ocular) have been examined. Pattern appearance-disappearance visual evoked cortical potentials were used, but only on bioccipital derivations did these show clear lateralization. With the flash response the P2 component has a consistently shorter latency over the contralateral hemisphere to the eye stimulated.

Changes in the ERG and VEP across the life span were investigated. The dark adapted and scotopic ERGs both showed a progressive increase in the implicit times of the A and B waves and a reduction in the amplitude of the AB configuration. There was also an increase in the implicit times of the oscillatory potentials of the photopic ERG.

Abstract Intraabdominal infections are commonly encountered in clinical practice and represent a major cause of morbidity and mortality. The most common etiology is contamination of the peritoneal space by endogenous microflora secondary to loss of integrity of the gastrointestinal tract which results in secondary peritonitis. Primary peritonitis or spontaneous bacterial peritonitis is less common and usually occurs in the presence of ascites without an evident source of infection. Peritonitis associated with chronic ambulatory peritoneal dialysis is not discussed in this review. This review summarizes the significant progress which has been made with regard to primary and secondary peritonitis in the last two decades. The review emphasizes the issues of etiology, pathogenesis, microbiology, diagnosis, medical treatment and prevention.

Results for the thermal emittance of copper films deposited on glass are reported for the 40–460 °C range. The values found are substantially below those previously reported for pure copper samples and are smaller than is predicted on the basis of diffuse scattering of electrons by the metal surface.

The in vitro activity of norfloxacin (MK366) against 477 aerobic gram-negative and gram-positive clinical isolates was compared to that of nalidixic acid, nitrofurantoin, ampicillin, cephalexin, trimethoprim, sulfamethoxazole, and the combination trimethoprim-sulfamethoxazole. Norfloxacin was more active than the other agents against all gram-negative organisms tested. Minimal inhibitory concentrations (MICs) ofPseudomonas aeruginosa were ⩽ 0.125–32 mg/l with 90 % inhibited (MIC90) by 4 mg/l; MICs of theEnterobacteriaceae includingSerratia marcescens were ⩽ 0.125–8 mg/l with an MIC90 of ⩽ 4 mg/l. There was also excellent activity against the grampositive cocci includingStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and the enterococci, with MICs ⩽ 0.125–4 mg/l and an MIC90 ⩽ 4 mg/l. Only 8 of 477 organisms were norfloxacin-resistant (MIC ⩾ 16 mg/l): 3 of 100Pseudomonas aeruginosa, 3 of 10Pseudomonas maltophilia and 2 of 15Streptococcus bovis strains. In contrast, 97 % of the gram-positive cocci and 49 % of the gram-negative bacilli were nalidixic acid-resistant (MIC ⩾ 32 mg/l). Norfloxacin shows excellent activity against a wide range of bacteria and merits further study as a urinary antibacterial agent.

Twenty women with recurrent or persistent urinary tract infections were treated with a fixed combination of trimethoprim-rifampin (TMP-RAM). The site of infection was established by the antibody-coated bacteria test. Sixteen women had upper tract infections (antibody-coated bacteria tests positive); eight were cured, three failed, and five relapsed. All four women with lower tract infections (antibody-coated bacteria tests negative) were cured. Three of five patients with structural abnormalities failed. The 12 cures and 5 relapses were associated with organisms susceptible to either TMP (minimal inhibitory concentration, less than or = to 7 micrograms/ml) or RAM (minimal inhibitory concentration, less than or = to 32 micrograms/ml). In contrast, two of the three failures were associated with organisms resistant to both TMP and RAM. In one patient, RAM resistance emerged during treatment. During therapy, urinary strains were eradicated from the periurethral and anal-canal areas in all but 3 fo 16 patients. Adverse reactions, noted in 16 women, included nausea (10), dizziness (6), headaches (2), rash (1), an blurred vision (1). Antimicrobial susceptibility data on 246 isolated from urinary, periurethral, and anal-canal specimens are included. Our findings suggest that TMP-RAM is effective in urinary infections and may prevent the emergence of RAM-resistant strains.

We used the isolated perfused rat kidney to test the hypothesis that the renal pharmacokinetics and pharmacodynamics of atrial natriuretic peptide (ANP) are saturable and dependent on the method of administration. Wistar rat kidneys were perfused for 90 min after a bolus dose or continuous infusion of 45, 180, 450 ng of ANP. ANP clearance ranged from 3.27 to 2.28 ml/min after bolus administration. ANP clearance fell after infusion, resulting in a disproportionate increase in the ANP concentration with increasing infusion rate. The ANP half-life was unaffected by dose in the bolus group averaging 18 min. Increasing the ANP dose also increased the amount of Na excreted into the urine, but there were no differences between experimental groups. However, the area under the curve responsible for the natriuresis was 36 to 41% lower after infusion. Exogenous creatinine clearance, renal perfusion pressure and flow and renal vascular resistance were not affected. We conclude that the renal pharmacokinetics of ANP are saturable and are altered by the method of administration due to a down regulation of the ANP receptor. Furthermore, infusion of ANP should result in a greater net natriuresis due to resulting greater ANP concentrations at steady state and an apparent increased sensitivity of the kidney to ANP after infusion.

The influence of argon gas pressure (0.15–40 Pa) on the refractive indices n,k of dc planar-magnetron reactively sputtered cermet and amorphous semiconductor films has been investigated for a layer thickness of ~50 nm. Stainless steel–carbon and amorphous hydrogenated carbon layers with relatively low index n and stainless steel–silicon and amorphous hydrogenated silicon layers with relatively high index n are examined with a view to solar selective surface applications. The development of structural porosity with associated reduction in n for layers deposited at high argon pressure significantly improves the solar absorptance of surfaces incorporating stainless steel–silicon or amorphous hydrogenated silicon layers.

The visual evoked potential to flash stimulation has been studied in premature infants for many years. There have been no studies of the response to pattern reversal stimuli during the pre-term period, however. Twenty babies all born prematurely between 32 and 35 weeks post menstrual age had pattern reversal visual evoked potentials recorded on at least two occasions between the ages of 32.5 and 52 weeks post menstrual age with the first recording prior to reaching 40 weeks post menstrual age. The stimulator consisted of a small hand-held television with a 55 × 40 mm screen, and responses were averaged by a Cadwell 5200 averager. The check size was 7 × 7 mm and the contrast was 78%. The stimulator was held at a distance of 20cm from the eyes. The angular subtense of the TV screen was 15.3 ° × 11.31 °. On each occasion flash visual evoked potentials were obtained for comparison, as were flash electroretinograms recorded with a DTL electrode. The infants were randomly assigned to receive breast milk substitute with or without taurine.

The sensitivity of transient, pattern-reversal visual evoked potentials in the detection of early compressive lesions of the chiasm is controversial in the literature. There have been claims that the technique is capable of detecting an abnormality in the absence of any demonstrable visual field loss, and conversely that VEPs are not reliable for the detection of chiasmal lesions even when a bitemporal hemianopsia is clearly recordable. Using nine patients with pituitary adenoma we attempted to quantify the extent of visual field loss and correlate the diagnostic capabilities of topographically recorded potentials following full- and half-field stimulus presentations of various field and check sizes. Differential light thresholds were measured and quantified according to one investigator's graticule for the neural representation of visual space. Results show a strong correlation between the degree of information loss and the diagnostic value of the visual evoked potential. The technique was, however, capable of detecting abnormality in the absence of recordable field loss when large field and check sizes were used.