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Genital presentation of filarial disease is not uncommon in endemic areas of the world. Acute, febrile illness involving the epididymis and spermatic cord (funiculoepididymitis) is one of many such presentations. With an internationally mobile society, physicians today, even in nonendemic areas, may encounter patients with filarial infestations. We report the first case of presumptive diagnosis of this disease using scrotal ultrasound.

The TWIST Collaboration has measured the Michel parameter $\rho$ in normal muon decay, $\mu^+ \to e^+ \nu_e \bar{\nu}_{\mu}$. In the Standard Model, $\rho$ = 3/4. Deviations from this value require mixing of left- and right-handed muon and electron couplings in the muon-decay Lagrangian. We find $\rho$ = 0.75080 $\pm$ 0.00044(stat.) $\pm$ 0.00093(syst.) $\pm$ 0.00023, where the last uncertainty represents the dependence of $\rho$ on the Michel parameter $\eta$. This result sets new limits on the $W_L-W_R$ mixing angle in left-right symmetric models., Comment: 4 pages, 3 figures, submitted to PRL

The study aimed to describe changes in the distribution of body mass index (BMI) among white non-Hispanic US men aged 40-69 years throughout the 20th century.The subjects were 12 312 randomly drawn Union Army veterans examined between 1890 and 1900, and 4059 NHANES (National Health and Nutrition Examination Survey) participants examined between 1976 and 2000.The study compared descriptive statistics of the age- and year-specific distributions of BMI.Between 1890 and 2000, median BMI of men aged 50-59 years increased by 5.7 kg/m(2) (25%), while the standard deviation almost doubled. In this age group, the current distribution of BMI is less right-skewed than in the earlier cohort. Obesity prevalence increased from 3.4% to 35%. In 1890-1894, median BMI declined with age, but by 2000 the age pattern had been reversed. The average annual growth rate of median BMI was lowest between 1900 and 1976 and has been rising to 0.5% per annum between 1988 and 2000.The increase in median BMI accounts for 75% of the rise in obesity prevalence between 1890 and 2000. The remainder must be attributed to changes in other features of the distribution, most notably the increased variance of BMI.

Lipomas are common benign tumours, but intrathoracic lipomas are rare and peripheral lung lipomas exceptionally rare. Seven cases--all in men--have been described in the world literature, diagnosed after thoracotomy and excision. We report a case of a peripheral intrapulmonary lipoma in a woman presenting as an opacity on a routine chest radiograph. The CT characteristics and the finding of the same lesion on reviewing a barium enema film from 12 years earlier allowed a confident diagnosis, avoiding the need for surgical excision. This is the first reported case of peripheral lung lipoma in a woman and highlights the value of reviewing previous radiographs.

Atlantic salmon postsmolts were fed a control diet or one of 9 experimental diets containing various blends of two vegetable oils, linseed (LO) and rapeseed oil (RO), and fish oil (FO) in a triangular trial design, for 50 wk. After sampling, fish previously fed 100% FO, LO and RO were switched to a diet containing 100% FO for a further 20 wk. Fatty acid compositions of flesh total lipid were linearly correlated with dietary fatty acid compositions (r = 0.99-1.00, P < 0.0001). Inclusion of vegetable oil at 33% of total oil significantly reduced the concentrations of the highly unsaturated fatty acids, eicosapentaenoate [20:5(n-3)] and docosahexaenoate [22:6(n-3)], to approximately 70 and 75%, respectively, of the values in fish fed 100% FO. When vegetable oil was included at 100% of total dietary lipid, the concentrations of 20:5(n-3) and 22:6(n-3) were significantly reduced to approximately 30 and 36%, respectively, of the values in fish fed FO. Transfer of fish previously fed 100% vegetable oil to a 100% FO diet for 20 wk restored the concentrations of 20:5(n-3) and 22:6(n-3) to approximately 80% of the value in fish fed 100% FO for 70 wk, although the values were still significantly lower. However, in fish previously fed either 100% LO or RO, concentrations of 18:2(n-6) remained approximately 50% higher than in fish fed 100% FO. This study suggests that RO and LO can be used successfully to culture salmon through the seawater phase of their growth cycle; this will result in reductions in flesh 20:5(n-3) and 22:6(n-3) concentrations that can be partially restored by feeding a diet containing only marine FO for a period before harvest.

The influence of sonication on the surface structure and chemical stability of porous silicon (PS) thin films prepared by an open-circuit stain-etch is described. An analysis of differences in surface morphologies by atomic force microscopy between samples prepared either in the presence or absence of sonication reveals that sonication generates a relatively rougher, thicker film as evidenced by the magnitudes of average and root-mean square surface roughness (R a ) and the maximum height of surface features. These differences result in stain-etch porous Si films possessing greater chemical stability to exposure to reagents such as water and organoamines

PlanMaker, a design knowledge entry tool based on the Falcon Framework, is presented. PlanMaker is a customized version of a spreadsheet. The spreadsheet is linked to a simulator and a schematic capture tool, allowing designers to capture their know-how to domains of design simulation, analysis, and verification. Know-how can be entered without great software expertise and can be stored in reusable external libraries.

Current guidelines suggest that, for patients at moderate risk of death from unstable coronary-artery disease, either an interventional strategy (angiography followed by revascularisation) or a conservative strategy (ischaemia-driven or symptom-driven angiography) is appropriate. We aimed to test the hypothesis that an interventional strategy is better than a conservative strategy in such patients.We did a randomised multicentre trial of 1810 patients with non-ST-elevation acute coronary syndromes (mean age 62 years, 38% women). Patients were assigned an early intervention or conservative strategy. The antithrombin agent in both groups was enoxaparin. The co-primary endpoints were a combined rate of death, non-fatal myocardial infarction, or refractory angina at 4 months; and a combined rate of death or non-fatal myocardial infarction at 1 year. Analysis was by intention to treat.At 4 months, 86 (9.6%) of 895 patients in the intervention group had died or had a myocardial infarction or refractory angina, compared with 133 (14.5%) of 915 patients in the conservative group (risk ratio 0.66, 95% CI 0.51-0.85, p=0.001). This difference was mainly due to a halving of refractory angina in the intervention group. Death or myocardial infarction was similar in both treatment groups at 1 year (68 [7.6%] vs 76 [8.3%], respectively; risk ratio 0.91, 95% CI 0.67-1.25, p=0.58). Symptoms of angina were improved and use of antianginal medications significantly reduced with the interventional strategy (p0.0001).In patients presenting with unstable coronary-artery disease, an interventional strategy is preferable to a conservative strategy, mainly because of the halving of refractory or severe angina, and with no increased risk of death or myocardial infarction.

