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The ordinary refractive index of sapphire, at 532 nm, was measured in single crystals subjected to elastic, uniaxial tensile (and compressive) strain along the c axis in plate impact experiments. The refractive index under both tension and compression was determined from the difference between the uncorrected particle velocities from velocity interferometer measurements and the known particle velocities in symmetric impact experiments. Results to a peak stress of 100 kbar in tension and compression show that the refractive index has an overall monotonic, nonlinear dependence on density that is asymmetric about the ambient density. In compression, the refractive index decreases by an extremely small amount; in contrast, the change is relatively larger in tension. These refractive index results at large tensile stresses suggest that sapphire polarizability is quite different under compression and tension. Compression measurements by themselves can be approximated well by a linear refractive index–density relation, resulting in a window correction (at 532 nm) that is a constant fraction of the true particle velocity up to at least 115 kbar longitudinal stress. The present data also provide high-precision shock velocity results in compression and demonstrate the appropriateness of using second and third order elastic constants for calculating the elastic response of sapphire under uniaxial tensile strain loading.

Object: To determine if vulvar melanosis progressed to melanoma over a period of 20 years or more. Methods: In 2010 the hospital records from the Royal Brisbane Hospital Vulvar Clinic between 1976 and 1988 were reviewed and cross checked with the state wide Queensland Centre for Gynaecological Cancer (QCGC) data base to determine if any patient had been lost to follow up and subsequently developed a vulvar melanoma. Data collected were stored and analysed using the computer software Statistical Package for the Social Sciences (SPSS) 11.0. Results: None of the 12 patients developed vulval melanoma in the years up to 2010. Conclusion: In this small group, followed for more than 20 years, melanosis was not a precursor of melanoma. One patient, who attended the Vulvar Clinic but was not included in this melanosis study, was found to have co-existing melanosis well away from her melanoma in situ and malignant melanoma at presentation. It was not possible to determine if these findings represented a progression of the benign to malignant. Biopsy of abnormal hyper pigmented vulvar skin is recommended. Current knowledge suggests that vulvar melanosis is a benign condition but to be on the safe side follow up of all hyper pigmented vulval lesions to detect early malignant change is recommended.

Sapphire crystals were shocked to 190 kbar along the a axis to characterize their use as optical windows, for velocity interferometry measurements, up to their Hugoniot elastic limit. When partially polarized light is incident on the samples, birefringence in the material is manifested as a beat frequency in the probe light that is returned from the specimens. Proper procedures for interpreting the velocity interferometry data for various polarization conditions were developed. The refractive indices at 514.5 nm wavelength decreased linearly with the density. The data were analyzed to yield three photoelastic coefficients: p12, p31, and p41. Calibration is developed for any polarization state of the probe light. Particle velocity wave forms are consistent with elastic behavior up to 170 kbar shock stress, and evidence of deviation from elastic behavior is present at 190 kbar impact stress. High precision shock velocity measurements are reported to 170 kbar stress along the a axis.

Shock wave experiments were performed to characterize z-cut, α-quartz as an optical window for velocity interferometry measurements. Refractive index changes and shock velocities were determined to 60 kbar peak stress. Results indicate that the window correction to velocity measurements is a constant fraction of the actual particle velocity, Δu/u=0.081 07. Shock velocity measurements provide the Hugoniot curve to 60 kbar, and yield the fourth-order elastic constant, C3333=174 810 kbar. By combining the velocity correction factor and the shock velocity measurements, the refractive index is determined to be a linear function of density. This finding is used to show that the velocity correction appropriate for a step jump may be applied to monotonically time-dependent wave forms with negligible error. The present work has demonstrated the use of z-cut quartz as an optical window to 60 kbar.

