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Objectives To develop a preoperative nomogram that would predict the risk of a postoperative complication for pheochromocytoma patients undergoing adrenalectomy using an international database. Methods We retrospectively analyzed preoperative variables and postoperative outcomes in patients who underwent adrenalectomy for pheochromocytoma in three institutions from 2000 to 2017. Internal validation of a generated nomogram was carried out with receiver operating characteristics, calibration plots, and decision curve analyses. Results A total of 153 patients who had undergone 166 adrenalectomies were included in the study. Overall, post-adrenalectomy complications were seen in 30% of patients, whereas 9.6% of patients sustained a Clavien ≥3a complication. Independent predictors of a complication were a history of hypertension, body mass index, tumor size, and Charlson Comorbidity Index score. On internal validation, the multivariable model generated a nomogram that predicted a postoperative complication or clinically hemodynamic event with an area under the curve of 0.86, showed good calibration and had an overall net benefit. Conclusions An internally validated nomogram combining body mass index, Charlson Comorbidity Index score and tumor size can predict the probability of a post-adrenalectomy complication in those with and without hypertension. The model, the first of its kind in pheochromocytoma surgery, identifies patients at risk of a postoperative complication at the time of their presentation with pheochromocytoma.

Commercially available refined vegetable oils were investigated as calibration standards for the filtration device and protocol specified by ASTM D7501 for conducting the biodiesel cold soak filtration test. Filtration time was determined to be a function of the amount of vacuum applied during filtration, with an 8 % change in the filtration time of soybean oil occurring across the vacuum range specified by ASTM D7501. At a constant vacuum of 57 cm Hg the mean filtration time of 150 mL of soybean oil was independent of operator, device, and oil lot number. Mean filtration time was also largely independent of brand: the average of the mean filtration times of replicate samples of seven brands of soybean oil was 396 s with a minimum significant difference (MSD) of 28 s, and the filtration times of seven of eight brands of soybean oil tested fell within this MSD. Refined edible-grade corn, canola, peanut, safflower and sunflower oils gave reliable filtration times and would be suitable standards. Each oil exhibited a characteristic filtration time, all greater than that for soy oil. Filtration times were an approximately linear function of kinematic viscosities, as predicted by Darcy’s Law. Edible vegetable oils can serve as reliable, affordable, consistent and generally available materials for confirming the operability of the filtration device used in the biodiesel cold soak filtration test.

To evaluate a newly developed noninvasive ambulatory, quantitative polymerase chain reaction (Q-PCR) Epstein-Barr virus (EBV) DNA detection and screening system (NP Screen™) for nasopharyngeal carcinoma (NPC).Correlation of the nasopharyngeal epithelial EBV-DNA levels and clinical findings by nasopharyngoscopy and final pathologic diagnosis of NPC with biopsy.Multicenter ENT/Oncology clinics in Hong Kong (Radiation Oncology Clinic at the Queen Elizabeth Hospital and Radiation Oncology Clinic and Head and Neck Clinic, Queen Mary Hospital, University of Hong Kong) and in Toronto, Canada (the Otolaryngology-Head and Neck Clinic at the Rouge Valley Health System and 2 large ENT practices in Toronto).A single-use trans-oral brush was used for rapid, nontraumatic nasopharyngeal (NP) epithelial cells DNA harvest in 600 Chinese patients, combined with a preservation and shipping kit for remote, real-time Q-PCR EBV DNA determinations.All 600 patients had NP brushings using NP Screen in an ambulatory environment, and no adverse events or complications were recorded. A final 578 patients were included with sufficient amount of DNA for completion of the Q-PCR assay. Of these 578 patients, 94 were confirmed positive for NPC histologically. The study yielded a sensitivity of 98.9%, specificity of 99.3%, positive predictive value (PPV) of 96.9%, and negative predictive value (NPP) of 99.7% for NP Screen in detecting NPC. Endoscopy had a sensitivity of 94%, specificity 97.1%, PPV 85%, and NPP 98.9%.The trans-oral brushing system fulfills the characteristics of a noninvasive, sensitive, specific detection method suitable for routine, large-scale ambulatory NPC risk assessment for high-risk NPC populations.

First-line treatment for problematic infantile hemangiomas (IH) consists of systemic corticosteroids or, more recently, beta-blockers, while treatment failures or residual lesions may require surgical intervention. There is limited knowledge if prior medical intervention is associated with a better surgical outcome. This retrospective cohort study revealed that medical intervention, whether systemic steroids or beta-blockers, did not influence ultimate surgical outcomes when compared with patients who were not medically treated. However, patients who received prior medical treatment and those who received beta-blockers underwent surgical intervention at an earlier age.