This report describes a surgical technique for root coverage using an acellular dermal graft material and a coronally positioned flap. Video clips of a root coverage surgery are included using the graft material to cover multiple teeth in the same quadrant. Three additional completed cases are presented in which a mean root coverage of 97% was achieved, resulting in 100% coverage on 9 of 11 teeth. The results from this case series conform with the available evidence on the use of acellular dermal graft material in root coverage procedures.

The present study was undertaken to establish whether the formation of 22:6n-3 from 18:3n-3 and/or 20:5n-3 can occur in turbot liver and if this conversion is consistent with the operation of a Delta4 desaturase-independent pathway. At the same, time the effects of feeding a diet devoid of long chain polyunsaturated fatty acids (PUFA) on the patterns of esterification and modification of 18:3n-3, 20:5n-3 and 18:2n-6 by turbot hepatocytes and liver microsomes were examined. For this purpose, two groups of fish (25-30 g) were employed: one was fed a commercial diet containing fish oil (FO) and thus rich in long chain n-3 PUFA and the other was fed an experimental diet based on olive oil (OO). After 5 months of feeding, hepatocytes and liver microsomes isolated from individuals in the two groups of fish were incubated with [1-(14)C]-PUFA [either 18:3n-3, 20:5n-3 or 18:2n-6]. After 3 h of incubation, most radioactivity from all three radiolabelled substrates incorporated into lipids by hepatocytes and microsomes was recovered in the original substrate. The formation of desaturation products of n-3 radiolabelled substrates was higher in hepatocytes isolated from OO-fed than FO-fed fish. Small amounts of radiolabelled 22:6n-3 were formed from [1-(14)C]18:3n-3 and [1-(14)C]20:5n-3, but only by hepatocytes from fish fed OO, which also synthesised a small amount of radiolabelled 24:6n-3 from 14C-20:5n-3. Elongation products predominated over desaturation products in hepatic microsomes from both groups of fish studied, particularly in microsomes from fish fed FO. The results confirm that regardless of the long chain PUFA content of the diet, the production of 22:6n-3 in turbot liver from 18:3n-3 and/or 20:5n-3, and of 20:4n-6 from 18:2n-6, is very limited. The presence of radiolabelled 24:6n-3 in microsomes coupled with the absence of radiolabelled 22:6n-3 suggests that the formation of 22:6n-3 that does occur in turbot liver cells, may involve C24 intermediates and peroxisomal beta-oxidation.

Supplies of marine fish oils (FO) are limited and continued growth in aquaculture production dictates that substitutes must be found that do not compromise fish health and product quality. In this study the suitability of crude palm oil (PO) as a replacement for FO in diets of Atlantic salmon was investigated. Duplicate groups of Atlantic salmon post-smolts were fed four practical-type diets in which the added lipid was either 100% FO and 0% crude PO (0% PO); 75% FO and 25% PO (25% PO); 50% FO and 50% PO (50% PO); and 100% PO, for 30 wk. There were no effects of diet on growth rate or feed conversion ratio nor were any histopathological lesions found in liver, heart or muscle. Lipid deposition was greatest in fish fed 0% PO and was significantly greater than in fish fed 50% and 100% PO. Fatty acid compositions of muscle total lipid were correlated with dietary PO inclusion such that the concentrations of 16:0, 18:1(n-9), 18:2(n-6), total saturated fatty acids and total monoenoic fatty acids increased linearly with increasing dietary PO. The concentration of eicosapentaenoic acid [20:5(n-3)] was reduced significantly with increasing levels of dietary PO but the concentration of docosahexaenoic acid [22:6(n-3)] was significantly reduced only in fish fed 100% PO, compared with the other three treatments. Similar diet-induced changes were seen in liver total lipid fatty acid compositions. Hepatic fatty acid desaturation and elongation activities were approximately 10-fold greater in fish fed 100% PO than in those fed 0% PO. This study suggests that PO can be used successfully as a substitute for FO in the culture of Atlantic salmon in sea water. However, at levels of PO inclusion above 50% of dietary lipid, significant reductions in muscle 20:5(n-3), 22:6(n-3) and the (n-3):(n-6) PUFA ratio occur, resulting in reduced availability of these essential (n-3) highly unsaturated fatty acids to the consumer.

This chapter presents the basic structural features of the nitrogenase proteins focusing on the established functions of the various Fe–S based clusters within the proteins. The mechanism of nitrogenase is also described. The mechanism of nitrogenase is the electron-transfer pathway, which is common to all nitrogenases. Electrons are supplied by a ferredoxin or flavodoxin in vivo and transferred initially to the Fe–protein of nitrogenase, which contains a single {Fe 4 S 4 } cuboidal cluster. The electrons are subsequently transferred to the MoFe–protein leading to reduction of dinitrogen. The electron transfer to dinitrogen is coupled to proton transfer and the hydrolysis of MgATP. The MoFe–protein contains two structurally unique Fe–S based clusters. The P-clusters almost certainly act as capacitors, storing electrons until they are required by the active site, for the conversion of dinitrogen into ammonia. The active site is called FeMo-cofactor. The biological role of nitrogenase is to convert dinitrogen into ammonia. However, in the laboratory, the enzyme is capable of transforming a variety of other molecules and ions such as H + , RNC, N 3 - , CN, cyanamide alkynes, cyclopropene, and N 2 O.