Summary Aims Altered proximal tubular cell growth and interstitial fibrosis are features of diabetic nephropathy and correlate with disease progression. These observations are poorly understood, although it has been suggested that they are secondary to glomerular disease. The primary aim of this study was to assess the direct effects of high extracellular glucose concentrations on the human tubulointerstitium. Methods Primary cultures of human proximal tubule cells (PTCs) and cortical fibroblasts (CFs) were grown for 6 days in media containing either 6.1 mmol/l or 25 mmol/l glucose. Cell proliferation, thymidine uptake (a marker of DNA synthesis), protein content and collagen synthesis were measured. Results In PTCs, exposure to high glucose was associated with a 410 ± 108% increase in cell numbers (P

This pilot study investigated the frequency, cause and progress of abnormal liver function tests (LFTs) in severe anorexia nervosa. Six consecutive cases of anorexia nervosa severe enough to require hospital admission and 14 outpatients with anorexia nervosa had LFTs performed. All inpatients had abnormal LFTs, with grossly elevated liver enzymes in four patients. All normalized quickly with weight gain apart from one whose alanine transaminase (ALT) remained slightly elevated. Investigations failed to reveal any other cause of liver disease. ALT values were slightly elevated in three outpatients. Abnormal LFTs occur in some patients with anorexia nervosa. Most resolve quickly and are not associated with hepatic failure. A larger study is required to determine the frequency of occurrence, cause and natural history. Copyright © 1999 John Wiley & Sons, Ltd and Eating Disorders Association.

Skin entrance doses of patients undergoing interventional x-ray procedures are capable of causing skin damage and should be monitored routinely. Single TLD chips are not suitable because the location of maximum skin exposure cannot be predicted. Most photographic films are too sensitive at diagnostic x-ray energies for dosimetry, exhibit temporal changes in response, and require special packaging by the user. We have investigated the suitability of laser heated MgB 4 O 7 TLDs in a polyimide binder in the range of 0.2–20 Gy. These are available in radioluscent arrays up to 30×30 cm for direct measurement of patient skin dose. Dose response was compared with a calibrated ion chamber dosimeter. Exposures were made at 60, 90, and 120 kVp, at low (fluoroscopy) and high (DSA) dose rates, and at different beam incidence angles. Longitudinal reproducibility and response to temperature changes during exposure were also checked. The dose response is linear below approximately 6 Gy where the slope starts to increase 2% per Gy. Errors were less than ±2% over a 0–80 degree range of beam incidence angles; less than ±3% for both dose rate variations and kVp differences between 70 and 120 kVp. The response was unaffected by temperature changes between 20 and 37 °C. Reproducibility is currently ±7%. MgB 4 O 7 TLD arrays are suitable for patient dosimetry in high dose fluoroscopy procedures if appropriate calibrations are used. Uncertainty in skin dose measurement is less than 10%, which is substantially better than film dosimetry.

Laparoscopic assisted vaginal hysterectomy (LAVH) performed in 109 cases has been reviewed. In this series the mean operative time was 89 minutes and mean inpatient hospitalization was 3.7 days. Throughout the review, 6 patients were considered to have major complications and each is discussed. The association of previous caesarean section and bladder damage is noted. LAVH widens the indications available for vaginal hysterectomy in younger women in whom the abdominal approach would previously be indicated, but extra caution is advised when this technique is first introduced to a gynaecological service.

Physiologically optimized processes, such as respiration, walking, and cardiac function, usually show a range of variability about the optimized value. Airway resistance has, in the past, been noted as variable, and this variability has been connected to pulmonary disease (e.g., asthma). A hypothesis was presented many years ago that postulated airway resistance as an optimized parameter in healthy individuals, and we have noticed that respiratory measurements made with the airflow perturbation device (APD) tend to be variable in nature. It was posited that this variability indicates that respiratory resistance is optimized similarly to other physiological processes. Fifty subjects with a wide range of demographics volunteered to have 100 measurements made of their respiratory resistances. Resistances were separated into inhalation and exhalation phases. These were plotted and shown to have frequency distributions that were consistent with expectations for an optimized process. The frequency distributions were not quite symmetrical, being skewed slightly toward upper resistances. Comparison between subject data and data from a mechanical respiratory analog showed that subject resistance variation is overwhelmingly from the respiratory system and not from the APD.

The Spectral and Photometric Imaging Receiver (SPIRE) is one of three scientific instruments onboard the European Space Agency's Herschel Space Observatory launched on 14 May 2009. The low to medium resolution spectroscopic capability of SPIRE is provided by an imaging Fourier transform spectrometer of the Mach-Zehnder configuration. Results from the in flight performance verification phase of the SPIRE spectrometer are presented and conformance with the instrument design specifications is reviewed.

The non-linear behaviour of bolometric detectors can lead to significant radiometric errors in Fourier spectroscopy if left uncorrected. We discuss preliminary investigation of this effect and its correction.

