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Pediatric pain is challenging to assess and manage. Frequently underestimated in children, untreated pain may have consequences including increased fear, anxiety, and psychological issues. With the current opioid crisis, emergency physicians must be knowledgeable in both pharmacologic and non-pharmacologic approaches to address pain and anxiety in children that lead to enhanced patient cooperation and family satisfaction. This document focuses pain management and distress mitigation strategies for the brief diagnostic and therapeutic procedures commonly performed.

Simultaneous distillation-extraction (SDE) and solid phase micro extraction (SPME) are procedures used for the isolation of flavor compounds in foods. The purpose of this study was to optimize SDE conditions (solvent and time) and to compare SDE with SPME for the isolation of flavor compounds in Jin Xuan oolong tea using GC-MS and GC-O. The concentration of volatile compounds isolated with diethyl ether was higher (P < 0.05) than for dichloromethane and concentration was higher at 40 min (P < 0.05) than 20 or 60 min extractions. For SDE, 128 volatiles were identified using GC-MS and 45 aroma active compounds using GC-O. Trans-nerolidol was the most abundant compound in oolong tea. The number of volatiles identified using GC-MS was lower in SPME than SDE. For SPME, 59 volatiles and 41 aroma active compounds were identified. The composition of the volatiles isolated by the 2 methods differed considerably but provided complementary information.

Objective To establish a reproducible method for the culture of primary equine corneal epithelial cells, keratocytes, and endothelial cells and to describe each cell’s morphologic characteristics, immunocytochemical staining properties and conditions required for cryopreservation. Procedures Corneas from eight horses recently euthanized for reasons unrelated to this study were collected aseptically and enzymatically separated into three individual layers for cell isolation. The cells were plated, grown in culture, and continued for several passages. Each cell type was characterized by morphology and immunocytochemical staining. Results All three equine corneal cell types were successfully grown in culture. Cultured corneal endothelial cells were large, hexagonal cells with a moderate growth rate. Keratocytes were small, spindloid cells that grew rapidly. Epithelial cells had heterogenous morphology and grew slowly. The endothelial cells and keratocytes stained positive for vimentin and were morphologically distinguishable from one another. The epithelial cells stained positive for cytokeratin. Keratocytes and endothelial cells were able to be cryopreserved and recovered. The cryopreserved cells maintained their morphological and immunocytochemical features after cryopreservation and recovery. Discussion This work establishes reproducible methods for isolation and culture of equine corneal keratocytes and endothelial cells. Cell morphology and cytoskeletal element expression for equine corneal epithelial cells, keratocytes, and endothelial cells are also described. This has not previously been reported for equine corneal cells. This report also demonstrates the ability to preserve equine keratocytes and endothelial cells for extended periods of time and utilize them long after the primary-cell collection, a feature that has not been reported for veterinary corneal cell culture.

40 patients with acute leukaemia and severe granulocytopenia were treated with granulocyte transfusions for bacteriologically documented or clinically suspected septicaemia. The patients received an average of 5 transfusions each with 2.1 times 1010 granulocytes per m2 body surface area per day. 26 patients showed clinical benefit from transfusion therapy as documented by the course of blood cultures, local lesions and fever. Only patients with regeneration of granulopoiesis had definite benefit from granulocyte transfusions. All other patients died ultimately from septicaemia.

Purpose The purpose of this study was to identify the most active matrix metalloproteinases (MMP) within the aqueous humor and iridocorneal angle tissue involved in the normal canine eye, and to compare these results to the MMP activity in dogs with glaucoma. Animal studied Aqueous humor samples from 32 normal eyes and 26 glaucomatous eyes were obtained through aqueous centesis and analyzed for MMP activity. Iridocorneal angle tissue from 16 enucleated normal canine eyes and 5 enucleated glaucomatous eyes were dissected and homogenized into solution. Procedure Bradford total protein assays were determined for aqueous humor samples and iridocorneal angle tissue samples. Substrate gelatin zymography was performed using 0.2 µL volumes of an MMP-2/MMP-9 control, 2 µL volumes of aqueous humor samples, and 10 µg weights of total protein from iridocorneal angle tissue. The presence of MMP gel bands were identified visually and measured quantitatively by densitometry technique. A statistical analysis was performed on the data using Student's t-test, multiple logistic Wald's chi-squared regression, Pearson correlations, and repeated measures analysis. Results Within the aqueous humor of canine eyes, MMP-2 latent form was found to be the most relevant MMP. The quantity of latent MMP-2 within the aqueous humor of the glaucoma samples was significantly increased compared to the normal aqueous samples (P