To assess the direct medical costs and cost effectiveness of routine eptifibatide use amongst patients with unstable angina and myocardial infarction without persistent ST-segment elevation in the Western European subgroup of the PURSUIT trial.Health care resources were collected for the Western European PURSUIT trial patients (n=3697). Unit costs for major resources were developed within six countries using a consistent bottom-up methodology. Resource consumption from the Western European population was used to calculate the average direct medical costs per patient in the eptifibatide and placebo arms of the trial. Eptifibatide was estimated to cost 524 Euros per treatment. Long-term survival estimated from the 6-month trial survival data and combined with the cost data was used to calculate cost-effectiveness ratios. Additionally, cost per death and non-fatal myocardial infarction at 30 days was calculated. Sensitivity analyses were conducted on the discount rate and resource consumption. Cost-effectiveness ratios ranged from 9603 Euros to 18 115 Euros per year of life saved with 3% discount. Using resource consumption based on countries with low coronary arteriography rates, the cost per year of life saved was between 3329 Euros and 10 079 Euros. Using resource consumption based on high coronary arteriography rate countries, the cost per year of life saved was between 17 089 Euros and 24 099 Euros. Assuming no difference in treatment costs except for the addition of eptifibatide, the incremental cost per year of life saved was 23 818 Euros.Routine eptifibatide use was associated with a reduction in the combined end-point of death and myocardial infarction at 30 days, which was sustained at 6 months. Long-term projections indicate a modest increase in survival in eptifibatide patients. These data translate into cost-effectiveness ratios that compare favourably with other new technologies that are currently in use.

Transferring skills to non-clinic contexts remains a challenge for clinical psychologists. Research is needed that investigates strategies of transferring clinic skills as well as factors that are associated with successful transfer. This paper presents research that involved training clients to reduce blood pressure (BP) in the home environment and isolating factors related to successful BP reduction. Subjects diagnosed with mild hypertension participated in a controlled trial investigating the efficacy of continuous BP feedback in helping to reduce systolic BP in the clinic and home environment. While the benefits of learning BP feedback in the clinic was not shown to be beneficial over a control, training in the home environment was shown to reduce BP significantly in comparison to controls. Factors shown to be associated consistently and reliably with reduction of BP in the home were those that involved beliefs or expectations of self-control. Expectations (self-efficacy) and an internal locus of control consistently predicted the ability to reduce both systolic and diastolic BP in the home environment. Implications for the behavioural treatment of hypertension are discussed. Copyright © 2001 John Wiley & Sons, Ltd.

The in vitro incorporation of 3H-radio-labeled arachidonic (20:4n-6) and docosahexaenoic (22:6n-3) acids by the photosensitive trout pineal gland was visualized using photon and electron microscopy. After 6 hr of incubation, 3H-20:4n-6 appeared distributed in photoreceptors, as well as in glial cells, whereas 3H-22:6n-3 was preferentially taken up by photoreceptors, mainly in the apical part (including the photoreceptive outer segment). Radioactivity was mainly seen over membranes of glia when the incorporation of 3H-20:4n-6 was followed by 12-18 hr of chase. We also report differences in the incorporation of 14C-radio-labeled linoleic (18:2n-6), linolenic (18:3n-3), eicosapentenoic (20:5n-3), 20:4n-6, and 22:6n-3 acids into the lipids in glands cultured under different lighting regimes. Phosphatidylcholine and triacylglycerols contained most of the radio-labeled polyunsaturated fatty acids (PUFA) incorporated. The proportion of incorporated 20:4n-6 recovered in phosphatidylinositol was always significantly higher than that found with the other PUFA. At least 10% of radioactivity from each incorporated substrate, except 22:6n-3, was recovered in elongation products. It is concluded that the pineal gland of the trout can assimilate exogenous PUFA into cellular lipids in vitro, in a manner consistent with our previous in vivo findings. In terms of lipid composition, the trout pineal gland resembles more the vertebrate retina than the rat pineal gland. This might be related to the loss of direct photosensitivity of the mammalian pineal. Together, the differences reported herein between 22:6n-3 and 20:4n-6 suggest the former plays an important role in the phototransduction process, whereas the latter might be more specifically involved in the production of phosphoinositide-derived second messengers.

Murine typhus is a rickettsial infection that remains endemic in parts of Texas and California. Clinical manifestations of the infection are due to vasculitis. In a patient who acquired the infection in the United States, computed tomograhpy demonstrated intrasplenic pseudoaneurysms, infarcts, and hemorrhage.

Pentastomids comprise a highly specialized taxon of arthropod-like parasites that probably became adapted to the lungs of amphibians and reptiles early in their long evolutionary history. Few other macroparasites exploit this particular niche. Pentastomids are often large, long-lived and yet they cause little observable pathology in lungs, despite being haematophagous. The lungs of all tetrapods are lined with pulmonary surfactant, a remarkable biological material consisting of a complex mixture of phospholipids, neutral lipids and proteins that has the unique ability to disperse over the air-liquid lining of the lung. In the lower tetrapods it acts as an anti-glue preventing adhesion of respiratory surfaces when lungs collapse during swallowing prey or upon expiration. In mammals, pulmonary surfactant also plays a critical role regulating the activity of alveolar macrophages, the predominant phagocytes of the lower airways and alveoli. This review outlines the evidence suggesting that lung-dwelling pentastomids, and also nymphs encysted in the tissues of mammalian intermediate hosts, evade immune surveillance and reduce inflammation by coating the chitinous cuticle with a their own stage-specific surfactant. The lipid composition of surfactant derived from lung instars of the pentastomid Porocephalus crotali cultured in vitro is very similar to that recovered from the lung of its snake host. Pentastomid surfactant, visualised as lamellate droplets within sub-parietal cells, is delivered to the cuticle via chitin-lined efferent ducts that erupt at a surface density of400 mm(-2). The fidelity of the system, which ensures that every part of the cuticle surface is membrane-coated, testifies to its strategic importance. Two other extensive glands discharge membrane-associated (hydrophobic?) proteins onto the hooks and head; some have been purified and partly characterized but their role in minimising inflammatory responses is, as yet, undetermined.

The chemotactic regulator CheY controls the direction of flagellar rotation in Escherichia coli. We have determined the crystal structure of BeF3--activated CheY from E. coli in complex with an N-terminal peptide derived from its target, FliM. The structure reveals that the first seven residues of the peptide pack against the beta4-H4 loop and helix H4 of CheY in an extended conformation, whereas residues 8-15 form two turns of helix and pack against the H4-beta5-H5 face. The peptide binds the only region of CheY that undergoes noticeable conformational change upon activation and would most likely be sandwiched between activated CheY and the remainder of FliM to reverse the direction of flagellar rotation.