Atrial fibrillation (AF) may be present within a subset of patients with presumed cryptogenic TIA or stroke and remains undetected by standard diagnostic methods. We hypothesized that AF may be an under-recognized mechanism for cryptogenic TIA/stroke.A consecutive series of 56 patients with cryptogenic TIA/stroke was analyzed after diagnostic evaluation and Mobile Cardiac Outpatient Telemetry (MCOT) for up to 21 days. Demographic, radiographic, echocardiographic, and MCOT results were reviewed. Predictors of AF detection by MCOT were determined by univariate analysis including Student t test and Fisher exact tests and multivariate analysis.The median MCOT monitoring duration was 21 (range 5-21) days resulting in an AF detection rate of 23% (13/56). AF was first detected after a median of 7 (range 2-19) days of monitoring. Twenty-seven asymptomatic AF episodes were detected in the 13 patients, of which 85% (23/27) were30 seconds and the remaining 15% (4/27) were 4-24 hours in duration. Diabetes was predictive of AF detection by both univariate (p = 0.024) and multivariate analysis (OR 6.15; 95% CI 1.16 to 32.73; p = 0.033).There is a high rate of atrial fibrillation (AF) detection by Mobile Cardiac Outpatient Telemetry (21 days) in patients with cryptogenic TIA/stroke that may be related to extended monitoring duration, patient selection, and inclusion of all new onset AF episodes. Brief AF episodes (30 seconds) may be biomarkers of more prolonged and clinically significant AF.

A significant percentage of tympanic membrane (TM) perforations require some form of therapy to heal. Topical application of epidermal growth factor (EGF), a potent mitogen for epidermal and mesodermal cells, promotes healing of injuries in tissues histologically similar to TM, such as cornea and skin. We evaluated TM as a target tissue for EGF action. Specific, high affinity receptors for EGF were detected in TM (Kd = 3.1 nM, 150 fmol receptor/mg protein). Autoradiography of iodine 125-EGF binding to intact TMs revealed that EGF receptors were present on cells in the stratified squamous epithelial layer and in the stromal/mucoepithelial layer. Repetitive treatment of perforated cat TMs with 20 micrograms of EGF formulated in saline induced substantial hyperplasia of epithelial and stromal layers compared to paired TMs treated with saline. A single treatment of perforated cat TMs with 50 micrograms of EGF formulated in a hydrogel or in shredded Gelfoam produced significantly (p less than .05) smaller perforations at 6 days following the operation compared to paired TMs treated with vehicles. These results demonstrate that TM is a target tissue for EGF and that topical treatment with EGF stimulates healing of TM perforations.

Pi Technology and the Ford Motor Company are using MATLAB Simulink/Stateflow model based design and automatic code generation in C, for the main software development for three electronic control units targeted at the FordFocus fuel cell vehicle. The automatic generation of code for embedded automotive applications offers a number of potential advantages over traditional methods. These include faster development, the avoidance of coding errors and avoiding inconsistencies with the design specification. However, the use of automatically generated code in production-intent safety-related systems requires at least the same standard of validation and verification. If code generation were perfect, one could validate only the design. However, it is impractical to require that the code generator must be validated for all possible input designs. Furthermore it must be assumed that the compiler and the hardware can also introduce faults. Therefore we adopt the approach of testing output code for the particular designs we wish to implement, in the same manner as we would test hand-written code for production systems [1]. This retains the additional benefits of exposing the design to further detailed scrutiny in test preparation, and encouraging designs that are straightforward to test. This paper discusses the development lifecycle employed on this project, highlighting the particular benefits, issues, and challenges surrounding the use of automatically generated code for these production-quality safety-related automotive controllers.

Static mixers are increasingly being used to mix coagulants like alum in water treatment plants. This study investigates static mixers for this application using two complementary approaches. In the computational approach, a state-of-the-art computational fluid dynamics model was developed to predict the turbulent fluid flow in a helical static mixer for flow rates near those found in these mixers in water treatment plants. The model predictions show that a complex, three-dimensional fluid flow is produced within the mixer. In the experimental approach, a variety of static mixers of different design and different scales were tested for mixing alum for coagulation in a pilot plant study.

