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Il fegato e un organo con due afferenze vascolari, una arteriosa (arteria epatica) ed una venosa (vena porta), che condividono il sistema sinusoidale e quello di drenaggio rappresentato dalle vene sovraepatiche. Il flusso vascolare epatico e il risultato di un complesso meccanismo pressorio che regola l’efflusso splenico e mesenterico sostenuto dall’afflusso arterioso a tali distretti. In condizioni di normalita il gradiente pressorio, derivante dalla somma tra le pressioni idrostatiche ed osmotiche presenti nel sistema, favorisce il passaggio di sangue dai vasi afferenti alle vene sovraepatiche.

The aim was to compare the performances of contrast-enhanced (CE) ultrasonography (US) and spiral computed tomography (CT) in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma (HCC). We studied 50 patients with HCC who had biopsy-proven portal vein thrombi that had been detected with US and color Doppler US. Thirteen of the thrombi involved the main portal trunk and 37 the segmental branches. CEUS and CT were performed within a week of thrombus biopsies. For each imaging technique, diagnoses of thrombosis (present/absent) and thrombus nature (malignancy/benignancy) were made by experienced readers under blinded conditions and compared with pathological findings to determine accuracy rates for thrombus detection and characterization. Forty-four of the 50 thrombi were pathologically diagnosed as malignant and the remaining six were benign. CEUS detected 50/50 (100%) thrombi and correctly characterized 49/50 (98%). CT detected 34/50 (68%) thrombi and correctly characterized 23 of these 34 (68%). CEUS outperformed CT in terms of both thrombus detection (P < 0.0001) and characterization (P = 0.0001). CEUS appears to be significantly superior to CT for detection and characterization of portal vein thrombosis complicating HCC, and it should be considered in the staging of these tumors.

Amyloid beta (Abeta) is a metabolic product of amyloid-beta precursor protein (APP). Deposition of Abeta in the brain and neuronal degeneration are characteristic hallmarks of Alzheimer's disease (AD). Abeta induces neuronal degeneration, but the mechanism of neurotoxicity remains elusive. Here we show that overexpression of APP renders hippocampal neurons vulnerable to Abeta toxicity. Deletion of the extracellular Abeta sequence of APP prevents binding of APP to Abeta, and abolishes toxicity. Abeta toxicity is also abrogated by deletion of the cytoplasmic domain of APP, or by deletions comprising the Go protein-binding sequence of APP. Treatment with Pertussis toxin (PTX) abrogates APP-dependent toxicity of Abeta. Overexpression of PTX-insensitive Galpha-o subunit, but not Galpha-i subunit, of G protein restores Abeta toxicity in the presence of PTX, and this requires the integrity of APP-binding site for Go protein. Altogether, these experiments indicate that interaction of APP with toxic Abeta-species promotes toxicity in hippocampal neurons by a mechanism that involves APP-mediated Go protein activation, revealing an Abeta-receptor-like function of APP directly implicated in neuronal degeneration in AD.

Given the increased use of traditional medicines, possibilities that would ensure its successful integration into a public health framework should be explored. This paper discusses some of the links between biodiversity and traditional medicine, and addresses their implications to public health. We explore the importance of biodiversity and ecosystem services to global and human health, the risks which human impacts on ecosystems and biodiversity present to human health and welfare.

El presente trabajo tiene como propósito analizar la importancia de la Auditoria Administrativa Funcional en el área de ventas de las casas comerciales de Línea Blanca: La Curacao S.A. y El Gallo Más Gallo S.A., en la ciudad de Matagalpa, durante el primer semestre del año 2006. En el contenido de ésta investigación se abordaron temáticas sobre Auditoria Administrativa, Casas Comerciales de Línea Blanca, