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To examine nasal airway function using a disease-specific quality-of-life survey instrument in subjects undergoing Le Fort I osteotomy without simultaneous rhinosurgical procedures.We conducted a prospective cohort study of nasal airway function in consecutive Le Fort I osteotomy patients, who had not received simultaneous rhinosurgical procedures, between 2007 and 2008 at Kaiser Permanente Oakland Medical Center. We administered the Nasal Obstruction Symptom Evaluation (NOSE) survey before and 3 months after surgery. Clinical and radiographic examinations were performed, and the relevant medical and demographic factors were analyzed.The initial study sample comprised 55 patients, of whom 5 were excluded. Of the remaining 50 patients (median age 21 years, 60% women), the maxilla was advanced (median 4 mm, interquartile range 3 to 5) with minimal vertical change. During the follow-up period (median 5.5 months), significant improvement was seen in the NOSE scores for the cohort, with a median decrease of 10 units (P = .0005). Patients with moderate nasal obstruction (preoperative NOSE score25) had the greatest improvement (P.001). Those with severe nasal obstruction (preoperative NOSE score50) improved, however, this did not reach statistical significance (P.0625). The NOSE scores worsened in 10 patients; of these, 6 had minimal change. However, 4 had significant worsening, with 2 having symptomatic complaints. No predictor variables were identified in this small subgroup; however, individual case analyses revealed 1 subject with postoperative turbinate inflammation on the side of maxillary segmentalization and 1 had nasal septal buckling.Our overall findings have suggested that nasal airway function improved after maxillary advancement and that subjects with greater preoperative NOSE scores (25) were more likely to experience relief of nasal obstructive symptoms.

Purpose To examine the prevalence of complications and characterize the associated clinical findings in patients undergoing surgically assisted rapid palatal expansion (SARPE). Materials and Methods A retrospective evaluation was conducted of all patients who underwent SARPE from January 2004 through December 2008 at Kaiser Permanente Oakland Medical Center. Medical records were abstracted, and demographic factors and relevant comorbidities were identified. Clinical features of patients with complications (surgical and/or dental) after SARPE were characterized. Results One hundred thirty-one patients comprised the study sample and 11 patients were excluded. Of the remaining 120 patients (median age, 29.5 yrs; interquartile range, 22.0 to 39.0 yrs), 51.7% were women, 41 developed at least 1 complication, 33 had surgical complications, 18 had dental and/or periodontal problems, and 10 developed both surgical and dental or periodontal problems. Asymmetric and/or inadequate expansion was the most frequent surgical complication, found in 13.3% of the study cohort, and gingival recession (8.3%) was the most common dental complication. Two patients developed catastrophic periodontal bone defects resulting in loss of the central incisors; these patients had eccentric interdental osteotomies that caused separation of the bone from the root surface of the central incisors followed by postoperative osteotomy site infections. Conclusions Overall, the present findings suggest that, although major complications after SARPE were rare, asymmetric or inadequate expansion and dental and/or periodontal problems primarily involving the central incisors accounted for most complications. Future prospective and long-term follow-up studies are needed to identify individual risk factors that may predispose patients to adverse outcomes after SARPE.

There are many cephalosporins available and various ways of classifying them for clinical use. Oral cephalosporins probably need a classification of their own. This informal discussion was prompted by the appearance of the recommendations of an expert committee of the Paul Ehrlich Gesellschaft. The views of several other commentators are included. There is considerable individual variation in preference for different styles of classification depending on what the classification is for.

The WHO Model List of Essential Drugs is eagerly awaited in many countries as a guide to what should be provided for basic health needs. Colloquially known as the ‘Essential Drugs List’ it should perhaps be remembered that it is only a model list—a model which should be used to compile an essential drugs list. The essential drugs vary from country to country and even within a country so a single essential drug list cannot be compiled for the world. The text which accompanies the biennial updating of the list makes it clear that it is a Model and provides guidelines for establishing a national regional programme of essential drugs, criteria for selection of essential drugs and other supporting data. The list is a model only. This long preamble is necessary to forestall criticism of why some drugs are included and others excluded. A good deal of informed debate goes on over what is included on the Model List because the model list does tend to be accepted as ‘The Essential Drugs List’. Certainly the list does contain drugs which could make up the essential drugs for each country. As one would expect from the prevalence of infection in the world the Model List contains many antimicrobials and for this reason we are publishing the latest list of compounds in the Antibiotics/Chemotherapy Newsletter and in the International Journal of Antimicrobial Agents—the two official publications of the International Society of Chemotherapy. In the Newsletter we give only minimal information namely the list of anti-infective and anti-cancer drugs included on the list. In the International Journal of Antimicrobial Agents you can find more detail on model and the indications and reasons for additions, deletions and modifications made to the previous list. Needless to say the editors of both publications would like to receive comments on the list; the next revision is less than a year away.