We report our experience with 100 consecutive patients with reflux-induced esophageal structure managed surgically. Preoperative dilatation, total fundoplication gastroplasty, and postoperative dilatation were used in 98 patients. Only two required resection of the esophageal structure. We have identified preoperative factors that adversely affect the results. These include scleroderma; previous operation, either esophageal or gastric, and the severity of the esophageal stricture. Results of nonresectional operations are excellent in uncomplicated cases or with the addition of only one complicating factor. The more complicating factors, the worse the results. Those patients with three preoperative complicating factors do poorly and may benefit from esophageal resection. We conclude that results obtained from this conservative nonresectional management program justify continuance of the use of total fundoplication gastroplasty with preoperative and postoperative dilatation in the management of such patients.

We have developed an automated chromatographic chemical element separation system (ACCESS) and an automated injection system (AIS) for rapid and reproducible ion-exchange separations of various chemical species. The system is modular to allow for many different separation configurations. Two high precision chromatography pumps, LDCs, provide constant solvent pressure throughout the system. An additional pump, and a six-way valve, permit the use of a total of up to eight different eluants in succession. The system is controlled by an IBM PC running a BASIC program. Chemical yield with the system has been determined to be 80±9%.

Histiocytic necrotising lymphadenitis is the pathognomonic histological appearance of lymph nodes in Kikuchi's disease, a condition characterised by a brief systemic illness and lymphadenopathy. The case is described of a young man, originally diagnosed as having Kikuchi's disease by lymph node histology, who subsequently developed systemic lupus erythematosus with symmetrical polyarthritis, Coombs' positive haemolytic anaemia and haemorrhagic pneumonitis. The case emphasises that a range of diseases is associated with histiocytic necrotising lymphadenitis, belying the unitary impression given by the term Kikuchi's disease.

Reports in the literature suggest that one reason for the greater sensitivity of mice to the carcinogenicity of 1,3-butadiene (BD) is that exposed mice metabolize much more of the BD to 1,2,3,4-diepoxybutane (BDO2) than do exposed rats. The purpose of this study was to determine the tumorigenicity of BDO2 in rats and in mice exposed to the same concentration of the agent. Female B6C3F1 mice and Sprague-Dawley rats, 10 to 11 weeks old, 56 per group, were exposed by inhalation to 0, 2.5, or 5.0 ppm BDO2, 6 hours/day, 5 days/week for 6 weeks. Preliminary dosimetry studies in rodents exposed for 6 hours to 12 ppm BDO2 indicated that blood levels would be expected to be approximately 100 and 200 pmol/g at the two exposure concentrations in the rat and twice those levels in the mouse. During the 6-week exposure, the mice at the high exposure level showed signs of labored breathing during the last week, and four mice died. In the others, however, the respiratory symptoms disappeared after exposure ended. Rats showed no clinical signs of toxicity during exposure but developed labored breathing after the end of the exposure leading to the death of 13 rats within 3 months. At the end of the exposure, some animals (8 per group) were evaluated for the acute toxicity resulting from the BDO2 exposure. The remaining exposed rats and mice were held for 18 months for observation of tumor development. At the end of the exposure, rats had no biologically significant alteration in standard hematological parameters, but mice had a dose-dependent increase in neutrophils and decrease in lymphocytes. In both species the significant histopathologic lesions were in the nose, concentrated around the main airflow pathway. Necrosis, inflammation, and squamous metaplasia of the nasal mucosa, as well as atrophy of the turbinates, were all present at the end of exposure to 5.0 ppm. Within 6 months, necrosis and inflammation subsided, but squamous metaplasia remained in the mice. In rats that died after exposure, squamous metaplasia was seen in areas of earlier inflammation and, in other rats, extended beyond those areas with time. The metaplasia was severe enough to restrict and occlude the nasopharyngeal duct. Later, keratinizing squamous cell carcinomas developed from the metaplastic foci in rats but not mice. At the end of 18 months, the only significant increase in neoplasia in the exposed rats was a dose-dependent increase in neoplasms of the nasal mucosa (0/47, 12/48, and 21/48 for the control, 2.5 ppm, and 5.0 ppm exposures, respectively). Neoplasia of the nasal mucosa did not increase significantly in the mice; neoplastic lesions in the mice were observed in reproductive organs, lymph nodes, bone, liver, Harderian gland, pancreas, and lung. The only significant increase in neoplasms in a single organ in the mice was in the Harderian gland (0/40, 2/42, and 5/36 for the control, 2.5 ppm, and 5.0 ppm exposures, respectively). This tumor accounts for the apparent trend toward an increase in total neoplastic lesions in mice as a function of dose (10/40, 7/42, and 16/36 for control, 2.5 ppm, and 5.0 ppm exposures, respectively). These findings indicate that the metabolite of BD, BDO2, is carcinogenic in the respiratory tract of rats. An increase in respiratory tract tumors was not observed in similarly exposed mice despite the fact that preliminary studies indicated mice should have received twice the dose to tissue compared with the rats. High cytosolic activity of detoxication enzymes in the mouse may account, in part, for the differences in response.

The chronic (2-yr) inhalation toxicity of 1,3-butadiene (BD), a chemical used in large quantities to make rubber and plastics, differs greatly between mice and rats. Mice develop lung tumors after exposures to concentrations as low as 6.25 ppm, whereas rats develop mammary tumors only after exposures to 1000-8000 ppm BD. Extensive research has been carried out to determine where humans fit into this susceptibility range. Species differences in rates of metabolism of BD have been noted, but inconsistencies in metabolism data from different laboratories and some problems in the fit of physiologically based pharmacokinetic (PBPK) models with experimental data have left uncertainties. The experiments reported here are intended to clarify the issue of human metabolism of BD and to determine if metabolism of BD in cynomolgus monkeys is similar enough to metabolism in humans to use in vivo data from monkeys for PBPK modeling. The results indicate that for the reactions studied (oxidation of BD to the mono- and diepoxide), BD is metabolized substantially the same in monkey and human hepatic microsomes. The human metabolism data agreed with that reported earlier when the in vitro metabolism of BD was studied at low BD concentrations. Finally, BD at high concentrations was found to inhibit the further oxidation of its metabolite, the monoepoxide. Incorporation of this information on the competition between BD and its first oxidation product for CYP2E1 should improve the fit of PBPK models.