nn occur sold packaging ply many drinking at over the ways grocery (e.g., time), water tap pipes, a through store. water preservative plumbing, It is has a similar public a shelf (i.e., storage water to life food a disinfectant (i.e., supply tanks). and changes system, beverage As long residual), in we quality as products have we supand can the sold at the grocery store. It has a shelf life (i.e., changes in quality can occur over time), a preservative (i.e., a disinfectant residual), and packaging (e.g., pipes, plumbing, storage tanks). As long as we supply drinking water through a public water supply system, we have the responsibility to consider its acceptability for human consumption even though only a small percentage of tap water is used for drinking. Although a lack of acceptance of tap water flavor will not likely affect water production, it can be a major factor in public trust and confidence. Therefore, having an understanding of how the sensory properties of tap water are perceived is important for customer relations (Dietrich, 2006). Despite the strong relationship between taste and acceptability, the connection between drinking water taste, water quality, and water treatment has received little attention. As water treatment techniques become more effective at removing constituents from watersuch as with desalination and membrane processes the effect of water treatment on water taste is becoming more important. Anions and cations, including the hydrogen ioh, are largely responsible for the taste sensations at the cellular level of the taste buds. In water, anions and cations occur as a multifaceted "soup" of free ions, complexes, and even particulate matter. Ions are present simultaneously and interact depend

Humans are perplexed by the metallic odor from touchingiron metal objects, such as tools, cutlery, railings, doorhandles, firearms, jewelry, and coins. Phosphorus-containingiron which is under acid attack gives rise to a different“carbide”or“garlic”odorwhichmetallurgistshaveattributedto the gas phosphine (PH

The magnetic behavior of isolated nonmagnetic probe atoms (Cd) at ferromagnetic Ni surfaces and interfaces have been studied using perturbed angular correlation (PAC) spectroscopy. Atomic resolution is achieved making it possible to distinguish between probe atoms at various surface sites, i.e., in/at terraces, atomic steps, kinks. These different atomic surface sites have differing Ni coordination numbers, (i.e., the number of Ni nearest neighbours). With decreasing coordination number, a continuous nonlinear dependent correlation was found with increasing magnetic hyperfine fields (Bhf). Furthermore, experimental evidence is presented, that the induced s-moments on the Cd isolated impurity is independent of the details of the surface symmetry but essentially determined only by the coordination number. Finally, it has been observed that monolayers of Pd on Ni form large unit cells, which offer selected sites to the Cd impurity. We discuss this finding as basic research towards future applications with self-organizing patterned structures. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Objectives Predictors of the efficacy of highly active antiretroviral therapy (HAART) have been investigated in several studies. To increase current knowledge, the study aimed to acquire comprehensive data over an extended observation time, to obtain information on possible performance differences among individual drugs, and to identify factors with influence on the initial response to a HAART regimen and the sustainability of the response. Methods The data were obtained from a prospective, single University Medical School HIV cohort. Clinical, laboratory, and treatment parameters for 475 patients were collected over 4.5 years. HAART efficacy was determined by analysis of variance and multivariate survival analysis. Results The overall initial complete response (CR) (