Data presented in this study compare weight (kg) at birth, and at 205 (weaning) and 365 (yearling) days of age for bovine calves produced from nuclear transfer (CLONE), embryo transfer (ET), and artificial insemination/natural mating (AI/NM). Birth weight data, for three consecutive years, include 418 CLONE, 4687 ET and 8925 AI/NM calves. Additionally, data for (219 CLONE, 2515 ET and 3895 AI/NM) weaning and (66 CLONE, 1250 ET and 1630 AI/NM) yearling weights were analyzed. Calves produced by CLONE were grown and maintained with calves produced by ET and AI/NM. CLONE calves were approximately 20% larger at birth than calves produced by ET or AI/NM when all data were compared and when data were adjusted for sire or for sire and dam. Moreover, the variability in birth weight for CLONE calves was four- to 12-fold greater than for ET or AI/NM calves. The accelerated growth and variability did not continue beyond birth. The 205 day and 365 day weights of CLONE calves were less variable than their birth weight and were similar to those for ET and AI/NM calves. Differences between weight for CLONE, ET and AI/NM calves when measured as a percent of body weight declined from approximately 24% at birth to < 5% at 365 days.

Aging is associated with decreased ability to excrete salt and water, thus increasing the susceptibility to volume overload in older individuals. Meanwhile, plasma levels of atrial natriuretic peptide (ANP) increase progressively with age for unknown reasons. We compared the natriuretic and renal hemodynamic responses to low-dose ANP infusion in an elderly group of volunteers (mean age, 74 years) with those of a group of younger subjects (mean age, 29 years). A significant reduction below baseline values in effective renal plasma flow occurred in the young group after the 2-hour peptide infusion (657 +/- 125 v 476 +/- 92 mL/min [mean +/- 1 SD]) when compared with the elderly group (two-way analysis of variance; P0.02). A concomitant increase in renal vascular resistance was noted in the young group only during the same period (6,631 +/- 1,384 v 9,136 +/- 2,126 dyn s cm2 x 10(6)). This increase was also significantly higher than that in the elderly group (analysis of variance; P0.02). Both groups demonstrated similar natriuretic responses. Absolute sodium excretion had increased significantly above baseline values in both young and elderly subjects at the end of the 2-hour peptide infusion (111 +/- 25 mumol/min to 183 +/- 33 mumol/min v 107 +/- 23 mumol/min to 198 +/- 56 mumol/min) and remained elevated until 1 hour postinfusion. We conclude that the elderly subjects in our study demonstrated a diminished renal hemodynamic response to infusion of ANP while preserving a natriuretic response similar to that found in the younger subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Polysilicon Emitter Bipolar Transistor Technology is increasingly being used in modem VLSI for high speed applications [1]. An important feature of polysilicon emitter technology is that it lends itself to co-ordinated scaling of both vertical and lateral device dimensions. Therefore, devices with submicron feature sizes and emitter/base junctons shallower than 0.1?m can be easily achieved. Another important advantage of polysilicon emitter bipolar transistors is that they offer significantly higher current gains compared with conventional bipolar transistors [2]. This feature makes polysilicon emitter technology very useful for analogue applications. For these applications the noise performance of the device, especially the Low Frequency (I/f) noise is a very important parameter.

Calcium fenoprofen samples previously studied in powder form have been made into formulated tablets and into pure compressed discs. The wide variation in dissolution rate noted for powders is not noted in the early stages of tablet dissolution, all samples giving about the same rate in spite of variation in the disintegration rate. It is possible that smaller particles have been compressed or agglommerated to larger ones, or have been rendered hydrophobic by magnesium stearate. In later stages there is some intersample variation, apparently linked to larger particles in the parent active ingredient. Intrinsic dissolution rates from compressed discs cannot be influenced by any excipients as these are not present, or by particle size considerations as the area of the discs is constant. Rates differ only slightly after compression, and this is thought to be due to only partial retention of energetic differences following compression.