Transforming growth factor alpha (TGF-alpha) and its receptor (EGF-R) may regulate normal and malignant epithelial cell growth by an autocrine mechanism. We investigated the role of TGF-alpha in regulating head and neck SCC tumor growth.TGF-alpha and EGF-R levels were measured in 7 SCC cell lines and 14 SCC biopsies by RIA, Scatchard, and Western analysis. TGF-alpha autocrine stimulation of DNA synthesis in SCC cell lines was assessed by incubation with TGF-alpha neutralizing antibodies and tyrphostin AG 1478, a selective and potent inhibitor of EGF-R kinase.All SCC cell lines synthesized TGF-alpha and expressed elevated EGF-R levels compared to normal keratinocytes. Twelve of the 14 SCC biopsies contained TGF-alpha protein and 8 had specific EGF-R. Exogenous TGF-alpha or EGF significantly increased DNA synthesis in 4 of 5 SCC cell lines. TGF-alpha neutralizing antibodies or tyrphostin AG 1478 reduced DNA synthesis in the two SCC cell lines (FaDu and SCC9) tested.These results indicate that SCC cell lines and tumors usually synthesize TGF-alpha, have elevated levels of EGF-R, and are mitogenically stimulated by a TGF-alpha autocrine system. Selective inhibition of the TGF-alpha system by EGF-R kinase inhibitors or TGF-alpha neutralizing antibodies may be useful strategies for treating SCC that overexpress TGF-alpha and its receptor.

The ability of leucocytes to adhere to endothelium is essential for leucocyte migration into inflammatory sites. Some of these adhesion molecules are released from the cell surface and can be detected in serum. The soluble adhesion molecules intercellular adhesion molecule 1 (ICAM-1), E selectin, and vascular cell adhesion molecule 1 (VCAM-1) were studied in the serum of patients with Crohn's disease, ulcerative colitis, and healthy controls. A second blood sample was taken from patients with active disease after one month of treatment and a third two months after remission was achieved. Tissue expression of the same adhesion molecules was studied by immunohistology. Circulating VCAM-1 concentrations were significantly higher in patients with active ulcerative colitis (n = 11, median = 165 U/ml) compared with patients with inactive ulcerative colitis (n = 10, median = 117 U/ml, p < 0.005), active Crohn's disease (n = 12, median = 124 U/ml, p < 0.02), and controls (n = 90, median = 50 U/ml, p < 0.0001). Within each disease group there were no significant differences in E selectin or ICAM-1 concentrations between the active and inactive states, however, patients with active Crohn's disease had significantly higher ICAM-1 concentrations (n = 12, median = 273 ng/ml) than controls (n = 28, median = 168, p < 0.003). VCAM-1 concentrations fell significantly from pretreatment values to remission in active ulcerative colitis (p < 0.01). In Crohn's disease there was a significant fall in ICAM-1 both during treatment (p < 0.01) and two months after remission (p < 0.02). Vascular expression of ICAM-1 occurred more often and was more intense in inflamed tissue sections from patients with ulcerative colitis and Crohn's disease than from controls. Vascular labelling with antibody to E selectin also occurred more often in patients with active inflammatory bowel disease. In conclusion, increased circulating concentrations of selected adhesion molecules are associated with inflammatory bowel disease. There is also evidence of local upregulation, particularly of ICAM-1. Differential expression of adhesion molecules in tissue may play a part in the initiation of leucocyte migration and local inflammation; the function of circulating adhesion molecules is unknown, but may play a physiological part in blocking adhesion.

We have studied modulation of mucosal interleukin-6 (IL-6) secretion by T-cell activation and by anti-inflammatory agents in inflammatory bowel disease.In vitro secretion of IL-6 by biopsy specimens from patients with active ulcerative colitis was investigated in the presence of cyclosporin-A (CsA) and drugs that have other anti-inflammatory actions. Biopsy specimens from patients with quiescent ulcerative colitis or controls were stimulated with anti-CD3 antibody to activate mucosal T cells.Stimulation of control specimens increased IL-6 secretion (median increase, 147%; p0.003), which was prevented by CsA. In quiescent ulcerative colitis there was enhanced spontaneous secretion of IL-6 but a smaller, non-significant increase after T-cell activation (125%). Dexamethasone inhibited secretion in active ulcerative colitis (p0.006). 5-Aminosalicylic acid, 6-mercaptopurine, methotrexate, and indomethacin had no effect. There also tended to be a small reduction with CsA, but this just failed to reach statistical significance.In quiescent ulcerative colitis the enhanced spontaneous secretion of IL-6 may be a consequence of mucosal T-cell or macrophage activation: the smaller increase after T-cell stimulation suggests that one or both of these two cell types are already pre-activated.