(2000). Identification of Lung Tumor Antigens for Cancer Immunotherapy: Immunological and Molecular Approaches. Immunological Investigations: Vol. 29, No. 2, pp. 87-91.

Hyperbaric oxygen (HBO2) at approximately 3 atmospheres absolute (ATA) pressure is toxic to the mammalian CNS due to excessive O2 free radical production. No study has ever determined the effects ofor = 3 ATA of O2 on the membrane potential and firing rate of neurons in the mammalian brainstem. Likewise, no study has ever determined the effects ofor = 3 ATA pressure per se on brainstem neurons. Accordingly, we initiated intracellular recordings at 1 ATA in solitary complex neurons in slices (300 microns) of rat caudal medulla oblongata that were maintained inside a 72 liter hyperbaric chamber. Helium, which is inert and without narcotic effect at moderate levels of hyperbaria, was used to hydrostatically compress the submerged brain slice to determine the effects of pressure per se. Tissue oxygen tension and extracellular pH were also measured during exposure to hyperbaric gases. Six of 19 neurons were affected by hyperbaric helium; 5 cells were depolarized and 1 cell was hyperpolarized. Input resistance (Rin) either increased (n = 1) or decreased (n = 3). When control perfusate (0.95 ATA O2) was switched to perfusate saturated with 98% O2 (balance CO2, pH = 7.3-7.4, pO2 = 2.5-3.4 ATA; 2-18 minutes of exposure) in a separate pressure vessel, 8 of 13 neurons were depolarized and 5 neurons were insensitive. In the 8 O2-responsive neurons, Rin either increased (n = 5), decreased (n = 2) or was unchanged (n = 1). Three of 8 neurons depolarized by HBO2 were also depolarized by hyperbaric helium, usually with an additional change in Rin. We conclude that hydrostatic (helium) pressure and HBO2 independently increase excitability in certain solitary complex neurons. We hypothesize that these responses contribute, in part, to neural events that either precede or occur during CNS O2 toxicity.

We sought to evaluate the impact of percutaneous transluminal coronary angioplasty (PTCA) and medical treatment on self-perceived quality of life among patients with angina.The second Randomized Intervention Treatment of Angina trial (RITA-2) implemented initial policies of PTCA or continued medical treatment in patients with angina, allowing assessment of long-term health consequences.A total of 1,018 patients were randomly assigned (504 to PTCA and 514 to medical treatment). The short form 36 (SF-36) self-administered quality-of-life questionnaire was completed at randomization and three months, one year and three years later. To date, 98% of patients reached one year and 67% reached three years.The PTCA group had significantly greater improvements in physical functioning, vitality and general health at both three months and one year, but not at three years. These quality-of-life scores were strongly related to breathlessness, angina grade and treadmill exercise time both at baseline and at one year. The treatment differences in quality of life are explained by the PTCA group's improvements in breathlessness, angina and exercise time. The attenuation of treatment difference at three years is partly attributed to 27% of medically treated patients receiving nonrandomized interventions in the interim. For both groups, there were also improvements in ratings of physical role functioning, emotional role functioning, social functioning, pain and mental health, but for these the superiority of PTCA over medical treatment was less pronounced. After one year, 33% and 22% of the PTCA and medical groups, respectively, rated their health much better.Coronary angioplasty substantially improves patient-perceived quality of life, especially physical functioning and vitality, as compared with continued medical treatment. These differences are attributed to alleviation of cardiac symptoms (specifically, breathlessness and angina), but must be balanced against the small procedure-related risks of PTCA.

Visual event-related potentials (ERPs) were examined in 16 children (aged 5-14 y) with phenylketonuria (PKU) and 16 age- and sex-matched controls. Lifetime median measures of phenylalanine (Phe) were 230-460 micromol/l. The most recent Phe levels were 56-624 micromol/l. ERPs were recorded whilst the children performed a discrimination task. All stimuli were square wave gratings degree, which appeared for 33 ms. A response to an infrequent grating that differed in orientation or spatial frequency was required. The older children with PKU had a delay in the first peak (P1) of the ERP, and age-related changes in the amplitude of P1. There was attenuation of the second peak across age groups in PKU. There was no evidence of reduced response accuracy or longer reaction times in children with PKU. Latencies of the cognitive P3 were not delayed in PKU. The delayed early peaks are consistent with previous studies that have shown delayed visual evoked potentials in PKU. The lack of differences in reaction time and P3 may be due to relatively good Phe control in children with PKU, or to the simplicity of the task. Suggestions are made for future ERP studies of PKU.

The relationships between bone density, mobility, and fractures were assessed in 41 boys with Duchenne muscular dystrophy. Bone density in the lumbar spine was only slightly decreased while the boys were ambulatory (mean z-score, -0.8), but significantly decreased with loss of ambulation (mean z-score, -1.7). In contrast, bone density in the proximal femur was profoundly diminished even when gait was minimally affected (mean z-score, -1.6), and then progressively decreased to nearly 4 standard deviations below age-matched normals (mean z-score, -3.9). These are consistent with the findings that 18 (44%) of the boys sustained a fracture, 66% of these fractures involved the lower extremities, and there were no spinal compression fractures. Furthermore, four (44%) of nine boys who were walking with aids or support at the time of fracture never resumed walking after the fracture. Osteoporosis is most profound in the lower extremities of boys with Duchenne muscular dystrophy, and begins to develop early while still ambulating. Frequent fractures that may result in loss of ambulation are the clinical consequences.