Objective To investigate the potential damage to the canine corneal endothelium following transcorneal iridal laser photocoagulation using a semiconductor diode laser. Animals studied Sixteen young mongrel dogs. Procedures Baseline corneal endothelial cell counts and corneal thickness were measured in the central and temporal quadrants using a noncontact specular microscope under general anesthesia. Transcorneal iridal photocoagulation was applied using a semiconductor diode laser in a continuous mode with the use of an operating microscope. Fifteen dogs were treated, and the sixteenth dog served as a control. Fifteen different treatment combinations were randomly assigned to the 30 eyes; the fellow eye was treated differently. Three treatment factors were investigated: (1) laser energy intensity, (2) target tissue to endothelial distance, and (3) laser application duration. After 3 weeks the dogs were euthanized, specular microscopy was repeated, and the cornea was examined by scanning electron microscopy. Results Dyscoria and focal iris darkening were noted in all eyes immediately following laser treatment. Focal corneal edema (n = 2) and an incipient anterior capsular cataract (n = 1) were also noted. Baseline mean corneal endothelial cell densities were 2530 cells/mm2 centrally and 2607 cells/mm2 temporally. Postlaser corneal endothelial cell densities were 2499 cells/mm2 centrally and 2523 cells/mm2 temporally. Mean prelaser corneal thickness measurements were 0.555 mm centrally and 0.549 mm temporally. Postlaser corneal thickness measurements were 0.580 mm centrally and 0.554 mm temporally. Statistical analyzes revealed no significant changes in endothelial cell densities (P > 0.05) or corneal thickness (P > 0.05) induced by any treatment combination. Aside from tissue handling and processing artifacts, scanning electron microscopy revealed no endothelial cell damage. Conclusions Our study demonstrated by specular and scanning electron microscopy that diode laser iridal photocoagulation had no significant effect on the canine corneal endothelium within the parameters described. However, one must take into consideration the young age of the dogs and the potential for corneal endothelial cell regeneration in young dogs, and the relatively short period of postoperative study.

Chlorine in finished water can mask the more subtle odors of geosmin and 2-methylisoborneol (2-MIB), two chemicals that often trigger consumer complaints when present at even nanogram-per-litre concentrations. These are two of the odors that are revealed as chlorine dissipates in the distribution system, which is typically at the consumer's end. As a result, odor monitoring at the treatment plant may not identify unpleasant smells because chlorine levels at the plant are typically high and mask the other odors. Proper sensory evaluation of these odor-causing substances requires that the chlorine odor first be reduced or eliminated so that the secondary odor can be identified. In this study, ascorbic acid, hydrogen peroxide, oxalic acid, sodium thiosulfate, and ultraviolet (UV) irradiation were evaluated for their effectiveness in reducing chlorine solutions and for their subsequent usefulness in sensory analysis. Oxalic acid and UV irradiation were inefficient dechlorinators, and sodium thiosulfate produced a rotten-egg odor under the study conditions. Triangle testing and flavor profile analysis showed that ascorbic acid and hydrogen peroxide were effective in reducing chlorinous odors without producing new odors, and they did not alter the testers' sensory perceptions of geosmin and 2-MIB.

Disseminated mycobacterial disease was diagnosed in an eight-year-old domestic shorthaired cat, with involvement of the skin, lungs, lymph nodes and one eye. Mycobacterium simiae was cultured from skin biopsies on solid agar and in liquid media. This organism is known to cause pulmonary, cutaneous or disseminated infection in human patients with acquired immunodeficiency syndrome but has never been encountered as a pathogen in companion animals. Combination treatment with rifampicin, enrofloxacin and clarithromycin resulted in complete clinical remission within six months, with no side effects. No recurrence was observed in a 22-month follow-up period.

A 42-question survey mailed to 2,011 small public water systems in Virginia showed that this is a diverse, well-educated group of water system owners and operators who could receive their training for Virginia's new license classification through regional workshops, the internet, distance learning classes, and traditional textbook-based methods.

Inputs of copper-based crop protectants from tomato fields grown under plastic mulch agriculture (plasticulture) to an estuarine creek were investigated. Copper was measured in runoff from diverse land-uses including conventional agriculture, plasticulture, residences, and natural areas. Water column and sediment copper concentrations were measured in plasticulture and control (nonagriculture) watersheds. Copper concentrations in plasticulture-impacted creeks exceeded background levels episodically. High concentrations occurred during or immediately after runoff-producing rains. Concentrations of 263 μg/L total copper and 126 μg/L dissolved copper were measured in a tidal creek affected by plasticulture; concentrations exceeded the shellfish LC50 values and the water quality criteria of 2.9 μg/L dissolved copper. Control watersheds indicated background water column levels of ≤ 4 μg/L dissolved copper with similar copper levels during periods with and without rain. The copper concentrations in tomato plasticulture field runoff itself contained up to 238 μg/L dissolved copper. Copper concentrations in runoff from other land-uses were less than 5 μg/L dissolved copper. Creek sediment samples adjacent to a plasticulture field contained significantly higher copper concentrations than sediments taken from nonplasticulture watersheds.