Eighty-five patients with non-organic abdominal pain, were interviewed with the help of a questionnaire. Those who responded to a high fibre diet were excluded from the study. Twenty-seven patients had multiple pains and 58 described a single pain, which was intermittent in 39. A detailed analysis of the symptoms and family history of the latter group suggested that in 19 patients the symptoms might have been caused by abdominal migraine. Six of these 19 had typical migraine-associated symptoms during the attack, characteristic abdominal pain and a family or personal history of classical migraine. Abdominal migraine should be considered in patients with non-organic abdominal pain where symptoms are not typical of irritable bowel syndrome and when organic disease has been excluded.

A family with the autosomal dominant form of familial visceral myopathy is described involving four generations. The members illustrate several different clinical presentations including severe constipation, diarrhea, alternating constipation and diarrhea, volvulus, urinary tract infection, and retention of urine. One patient's history suggested that the uterus may have been involved. Diagnosis of this rare disease requires an awareness of the variable presentation and a careful histological examination of full-thickness sections of bowel. The potential pitfalls in both histological and clinical diagnosis of this condition are demonstrated in this family's history. The extensive involvement of small and large bowel in at least two family members is unusual in the autosomal dominant form of the disease, but their course has so far been favorable, lending further evidence to the impression that prognosis is good. This is of importance for genetic counseling of families who have this very rare disease.

New developments in the management of the rare endodermal sinus tumour of the ovary, together with the reporting of 2 additional patients, are presented. There is a need for accurate clinical and pathological evaluation of the disease. As shown in the present study, histochemical staining for alphafetoprotein (AFP) provides an additional factor in diagnosis, and monitoring of AFP levels in serum is a useful guide to treatment. The prognosis, previously uniformly poor, appears to be improved with the use of multidrug chemotherapy. In a collated series of 98 patients, the 24‐month survival rate was 65% in Stage I disease and 67% in Stage II disease. However, the choice of effective drugs remains uncertain. The improved survival of young patients with aggressive chemotherapy has now raised the question of preservation of fertility at the time of surgery. In a small collated series of 26 patients with Stage I disease, survival to 36 months was not jeopardized by the conservative removal of one tube and ovary. Copyright

In the five-year period 19/75 to 1979, 234 patients entered the Royal Brisbane Hospital Consultative Ovarian Carncer Clinic's management programme. Thirty-six patients were considered suitable for e valuation by a subsequent laparotomy following completion of the treatment programme. The clinic's protocol for second-look surgery and its results are presented. The findings, from the protocol-based surgery were accurate in 23 of 24 patients (96%) on the basis of subsequent follow-up, and surgery was free of complications in 33 of 36 patients (92%). The objectives of management are reviewed, and a recommendation about the timing of surgery is made. In all cases there must be individualization of treatment.

Gas embolism is a rare but potentially fatal complication of creating a pneumoperitoneum for laparoscopy. We report a case of carbon dioxide embolism during laparoscopy where the patient survived

Une observation rare: malade de 75 ans presentant un petit hematome sous-dural dans la region fronto-temporale gauche;. Les seules manifestations cliniques sont des crises epileptiques variees: convulsions, absences, confusion mentale etc.

During the past 10 years many new cardioactive drugs have been identified and some of them have been introduced into clinical practice. Many of these drugs have potential in the treatment of cerebrovascular diseases. Two groups of drugs, the Ca2+ entry blocking agents and the beta-receptor blocking agents, have attracted considerable attention and are being evaluated in a wide range of cerebrovascular disorders in both the clinical and experimental setting. The object of this chapter is to review current knowledge of these two groups of drugs in the treatment of cerebrovascular disease.

Summary: A case of multicentric vulval carcinoma-in-situ which progressed to invasive carcinoma during an 8-year period is presented. Various aspects of this disease are discussed.