To assess the frequency of carotid atherosclerosis and its relation to cardiovascular risk factors in a general elderly population of Mexico City.B-mode ultrasonography was performed to investigate carotid atherosclerosis in 145 CUPA (a research project) participants, between July 1993 and January 1996. The outcome was then related to cardiovascular risk factors.Prevalence of ultrasound-detected carotid atherosclerosis was 64.8%. Intimal-medial thickening was detected in 64 subjects (44.1%) and carotid plaques in 82 (56.5%); Fifty-two subjects had both intimal-medial thickening and plaques. However, only 8 subjects had carotid plaques with severe stenosis (5.5%). There were no significant differences in the prevalence of atherosclerotic lesions (male 61.9%, female 66.0%). Carotid atherosclerosis was significantly associated with age (p0.0001), high blood pressure (p0.001), isolated systolic hypertension (p = 0.01), hypercholesterolemia (p = 0.04), and diabetes mellitus (p = 0.06). Prevalence of carotid atherosclerosis increased progressively with the number of vascular risk factors.There was a high prevalence of carotid atherosclerosis in this general elderly population of Mexico City, and was almost equal to that reported in developed western countries. Age, hypertension, hypercholesterolemia, and diabetes were the strongest predictors of atherosclerosis.

Blood supply through collateral pathways improves regional cerebral blood flow and may protect against ischemic events. The effect of collaterals on the risk of stroke and transient ischemic attack (TIA), in the presence of angiographic severe internal carotid artery (ICA) stenosis, was assessed.Angiographic collateral filling through anterior communicating and posterior communicating arteries and retrograde filling through ophthalmic arteries were determined in all patients at entry into the North American Symptomatic Carotid Endarterectomy Trial. Kaplan-Meier event-free survival analyses were performed on 339 medically treated and 342 surgically treated patients.The presence of collaterals supplying the symptomatic ICA increased with severity of stenosis. Two-year risk of hemispheric stroke in medically treated patients with severe ICA stenosis was reduced in the presence of collaterals: 27.8% to 11.3% (P=0.005). Similar reductions were observed for hemispheric TIA (36.1% versus 19.1%; P=0.008) and disabling or fatal strokes (13.3% versus 6.3%; P=0.11). For surgically treated patients, the perioperative risk of hemispheric stroke was 1.1% in the presence of collaterals versus 4. 9% when absent. The 2-year stroke risks for surgical patients with and without collaterals were 5.9% versus 8.4%, respectively. Neither comparison in the surgical group was statistically significant. The observed reductions were independent of the degree of ICA stenosis and other vascular risk factors.Collaterals are associated with a lower risk of hemispheric stroke and TIA, both long term and perioperatively. Angiographic identification of collaterals assists in identifying patients with severe ICA stenosis at lower risk of stroke and TIA.

ARTEMIS is a new ground TEM system which employs the concept of distributed acquisition whereby a number of receivers can be deployed to make simultaneous TEM measurements in the same background noise environment. While also the name of a greek goddess, ARTEMIS stands for Array Receiver TEM Intelligent System. Special circuitry has been devised so that each receiver detects the transmitter pulse remotely for synchronisation. This avoids the need to use connecting cables which are logistically inconvenient and, furthermore are a souree of unwanted common mode noise. The lack of cables also makes it quicker and easier for the receivers to be deployed and in any desired array.

The preoptic area/anterior hypothalamus (POA/AH) sits as a boundary region rostral to the classical diencephalic hypothalamus and ventral to the telencephalic septal region. Numerous studies have pointed to the region's importance for sex-dependent functions. Previous studies suggested that migratory guidance cues within this region might be particularly unique in their diversity. To better understand the early development and differentiation of the POA/AH, cytoarchitectural, birthdate, immunocytochemical, and cell migration studies were conducted in vivo and in vitro using embryonic C57BL/6J mice. A medial preoptic nucleus became discernible using Nissl stain in males and females between embryonic days (E) E15 and E17. Cells containing immunoreactive estrogen receptor-alpha were detected in the POA/AH by E13, and increased in number with age in both sexes. From E15 to E17, examination of the radial glial fiber pattern by immunocytochemistry confirmed the presence of dual orientations for migratory guidance ventral to the anterior commissure (medial-lateral and dorsal-ventral) and uniform orientation more caudally (medial-lateral). Video microscopy studies followed the migration of DiI-labeled cells in coronal 250-microm brain slices from E15 mice maintained in serum-free media for 1-3 days. Analyses showed significant migration along a dorsal-ventral orientation in addition to medial-lateral. The video analyses showed significantly more medial-lateral migration in males than females in the caudal POA/AH. In vivo, changes in the distribution of cells labeled by the mitotic indicator bromodeoxyuridine (BrdU) suggested their progressive migration through the POA/AH. BrdU analyses also indicated significant movement from dorsal to ventral regions ventral to the anterior commissure. The significant dorsal-ventral migration of cells in the POA/AH provides additional support for the notion that the region integrates developmental information from both telencephalic and diencephalic compartments. The sex difference in the orientation of migration of cells in the caudal POA/AH suggests one locus for the influence of gonadal steroids in the embryonic mouse forebrain.

Ectopic intrathoracic kidney is a rare phenomenon and is usually an incidental finding on a chest radiograph. Of all intrathoracic kidneys, congenital ectopia is most often shown, with a traumatic etiology occurring much less frequently. We report a case of an ectopic intrathoracic kidney with associated renal cell carcinoma. Management, which was based on current treatment recommendations for isolated renal masses, consisted of radical nephrectomy. The patient has been without evidence of disease recurrence for 36 months after surgery.

1. If a purpose of photostasis - absorption of a constant number of photons by the retina, regardless of incident light levels - is to maintain rods at saturation during the light period, then in retinal regions where light intensity is low, rhodopsin concentration should be high, and vice versa. 2. Our ocular transmission photometric measurements revealed that the distribution of light intensity across the rat retina was not as simple as had been thought and, furthermore, that the local concentration of rhodopsin had a high negative correlation with the light intensity. 3. The reciprocity between these two parameters leads to nearly uniform rates of photon absorption in rods across the retina.

The origin of contrast in atomic force microscopy (AFM) lies in the probe's response to forces between itself and the sample. These forces most commonly result from changes in height as the tip is scanned over the surface, but can also originate in properties inherent in the sample. These have been exploited as further means of contrast and have spawned an array of similar imaging techniques, such as chemical force microscopy, magnetic force microscopy, and frictional force microscopy. All of these techniques use AFM as an extremely sensitive gauge to map forces at discrete sites on the surface. A natural extension of this approach is to map forces in an array, in order to create a force map. AFM can be used in aqueous or fluid environments, thus allowing the exploration of forces in biological systems under physiologically relevant conditions. By immobilizing one half of an interacting pair of proteins onto the tip and the other half onto the substrate, it is possible to investigate the electrostatic and hydrophobic interactions between them. We employed these techniques to examine the interaction between a pair of proteins of known affinity that are involved in exocytosis (NSF and alpha-SNAP) and separately to demonstrate how two-dimensional force mapping can be applied to the nuclear envelope to identify nuclear pore complexes.