Citation information: Backhouse S, Fox S, Ibrahim B & Phillips JR. Peripheral refraction in myopia corrected with spectacles versus contact lenses. Ophthalmic Physiol Opt 2012, 32, 294–303. doi: 10.1111/j.1475-1313.2012.00912.x Abstract Purpose: Previous studies suggest that the refractive status of the peripheral retina can influence the development and progression of myopia. Our aim was to compare peripheral refractions in the same cohort of human eyes corrected with spectacle lenses vs soft contact lenses. Methods: Ten young adults with moderate to high myopia (−5.00 D to −8.00 D) were investigated. Open-field autorefraction was used to measure on- and off-axis refractions with the eyes in primary gaze, when uncorrected, and when corrected with spectacles and contact lenses. Measures were made every 5° out to 30° horizontally in nasal and temporal retina and analysed as power vectors (M, J0, and J45). Partial coherence interferometry measures of eye size were also made on-axis and off-axis at 10o and 20o in nasal and temporal retina. Results: Subjects (mean age 24; range 19–29 years) had an average on-axis mean-sphere refraction of −6.33 ± 0.31 D (mean ± 1 S.E.) and an average axial eye length of 25.99 ± 0.20 mm. The average relative peripheral refraction (RPR) for all subjects across all eccentricities was hyperopic when uncorrected (+0.90 ± 0.14 D) and also when corrected with spectacles (+1.01 ± 0.13 D) but changed to a myopic RPR when corrected with contact lenses (−1.84 ± 0.61 D). There was a highly significant effect of correction on peripheral refraction (p

Reverse phase protein arrays represent a new proteomics microarray technology with which to study the fluctuating state of the proteome in minute quantities of cells. The activation status of cell signaling pathways controls cellular fate and deregulation of these pathways underpins carcinogenesis. Changes in pathway activation that occur between early stage prostatic epithelial lesions, prostatic stroma and the extracellular matrix can be analyzed by obtaining pure populations of cell types by laser capture microdissection (LCM) and analyzing the relative states of several key phosphorylation points within the cellular circuitry. We have applied reverse phase protein array technology to analyze the status of key points in cell signaling involved in pro-survival, mitogenic, apoptotic and growth regulation pathways in the progression from normal prostate epithelium to invasive prostate cancer. Using multiplexed reverse phase protein arrays coupled with LCM, the states of signaling changes during disease progression from prostate cancer study sets were analyzed. Focused analysis of phospho-specific endpoints revealed changes in cellular signaling events through disease progression and between patients. We have used a new protein array technology to study specific molecular pathways believed to be important in cell survival and progression from normal epithelium to invasive carcinoma directly from human tissue specimens. With the advent of molecular targeted therapeutics, the identification, characterization and monitoring of the signaling events within actual human biopsies will be critical for patient-tailored therapy.

This article traces some of the history of and logic behind the automation of weapons systems in relation to their planned deployment as an integral element of ‘homeland security’ in the US after the September 11th attacks. We focus primarily on unmanned combat air vehicles that have long been part of the Air Force’s R&D plans, but have now apparently found an event that justifies their production and deployment. What, we wonder, will be the effects on the urban landscape by using unmanned vehicles capable of ‘intelligently’ selecting a target and firing upon it, especially when the technology that allows these weapons systems to find the target as satellite coordinates relies on the same information technology that provides the infrastructure for ‘smart’ communities, and are already deployed in virtually all urban settings. By exploring the logic of speed and surprise that has driven the increased move toward and reliance on automated and intelligent weapons systems, we reveal how the arguments used in favor of developing and deploying such weapons systems also work as arguments against them. The technology that makes a weapons system intelligent, for example, also means that it has to be capable of choosing the wrong target, hence its ‘intelligence’. Similarly, the need to control the element of surprise has its logical end in the pursuit of the ultimate hidden vantage point, exemplified by the dark side of the moon. The technology and logic of the current ‘War on Terror’ fits neatly into already extant long–range military strategic planning, and could have a massive impact on the shape of urban environments in the immediate and distant futures. Cet article reprend en partie l’historique et la logique qui sous–tendent l’automatisation des systemes d’armes dans le cadre de leur deploiement en tant qu’element constitutif de la ‘seecurite de la patrie‘ aux Etats–Unis apres les attaques du 11 septembre. Il se consacre surtout aux aeronefs de combat sans pilote qui font partie des strategies de R&D de l’Air Force depuis longtemps meme si, apparemment, ils ont dorenavant trouve un evenement justifiant leur production et leur deploiement. Quels seraient les effets sur le paysage urbain d’un recours a ces vehicules sans pilote capables de choisir ‘intelligemment’ une cible et de la viser? Et ce, en particulier si la technologie qui leur permet de trouver la cible sous forme de coordonnees par satellite s’appuie sur cette meme informatique qui fournit l’infrastructure aux communautes ‘intelligentes’, celle–ci etant deja installee sur quasiment toutes les scenes urbaines. En s’interessant a la logique de rapidite et surprise qui a motive la tendance croissante et la dependance a legard des systemes d’armes automatises intelligents, l’article revele comment les arguments favorables au developpement et au deploiement de ces systemes fonctionnent aussi comme arguments contraires. La technologie qui rend intelligent un tel systeme signifie, par exemple, qu’il doit etre capable de choisir la mauvaise cible, donc son ‘intelligence’. De meme, le besoin de maitriser l’element de surprise trouve sa fin logique dans la recherche de la position cachee optimale, caracterisee par la face cachee de la lune. Technologie et logique de la ‘guerre’ actuelle contre la terreur s’adaptent parfaitement aux plans strategiques militaires de grande envergure deja en place et pourraient avoir une incidence enorme sur la conformation des environnements urbains dans un avenir a la fois immediat et lointain.