Results of theoretical and experimental magneto-optical studies of free excitons in wurtzite GaN are presented. The direct photoluminescence from free exciton states of high-quality GaN epilayers was studied by polarization-dependent magneto-optical measurements in magnetic fields up to 15 T. Zeeman splittings and diamagnetic shifts of the n = 1 and n = 2 states of the A exciton were observed for magnetic fields parallel and perpendicular to the hexagonal axis. The experimental data are described by a theory of the exciton energy structure in hexagonal semiconductors with wurtzite symmetry in the framework of the quasi-cubic approximation.

Objective: The aim of the study was to evaluate prospectively the sonomorphological feature of histologically verified endometriotic cysts. Methods: Transvaginal sonography was performed in 122 patients. Age distribution of the patients, and size and sonomorphology of the lesions were analyzed. Results: Eighty-one percent of the endometriotic cysts occurred in patients between 31 and 50 years old with a peak of 29% between 31 and 35 years. Most of the cysts (81%) ranged between 30 and 59 mm in diameter. Forty-three percent of the endometriotic cysts were observed as monolocular cysts with internal echoes. More than half of the findings were observed to be multilocular, partially without any internal echos, partially even with solid parts or purely solid. Conclusion: The so-called `typically' monolocular smooth-walled endometriotic cyst with internal echoes was only found in 43% of the cases. However, data from the literature show that one cannot assume even this special entity to represent endometriomas. Regarding all monolocular cysts with homogeneous internal echoes, one has to be aware of a great amount of functional cysts and a non-calculable residual risk of malignancy.

Electric field gradients (efg) in binary wurtzite-type semiconductors have been calculated self-consistently by application of the program WIEN 95 which is based on the LAPW method. The results were compared with measured efg at the A- and B-sites. All efg are small and they are largely influenced by the parameter u, which describes the displacement of the anion and cation sublattices and which has a low experimental accuracy. From the minimum of the total energy the reliable u parameters can be determined for substances where no experimental values exist. These u parameters show a linear dependence on the axis ratio c/a.

The odors of 15 organic compounds were evaluated by the flavor profile analysis (FPA) method. The FPA data were well described by the Weber-Fechner law, as indicated by the R 2 values (0.6-0.99). Odor threshold concentrations were obtained and ranged from

This research investigated the transport of land-applied nutrients and pesticides from unconfined aquifers to tidal surface waters of Virginia's coastal plain. Ground water, estuarine surface water, ground water discharge, upland soil, and offshore sediment samples were collected from May 1992 until February 1993 from four agricultural sites. Samples were analyzed for inorganic nitrogen and phosphorus and five pesticides atrazine, cyanazine, alachlor, metolachlor, and carbofuran. Pesticides from aqueous samples were determined by liquid-solid phase extraction followed by gas chromatography-electron capture detection (GC-ECD) and/or by pesticide-specific immunoassay. Soil and sediment samples were analyzed by extraction and gas chromatography/mass spectrometry (GC/MS). Nutrient measurements indicated that fertilizer nitrogen was moving from the ground water to the surface water, and nitrogen fluxes across the sediment-water interface were correlated with fresh water discharge rates. Mean nitrate-N flux was 2.48 mg/m2.hr, with a maximum value of 30.98 mg/m2.hr. Pesticides were detected in more than half of the upland soil samples, in approximately 40 percent of the ground water samples, and in just under 20 percent of the seepage meter samples. Pesticides were not detected in any of the offshore sediment samples or surface water samples. Alachlor and metolachlor were detected in upland soil samples at concentrations ranging from 10 to almost 500 micrograms/kg. All five pesticides were found in ground water samples at concentrations generally below 1 microgram/L, with alachlor atrazine, and metolachlor most frequently found. Alachlor, atrazine, cyanazine, and metolachlor were detected in water discharging across the sediment-water interface and entering estuarine waters at concentrations ranging from 0.05 to 0.5 micrograms/L. These levels were generally consistent with the amount of dilution due to the mixing of fresh ground water and saline pore waters prior to discharge across the sediment-water interface. Based on all positive detections of pesticides in ground water discharge, which represented approximately 18 percent of all samples, average flux rates of cyanazine, metolachlor, alachlor, and atrazine were 0.32, 0.37, 0.80, and 1.12 micrograms/m2.hr, respectively. These findings indicate that submarine ground water transport of both nutrients and pesticides does occur, and this transport route should be considered when implementing agricultural management practices. The levels of nitrogen transport to surface water appears significant. The overall levels of pesticide movement through ground water, although generally quite low, represent a transport route that is commonly neglected in watershed management.