A comparison of local cerebral blood flow estimates with the microsphere and the 4-[N-methyl-14C]iodoantipyrine ([14C]IAP) techniques has been performed in cats. Good correlation of [14C]IAP with microsphere flow estimates in the gray matter was found. In the white matter, however, [14C]IAP flow estimates were consistently lower than microsphere flow estimates. Error analysis of both techniques and comparison with previous studies suggest that peculiarities of white matter arterial vasculature with preferential microsphere accumulation may lead to this discrepancy. Microspheres did not interfere with flow as shown by the normal appearance of subsequent [14C]IAP autoradiograms. The number of microspheres seen on autoradiograms was used for an estimate of microvessels blocked by spheres and found to be negligible. The study also demonstrates that [14C]IAP is not diffusion limited up to the observed flow values of 2 ml.g-1.min-1. Both techniques might be used together for a combination of their respective advantages, which are temporal and spatial resolution for microsphere and [14C]IAP, respectively.

A tool is presented to quantify the risks of geothermal projects, the Geothermal Probabilistic Cost Model (GPCM). The GPCM model was used to evaluate a geothermal reservoir for a binary-cycle electric plant at Heber, California. Three institutional aspects of the geothermal risk which can shift the risk among different agents was analyzed. The leasing of geothermal land, contracting between the producer and the user of the geothermal heat, and insurance against faulty performance were examined.

Brain dysfunction is a major cause of morbidity and occasional mortality complicating many forms of heart surgery requiring cardiopulmonary bypass (CPB), including pediatric cardiovascular surgery (Becker 1982), cardiac transplantation (Hotson and Pedley 1976), and artificial heart implantation. This chapter focuses on the CNS complications associated with coronary artery bypass graft (CABG) surgery since it is the most common procedure utilizing CPB. In the United States over 150000 patients undergo CABG surgery annually and of these at least 5000 patients will suffer a stroke and perhaps 30000 more will experience a diffuse encephalopathy. Although CABG surgery and CPB pose many potential embolic, hemodynamic, and metabolic threats to the brain, the cause of neurologic dysfunction often remains obscure in the _ individual patient.

Summary: A case of ectopic vaginal trophoblast in association with a blighted ovum showing hydropic degeneration is presented. This combination satisfied the histological criteria of Szulman and Surti for inclusion as a partial mole. Subsequent follow-up revealed non-progression of the condition. The problems of obtaining a satisfactory classification for proliferative trophoblastic lesions are outlined.

A financial accounting model that incorporates physical and institutional uncertainties was developed for geothermal projects. Among the uncertainties it can handle are well depth, flow rate, fluid temperature, and permit and construction times. The outputs of the model are cumulative probability distributions of financial measures such as capital cost, levelized cost, and profit. These outputs are well suited for use in an investment decision incorporating risk. The model has the powerful feature that conditional probability distribution can be used to account for correlations among any of the input variables. The model has been applied to a geothermal reservoir at Heber, California, for a 45-MW binary electric plant. Under the assumptions made, the reservoir appears to be economically viable.

Background: Interprofessional education (IPE) is a novel teaching and learning initiative where students of more than one health profession learn interactively together. However, despite its potential for improving interprofessional relationships, there is little information regarding the participation of student dietitians in IPE. The aim of this paper was to consider the reaction of student dietitians to an IPE course in order to stimulate debate between dietitians regarding the issues relating to IPE. Methods: Student dietitians participated in an IPE course consisting of seven sessions on communication and ethics in health care together with students of medicine and nursing. Student dietitians completed an evaluation questionnaire following each session that surveyed their reaction to the session using both a Likert scale and free-text comments. Results: Twenty-six student dietitians completed the IPE course. All sessions were rated positively for interest value (P less than or equal to 0.14), learning experience (P less than or equal to 0.036) and value for clinical practice (P less than or equal to 0.05). The limited number of free-text comments indicated some positive experiences regarding interprofessional learning, teaching content and teaching strategy. Conclusions: This is one of very few evaluations to describe the reaction of student dietitians to IPE. Student dietitians had largely positive reactions to the IPE course. Further research is required to evaluate whether these positive reactions were a direct consequence of the inclusion of students from other health professions and whether these translate into positive effects on learning, behaviour and results. The opportunities for the dietetic profession posed by students' involvement in IPE are discussed.