Deletions of 3p25, gains of chromosomes 7 and 10, and isochromosome 17q are known cytogenetic aberrations in sporadic renal cell carcinoma (RCC). In addition, a majority of RCCs have loss of heterozygosity (LOH) of the Von Hippel-Lindau (VHL) gene located at chromosome band 3p25. Patients who inherit a germline mutation of the VHL gene can develop multifocal RCCs and other solid tumors, including malignancies of the pancreas, adrenal medulla, and brain. VHL tumors follow the two-hit model of tumorigenesis, as LOH of VHL, a classic tumor suppressor gene, is the critical event in the development of the neoplastic phenotype. In an attempt to define the cytogenetic aberrations from early tumors to late RCC further, we applied spectral karyotyping (SKY) to 23 renal tumors harvested from 6 unrelated VHL patients undergoing surgery. Cysts and low-grade solid lesions were near-diploid and contained 1-2 reciprocal translocations, dicentric chromosomes, and/or isochromosomes. A variety of sole numerical aberrations included gains of chromosomes 1, 2, 4, 7, 10, 13, 21, and the X chromosome, although no tumors had sole numerical losses. Three patients shared a breakpoint at 2p21-22, and three others shared a dicentric chromosome 9 or an isochromosome 9q. In contrast to the near-diploidy of the low-grade lesions, a high-grade lesion and its nodal metastasis were markedly aneuploid, revealed loss of VHL by fluorescence in situ hybridization (FISH), and contained recurrent unbalanced translocations and losses of chromosome arms 2q, 3p, 4q, 9p, 14q, and 19p as demonstrated by comparative genomic hybridization (CGH). By combining SKY, CGH, and FISH of multiple tumors from the same VHL kidney, we have begun to identify chromosomal aberrations in the earliest stages of VHL-related renal cell tumors. Our current findings illustrate the cytogenetic heterogeneity of different VHL lesions from the same kidney, which supports the multiclonal origins of hereditary RCCs. Published 2001 Wiley-Liss, Inc.

A case of hepatic mesenchymal hamartoma diagnosed prenatally with ultrasound and confirmed histologically post-delivery is presented. Although histologically benign, this lesion resulted in fetal demise secondary to congestive cardiac failure in the third trimester. The development of non-immune hydrops in association with a fetal hepatic mesenchymal hamartoma is a poor prognostic sign for perinatal survival.