The diminishing supply of cadaveric kidneys has prompted greater interest in living donor transplantation (LDT) and “marginal donors” in particular. The marginal nature of the donor may reflect source, age, or fitness with respect to the recipient.The extent to which these donors are used in the face of prolonged waiting times may reflect the varying bioethical issues and attitudes among professionals in different countries.© 1999 by Elsevier Science Inc.

Following the announcement of cold nuclear fusion being observed in electrochemical cells by Fleischmann and Pons1 and by Jones,2 we have searched for the characteristic radiations of thed+d andp+d fusion reactions in cells similar to those described in Refs. 1 and 2. No fusion product neutrons or gamma rays have been observed from either palladium or titanium cathodes. From measured D/Pd ratios in the systems with the palladium cathodes, we set upper limits on the fusion rates for our systems.

The ventromedial nucleus of the hypothalamus (VMH) is a key nucleus for regulating homeostatic, neuroendocrine, and behavioral functions. We conducted immunocytochemical analyses by using antisera directed against gamma-aminobutyric acid (GABA), its synthetic enzyme glutamic acid decarboxylase (GAD67), GABA-A receptor subunits (alpha2, beta3, epsilon), estrogen receptor-alpha, and Neuropeptide Y (NPY) in the region of the VMH in embryonic mice to identify potential patterning elements for VMH formation. Cells and fibers containing GABA and GAD67 encircled the primordial VMH as early as embryonic day 13 (E13) when the cytoarchitecture of the VMH was not recognizable by Nissl stain. At E16-17 the cytoarchitecture of the VMH became recognizable by Nissl stain as GABAergic fibers invaded the nucleus, continued postnatally, and by adulthood the density of GABAergic fibers was greater inside than outside the VMH. GABA-A receptor subunit expression (beta3 by E13 and alpha2 by E15) within the primordial VMH suggested potential sensitivity to the surrounding GABA signal. Brain slices were used to test whether fibers from distal or proximal sites influenced VMH development. Coronal Vibratome slices were prepared and maintained in vitro for 0-3 days. Nissl stain analyses showed a uniform distribution of cells in the region of the VMH on the day of plating (E15). After 3 days in vitro, cellular aggregation suggesting VMH formation was seen. Nuclear formation in vitro suggests that key factors resided locally within the coronal plane of the slices. It is suggested that either GABA intrinsic to the region nearby the VMH directly influences the development and organization of the VMH, or along with other markers provides an early indicator of pattern determination that precedes the cellular organization of the VMH.

We have determined the effects of three radiographic contrast media on platelet aggregation and degranulation in vitro. Aggregation was measured as loss of single platelets, and degranulation was measured as P-selectin expression using flow cytometry. Iopamidol added to hirudinized blood induced aggregation directly and also potentiated that induced by weak platelet agonists such as adenosine diphosphate (ADP). Iodixanol also potentiated platelet aggregation, but ioxaglate inhibited it. Iopamidol also caused marked platelet degranulation. The pro-aggregatory effect of iopamidol was evident in non-anticoagulated blood as well as in hirudinized blood, but not in citrated blood. In platelet-rich plasma (PRP) prepared from hirudinized blood neither iopamidol nor iodixanol directly induced platelet aggregation, but they rendered platelets hypersensitive to ADP. ADP antagonists inhibited the platelet aggregation and degranulation induced by iopamidol in whole blood, whereas aspirin, an inhibitor of thromborane A2 synthesis, did not. These data are consistent with clinical reports of increased thromboembolic risk with non-ionic low-osmolar media, and raise concerns about the routine use of these contrast media during diagnostic and interventional arteriographic procedures. Routine use of citrate in previous experiments may have masked a pro-aggregatory effect of some contrast media.

The stretched-vortex subgrid stress model for the large-eddy simulation of turbulent flows has been developed to the stage where it can be applied to realistic flow at large Reynolds numbers [1] [2]. The basic assumption of this model [3] is that the subgrid vortex structure consists of straight, stretched vortices containing a nearly axisymmetric subgrid vorticity field. Vortices of this type, such as the Burgers vortex and the stretched-spiral vortex have provided fair quantitative estimates of turbulence fine-scale properties [4]. These structures are probably an oversimplified model of fine-scale turbulence, but may nevertheless contain sufficient of the vortex-stretching and energy cascade physics characteristic of the small scales to provide a reasonable basis for subgrid-stress modelling for LES. The resulting subgrid stresses are $${{\tau }_{{ij}}} = K\left( {{{\delta }_{{ij}}} - e_{i}^{v}e_{j}^{v}} \right),$$ (1) where K is the subgrid energy and e i v , i = 1, 2, 3 are the direction cosines of the subgrid vortex axis. The local subgrid dissipation ϵ sgs is equal to the product of K with the component of \({{\tilde{S}}_{{ij}}}\) aligned with the vortex axis. A class of simple models is obtained when it is assumed that the subgrid vortices are aligned with the eigenvectors of the rate-of-strain tensor \({{\tilde{S}}_{{ij}}}\) [1]. Utilizing an assumed Kolmogorov form for the local subgrid energy spectrum, the model estimates the turbulent energy production at the resolved-scale cutoff in terms of the model parameters ϵ and the Kolmogorov prefactor K 0 and adjusts these parameters locally so as to continue the cascade through the cutoff to the subgrid vortex structures where the dissipation takes place.