Erythroid and myeloid colonies were grown from the bone marrow of 81 patients with myelodysplasia and the median number of colonies correlated with the FAB classification and Bournemouth score. CFU-GM were increased in CMML compared to RAEB and RAEBt. BFU-E were higher in RA than in the other FAB subgroups. Patients with a high Bournemouth score had poorer CFU-GM and BFU-E growth than those with a low score.

Forty Santa Gertrudis bulls were used to examine relationships among scrotal circumference, seminal quality, libido, and fertility [assessed as the percent pregnant of estrous females (PE rate) and the percent pregnant of females mated (PM rate)]. These bulls were selected from 220 two year old bulls to represent variations in scrotal circumference and seminal quality. Each of the 40 bulls were exposed to 100 cyclic Santa Gertrudis heifers for a 4-day (96 hr) breeding period. The number of estrous females available to each bull varied from 12 to 27. A breeding soundness examination (BSE) was conducted on each bull approximately 45 days prior to the 4-day breeding period and immediately after the 4-day breeding period. The three components of the BSE scroe (scrotal circumference, spermatozoal abnormalities and spermatozoal motility) were not significantly correlated with PE rate or PM rate at either evaluation. There was no significant correlation between PM rate and scrotal circumference; however, each of the 4 bulls having a scrotal circumference less than 30 cm had a PM rate below 31%. Relationships between seminal quality and PM rate were unclear and differed between the two evaluations. There was a trend for bulls having poor seminal quality at the first evaluation to improve by the second evaluation. Consequently, fluctuations in seminal quality between evaluations is one possible explanation for low correlations between seminal parameters and PM rate. Libido (number mated/number in estrus x 100) was positively correlated (r = 0.44) with PE rate. Using a stepwise regression procedure, the independent variables accounting for the most variation in PE rate (dependent variable) included libido, secondary spermatozoal abnormalities, and BSE score (r(2) = 0.44). Results of this study indicate that current methods of fertility evaluation did not accurately predict the fertility of individual Santa Gertrudis bulls as measured by PE rate and PM rate during a 4 day breeding period.

‘Dominant’ rams viewed by an audience of two submissive rams showed no alteration in mating behaviour in comparison with their performance when tested alone. Submissive rams, however, mounted and ejaculated less when viewed by two dominant rams than when tested alone. Theoretical and applied implications of these findings are discussed.

Summary Using a technique of sampling bile directly from the common bile duct at the time of endoscopic retrograde cholangiopancreatography (ERCP), the range of bacteria in the bile was studied quantitatively in patients with and without biliary disease. Bile specimens from io normal subjects were not infected. Twenty-one out of 22 patients (95 per cent) with stones in the common bile duct, and four out of seven patients with gall bladder stones had infected bile. A pure growth of a single infecting organism was found in only five of the 25 patients with infected bile. There was a high incidence of resistance to ampicillin amongst the coliform organisms isolated. The bile from patients following sphincterotomy was uniformly infected by mixed growths of bacteria. Bacteriological investigation of bile obtained by ERCP permits the choice of an appropriate antibiotic for use following the procedure, or to cover a subsequent operation, in a patient with gall stones and biliary infection.

This in vitro investigation evaluated the marginal seal of an injection-molded ceramic crown system used in combination with three adhesive luting systems. One of these systems was a glass-ionomer cement and the other two were based on composite resin materials. One of the latter materials is claimed by the manufacturer to bond to tooth structure and also to porcelain. The final luting material was used in conjunction with a commercially available porcelain bonding system and specific dentin bonding pretreatments. Following thermocycling, the marginal seal of the crowns was tested by use of a chemical marker intrusion technique. The extent of leakage along the sectioned crown/luting agent/tooth structure interfaces was recorded by using digital imaging microscopy. Minimal microleakage was demonstrated with the composite luting cement used in association with specific porcelain and dentin bonding pretreatments.

Infections of the urinary tract are frequent and common. They occur in practice at an annual prevalence rate of 26 per 1000.