Background: Scale invariance is a property of scientific laws or objects that change in a prescribed fashion if measurements are scaled, and is often represented by a power-law relationship. Power laws suggest that events of a large magnitude will be rare, while small events will be much more common, and that a simple mathematical law relates “severity” with frequency. Scale invariance has been demonstrated in scientific fields including physics, social science, and economics. The authors use the complication of a posttonsillectomy hemorrhage to test whether this property is a feature of surgical complications. Methods: Non-identifiable data were obtained regarding posttonsillectomy hemorrhage and subcategorized by calendar month, and the percentage rate of posttonsillectomy hemorrhage was calculated. The data were then transformed using a logarithmic function. This transformed data were plotted and a linear regression analysis was performed. Results: The 13-year period studied included 6,381 tonsillectomy procedures. The logarithm of the frequency of a given rate range of posttonsillectomy hemorrhage (y) was linearly related to the logarithm of the geometric mean of the rate range (x). The best-fit straight line was y = -1.3996× + 2.0624 with R2 = 0.851, n = 10, r = 0.922, and P < .001. Conclusions: The authors found that the incidence of posttonsillectomy hemorrhage is scale invariant. The practical implication is that the observation of rare incidences of large hemorrhage rates may not be due to a unique circumstance or a particular operative fault. To reduce the incidence of extreme rates of postoperative hemorrhage, a review of the entire process of tonsillectomy would be required. Scale-invariance analysis may represent a novel tool that should be considered when reviewing surgical complications.

Purpose To evaluate early environmental influences (e.g. litter size, birth weight, birth season) on adult refractive error in dogs. A previous familial aggregation analysis has shown that the distribution of refractive error in a large family of pedigree Labrador Retrievers has a significant genetic component, but that litter size and other residual/environmental factors also have significant effects. Methods Refractive error was measured by cycloplegic retinoscopy in both eyes of 166 dogs, 1-8 years of age and free of ocular pathology, from a large family of pedigree Labrador Retrievers. All dogs originated from the same breeding colony. The early records of these dogs included information on birth weight, maternal litter cohort, litter size and neonatal weight gain, measured daily for the first 6 weeks. These factors were analyzed to investigate their effect on adult refractive error. Results The average adult spherical equivalent refraction (SER) was -0.44D (-5.38D to +1.65D, n = 166): 35% were myopic (SER ≤ -0.50D), 58% emmetropic (SER = -0.49 to +0.99) and 7% hyperopic (SER ≥ +1.00D). Mean birth weight was 421±57g. Higher birth weight was weakly (R=0.3) correlated with more hyperopic adult refractions. Relative to large litters (≥ 7), dogs from small litters (< 7) gained more weight within the first 6 weeks of life and were on average 0.43D more myopic. Conclusion The dog provides a unique model for studying a wide range of environmental influences on the development of naturally occurring, high prevalence, low degree myopia.

Capillary gas chromatographic separations were performed with an electronic pressure control system developed to provide precise closed-loop control of inlet pressure through the use of a solid state micro-machined pressure sensor and electronically controlled proportional valve. The closed-loop control of the electronic system provided better precision than the open-loop control achieved by manual pressure regulation. Closed-loop control can perform pressure programming, which can be combined with temperature programming to optimize separations. The pressure sensor monitors the integrity of the flow system and singals the controller to reduce flow in the presence of a sudden loss of system pressure.

Several lines of evidence suggest that genetic factors and environmental exposure play a role in the development of pulmonary fibrosis. The authors evaluated families with familial pulmonary fibrosis (FPF), defined as the presence of two or more cases of idiopathic interstitial pneumonia (IIP) in first degree family members. In total, 56 families with FPF were evaluated with 193 affected and 196 unaffected individuals. The presence of FPF was based on clinical history, DLCO, and CXR in 27 (14%); clinical history and HRCT scan in 102 (53%); clinical history and SLB in 55 (28%); and clinical history and autopsy in nine (5%). Older age (67.8 vs. 53.6; P

Rat liver lactate dehydrogenase (LDH) has been synthesized in hepatocytes and in a cell-free translation system. The subunit synthesized in both systems displayed the same electrophoretic mobility upon sodium dodecyl sulfate/polyacrylamide slab gel electrophoresis. Sequence analysis of the subunits translated in vitro and synthesized in vivo indicated N-acetyl-alanyl-alanine for both N termini. Thus, the newly synthesized subunit does not exhibit an amino-terminal extension. The mRNA for the lactate dehydrogenase subunit was exclusively found in free polysomes. A size of 2120 ± 240 nucleotides was estimated for the mRNA. Only about 50% of these nucleotides are needed to code for the polypeptide chain of the enzyme.

Reference to the literature regarding the South African forest tree Olinia cymosa Thunb. (" Hard Pear ") reveals that almost the whole of our knowledge concerning it has been confined to systematic descriptions. The aim of the studies described in this paper has been to collect information respecting the nature and life history of flowers, fruits, and first regeneration stages of this important species. 0. cymosa not only plays an important part in forest succession in the Knysna forest region, but also produces a most excellent timber for constructional purposes. Propagation of the species in sylvicultural practice is clearly desirable, but this has been rendered practically impossible on account of the lack of basic data concerning the biology of its flowers, fruits, and regeneration.