Objective: The aim of the study was to evaluate whether detection of cervical carcinoma or cervical dysplasia is possible with the use of transvaginal sonography (TVS). Method: TVS was performed in 215 patients with pathological cervical cytology (PAP III-V), suspicious clinical findings or histologically verified carcinoma of the cervix. Results: Cone biopsy in 54 patients with suspicious cytology and normal cervical features revealed 26 cases of cervical intra-epithelial neoplasia (CIN) 0-II and 19 cases of carcinoma in situ. Sonography failed to detect cervical carcinoma in only nine cases (stages Ia, Ib and IIa). False-positive results of TVS were associated in no cases with CIN 0. In 161 cases with suspicious cervical lesions, 133 invasive cancers and 23 carcinomas in situ were detected. The most striking cytological finding was that 92% of patients with PAP III/IIID and abnormal sonographic signs, and 7% with normal sonographic results and suspicious PAP, had cancer of the cervix uteri. Conclusion: We conclude that TVS could be usefully applied to the routine pretreatment evaluation of patients with cervical carcinoma.

Short-term toxicity tests using mitochondrial and microsomal metabolism were developed and applied to a series of eight quinones. In the mitochondrial assay, the degree to which test compounds inhibited mitochondrial respiration varied from an effective concentration (EC50) of 9 to 125 [mu]M. In the microsomal assay, the maximum percentage of increase over control oxygen consumption rates elicited by the quinones ranged from 8 to 837%. The ability of the compounds to stimulate microsomal oxygen uptake reflects their capability to redox cycle and form reactive oxygen species. Results of the mitochondrial and microsomal assay were statistically correlated with several quinone physicochemical parameters and qualitatively compared to reduction potential. The biological response observed in both test systems appeared to be most strongly influenced by the reduction potential of the quinone. Biomechanisms of action were suggested on the basis of this relationship. To assess the ability of the mitochondrial and microsomal assays to indicate toxicity of the quinonoid compounds, results were statistically correlated with literature-derived toxicity data. It was concluded that the mitochondrial assay appears to be a valid indicator of acute toxicity, whereas the microsomal assay better portends the potential for chronic toxicity.

Triplicate wastewater sludge samples, from three small municipal facilities that received no industrial inputs, were analyzed by the Extraction Procedure Toxicity Test (EP) and Toxicity Characteristic Leaching Procedure (TCLP). These tests evaluate the potential for organic and inorganic chemicals to leach from the sludge. Six surrogate chemicals were spiked into the sludges to monitor recoveries of specific chemicals by the two procedures. The recoveries for the surrogate chemical spiked into the sludges were low (0.1−33%) and variable for both tests. EP and TCLP tests performed similarly in that both tests yielded highly variable results in terms of the number of chemicals and the concentrations detected in the replicate samples

Two hundred twenty-four sera were collected from 34 HIV-1 infected patients during an observation period of up to 4.5 years (109 patient years of observation). The sera were tested for the presence of antibodies against the HIV-1 virion infectivity factor (vif) protein. Thirty sera from 6 HIV-1 seronegative individuals served as negative controls. The sera were immunoblotted against a recombinant, prokaryotically expressed vif protein. The prevalence of anti-vif antibodies increased significantly with progression of the disease from 18% to 81% (P less than 0.0001) which suggests a possible role of vif in HIV-1 replication and pathogenicity.