SIR, — We wish to report a clinical presentation not previously associated with bovine viral diarrhoea virus type 2 (bvdv-2) in the uk. On uk farms where bvdv-2 previously has been detected, up to six persistently infected animals have been identified, with little clinical evidence of acute bvdv

To evaluate the information about prevalence of hypertension at a national level, several articles published either within or outside Mexico from 1933 to 1995 were reviewed. Variables about criteria and methodology were considered: the BP readings, method used, cutting points to define hypertension, year for screen. There were 30 papers out of 7 states, 16 reporting the Federal District of Mexico, 3 from Jalisco, 3 from Yucatán and 2 from Tamaulipas, there was only one referring to the State of Mexico, one to Veracruz, one to Michoacán and another referring to Mexicans in USA; as whole population there were two, one by the Instituto Mexicano del Seguro Social and another by Secretaría de Salud. A wide variation in prevalence was found (0.47 to 30.9%) mainly attributed to different sampling, measurements and reporting methodology. Few information was disclosed regarding female and elderly populations. The trend is slightly increasing, as expected accordingly to other information sources, but the problem might actually be masked by bias interference. Most of the studies performed have contributed so far to explore the gross prevalence, but may not reach scientific evidence to base evaluations of preventive interventions. The problem may not just be happening in this country. Variability may be partially controlled following the international recommendations to record arterial blood pressure, but still, there is a lack of recommendations to uniform epidemiological reports. Otherwise the values of hypertension prevalence may not be useful for hypertension surveillance.

Percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) are both effective intervention strategies for patients with coronary heart disease. We report comparative long-term clinical and health-service cost findings for these interventions in the first Randomised Intervention Treatment of Angina (RITA-1) trial.1011 patients with coronary heart disease (45% single-vessel, 55% multivessel) were randomly assigned initial treatment strategies of PTCA or CABG. Information on clinical events, subsequent intervention, symptomatic status, exercise testing, and use of health-care resources is available for a median 6.5 years of follow-up. Analyses were by intention to treat.The predefined primary endpoint of death or nonfatal myocardial infarction occurred in 87 (17%) PTCA-group patients and 80 (16%) CABG-group patients (p=0.64). Similarly, there was no significant treatment difference in deaths alone (39 PTCA, 45 CABG), of which 46% were cardiac related. In both groups, the risk of cardiac death or myocardial infarction was more than five times higher in the first year than in subsequent years of follow-up. 26% of patients assigned PTCA subsequently also had CABG, and a further 19% required additional nonrandomised PTCA. Most of these reinterventions occurred within a year of randomisation, and from 3 years onwards the reintervention rate averaged 4% per year. In the CABG group the reintervention rate averaged 2% per year. The prevalence of angina was consistently higher in the PTCA group, with an absolute average 10% excess compared with the CABG group (p0.001). Total health-service costs over 5 years showed no significant difference between initial strategies of PTCA and CABG (mean difference pounds sterling 426 [95% Cl -pounds sterling 383 to pounds sterling 1235]; p=0.30). The clinical and cost comparisons showed similar patterns for patients with single-vessel and multivessel disease.Initial strategies of PTCA and CABG led to similar long-term results in terms of survival and avoidance of myocardial infarction and to similar long-term health-care costs. Choice of approach, therefore, rests on weighing the more invasive nature of CABG against the greater risk of recurrent angina and reintervention over many years after PTCA.

Background The role of vitamin A in early primary biliary cirrhosis (PBC) remains uncertain. Methods We assessed dark adaptation and assayed vitamin-A-related compounds in 10 patients with early PBC and a group of age-and sex-matched controls. Results In patients compared with controls: (i) mean final light threshold value was 11.8% greater (p < 0.004), (ii) time taken to see the first light stimulus was longer (2.8 ± 0.6 vs 1.4 ± 0.2 min, mean ± SEM; p < 0.03) and (iii) sensitivity to light stimuli was impaired after 6 min in the dark (p < 0.03). Three patients had an abnormal final light threshold despite receiving regular vitamin A; two had a low serum vitamin A. Raised serum bilirubin and increased age were the most important determinants of impaired dark adaptation. Conclusions Patients with early PBC have modestly impaired dark adaptation, despite standard vitamin A supplementation, although these changes may not have a significant effect on visual function. Vitamin A supplementation should be recommended for older patients with jaundice, but its effect should be carefully monitored.

Multiple sclerosis (MS) has been reported to occur in association with other autoimmune diseases. Here we report the case of a woman with primary progressive MS who developed and died of Goodpasture's syndrome associated with anti-glomerular basement membrane antibodies. Of interest she had the human leukocyte antigen haplotype (DRB1*1501-DQA1*0102-DQB1*0602) most frequently associated with these two diseases; however, it is likely that other genes, particularly those involved with immunoregulation, also contributed to her susceptibility to these diseases. The association of MS and autoimmune renal disease may be more common than currently recognized.

Blood pressure presentation mode and personality are likely to influence biofeedback outcome. Thirty-six normotensive subjects were randomly assigned to visual or auditory continuous systolic feedback. "Distracting speech" and "broad band noise" were also superimposed and the effect on the biofeedback response was investigated. Psychological influence was also investigated. Systolic pressure reduction of 4 +/- 4.3 mmHg (visual, p = .04) and 5 +/- 5.5 mmHg (visual + auditory, p = .03) were achieved compared with auditory feedback (2 +/- 4.7 mmHg), which was less effective. The addition of noise or speech had no effect on the systolic response, but speech adversely affected diastolic reduction (p = .04). Mood (p = .003) was associated with systolic lowering, whereas increased trait anxiety (p = .06) and expectation (p = .03) had trends for opposite effects. Increased anger-hostility, state-anxiety, and expectation (p = .06) had links with systolic raising capability. We conclude that feedback modality and psychological characteristics have implications for studies investigating blood pressure manipulation capability.

The purpose of the study was to assess developments in the theory of mind suggested by changes in the organization of cognitive verb extensions during the elementary school years. Adults and 3rd- and 5th-grade children were provided with a set of mental activity scenarios and were asked to select the best verbs from a list of cognitive verbs that might apply to each scenario. Changes in organization were assessed by examining overlapping uses of cognitive verbs in different contexts. There were 3 major changes with development: (a) the understanding of the role of memory in input functions increased, (b) the interrelatedness of memory- and comprehension-related verbs increased, and (c) the importance of cognitive certainty and uncertainty engaged by constructive processing verbs increased. Together, these findings suggest that a constructivist theory of mind develops in later childhood.