In the investigation of the basic interrelations of terrestrial plants and animals in natural communities, it is essential that information as to the exact or the approximate numbers of animals present should be obtained. Not only is information required as to the number present at any one time, but also as to the variation in numbers in selected communities according to seasonal and other conditions. Upon knowledge of the absolute numbers and of the variations in numbers of animals from period to period, it is possible to base conclusions as to the influences of given species of animals in given biotic communities. It is to be noted that not only is this knowledge likely to throw much light upon the structure and development of natural communities, but also has definite practical uses in the fields of economic entomology, range, forest and agricultural practice, and the investigation of such diseases as plague, human and animal trypanosomiasis, and malaria. From the general standpoint, Elton ('27, '29) has drawn attention to the importance of studying the numbers and the variations in numbers of various animals, while the work of the U. S. Biological Survey upon the relations of rodents to range management should make the most sceptical realize the earnest necessity of knowing more about the matter of animal numbers. ln such problems as that presented by the tsetse-fly in Africa, there is an everincreasing demand for data regarding the numbers of animals of different species in different communities at different time and under definite conditions. As Elton ('27, p. ioi) has pointed out, we know very little about the matter of animal numbers. The field is a new one, and as yet the methods employed are empirical and not satisfactory-there is much scope for broadly trained field workers gifted with imagination of the right type, to evolve new and improved ways of obtaining quantitative data. Methods employed by ecologists studying vegetation quantitatively are applicable directly in a few instances only-sDecial methods are needed. I have referred to the biotic c0111m11uluity-a brief explanation of this term

Insufficient importance is attributed to mortality in studies of plant distribution and succession. Indeed, as one ecologist has remarked in the course of correspondence with the writer, one is almost accused of having a morbid mind if one emphasizes the need for investigation of the factors responsible for mortality in plants. Some pass the matter lightly by, others do not even remember its existence. In South Africa attention has been directed to the subject, in passing, by flews ('20, p. 450) and Schonland ('24, p. 456), while in America Clements ('i6, pp. 58-6o) has kept it in mind. The work of Watt ('I9, 23) in Britain has been particularly valuable. On reviewing the results of various ecological experiments in the indigenous forests of the Knysna region, the writer has been forced to the conclusion that much light is likely to be cast upon various problems in plant sociology by means of a thorough investigation of the agencies responsible for death, and of the amount and rate of death for which they are responsible. It is thought that a general account of the results of some studies being carried out by the writer may set forth certain points of interest and of importance. The mortality is greatest in the flowers, fruits and young regeneration, and in this communication attention is confined to a review of the factors causing death in these stages of ten of the more important tree species in the Knysna forests. Such factors are the following

Ecology, defined by Haeckel in i869 as that science concerned with the reciprocal relations of organisms and the external world, hitherto has been occupied largely with the development of concepts and methodology. In agriculture and forestry, alone, has it been employed to any significant extent as a means of gaining knowledge upon subjects of economic import. The results being derived by the ecological investigations of the Forest Service and Biological Survey in the United States Department of Agriculture support in no uncertain manner the view that crop-production, grazing control, stock-raising, and silviculture can advance only to the degree in which they are directed along ecological lines-they being but applied ecology. In the more elevated sphere of human relations, endeavor, and destiny, the suggestive work of Huntingdon and others indicates that in the realms of politics and executive government, the concepts and methods of ecology should do much to elucidate what is now profound. Ecology, until very recently, never had been harnessed as the principal for the extraction of fundamental truths relating to a biological problem as bewildering in its complexity, as comprehensive in its interrelations, as that wide-ranging, relentless scourge of vast areas of the Dark Continent-tsetse. On account of the many-sided nature of the tsetse problem, ecological methods not only find considerable scope, but further, meet the opportunity of proving their worth in a subject that so far has defied solution. Given fair working facilities, given time in which to evolve a methodology suited to the subject, ecology should go a long way toward making possible the control or the elimination of the vectors of human and animal trypanosomiasis. The general objects of this communication are to draw attention to the interesting feature of a great biological problem being approached by the methods of the ecologist, to define the working concept, and to consider briefly the methodology employed and employable.

Scores on the Body Elimination Attitude Scale were related to the academic major and vocational interest of college students (N = 105). Students with business-oriented majors expressed more body elimination disgust than those with human-services-oriented majors. On the Thurstone Interest Inventory, the Business scale was associated positively with disgust, and the Humanitarian and Linguistic scales were associated negatively with this aversion. Theoretical and potential practical implications are discussed.