In this investigation the effects of chlorophenols on rat liver mitochondrial respiratory parameters were determined and compared to the toxicities of those compounds in a variety of biological systems currently being used for toxicity testing. Mitochondrial fractions were exposed to six concentrations of five different chlorophenols in a semiclosed, 2-ml reaction vessel. Respiratory parameters were measured polarographically with an oxygen electrode and compared to control experiments. The toxicity of the chlorophenols, as measured by the concentration reducing the respiratory control ratio of the control to 50% (RCR50), increased with increasing chloro substitution. RCR50 concentrations ranged from 599 μM with 2-chlorophenol to 0.110 μM with pentachlorophenol. The RCR50 concentrations for the five chlorophenols were compared to six physicochemical parameters for the same chlorophenols; high degrees of correlation between the RCR50 concentrations and the physicochemical parameters were found (r ≥ 0.890). The highest correlation coefficient obtained was with the n-octanol/water partition coefficient (r = 0.991), indicating that the ability of chlorophenols to partition into the lipid mitochondrial membrane plays a significant role in eliciting its toxic effect. RCR50 concentrations were also compared to nine currently existing short-term toxicity tests. High degrees of correlation were obtained with several of the tests, including algal, bacterial, and fish bioassays. This suggests that the uncoupling of oxidative phosphorylation may be the major mechanism by which chlorophenols cause toxicity to intact cells as well as more complex organisms. The use of mitochondrial respiratory parameters appears to offer a complementary approach as a short-term toxicity test for this class of compounds. Further development and testing with a variety of other toxicants is suggested.

ICAM-1 is a cell surface glycoprotein which is one of the ligands for the leukocyte function-associated antigen (LFA-1). It is involved in leukocyte adhesion to endothelial cells as well as in immune functions requiring cell-cell contact. The quantitative expression of ICAM-1 in various cell types can be either induced or enhanced by treatment with cytokines, such as interferon-gamma (IFN-gamma), tumor necrosis factor (TNF)-alpha or interleukin 1 (IL 1), a phenomenon which results in the augmentation of binding to LFA-1-positive cells. In contrast, treatment with anti-ICAM-1 antibodies blocks this binding. A monoclonal antibody (mAb), termed 7F7, which recognizes an epitope on ICAM-1, was used to investigate the role of ICAM-1 in cytokine production by T lymphocytes and monocytes. Production of TNF-alpha. IFN-gamma and IL1 was significantly inhibited (p less than 0.01) by the incubation of mAb 7F7 with phytohemagglutinin-activated blood mononuclear cells (MNC) or isolated E rosette-positive T lymphocytes. The maximal level of inhibition was reached with 1 microgram/ml of purified antibody. A similar inhibition was obtained using saturating concentrations of 400 microliters/ml of mAb 7F7 hybridoma supernatant corresponding to an inhibitory activity of 1 microgram of purified mAb. In contrast, granulocyte/macrophage-colony-stimulating factor release showed a heterogeneous response over five experiments with an increase found in three experiments and a decrease in two experiments. Addition of increasing concentrations of supernatant or purified mAb to unstimulated MNC or T lymphocyte cultures had no effect on cytokine release. The observed inhibition of the production of TNF-alpha. IFN-gamma and IL 1 by antibody-mediated blockade of the ICAM-1 structure probably represents a negative circuit that serves to tune the activation of leukocytes and to avoid an overproduction of cytokines.

In a prospective study, 29 patients were observed over a period of 42 weeks for signs of oral candidosis (OC), immunological parameters and other typical AIDS-related events. Before the study started, no OC was observed in any of the patients. During the observation period, OC was diagnosed in 12 of the 29 patients (41%). 5 of these 12 patients (42%) developed full-blown AIDS during the 42 weeks. In contrast, a progression to AIDS was observed in only 1 of the 17 patients (5.9%) without OC. The laboratory findings for patients with and without OC showed statistically significant differences for neopterin (23.6 against 14.4 nmol l-1), CD4 counts (417 against 763/mm3) and CD4/CD8 ratios (0.45 against 0.85). Based on these results, it seems justifiable to consider prophylactic measures such as pentamidine inhalation and/or treatment with zidovudine in HIV-infected patients with immunodeficiency and occurrence of OC.

These odors were described by terms such as «kerosenelike», «cat-urine-like», and «strong chlorinous» The principal conclusions derived from the study are that the strong chlorinous odors are caused by ClO 2 itself, whereas the kerosenelike and cat-urine-like odors are products of gas-phase reactions between ClO 2 liberated from the water and organic substances in the air inside the customer's residence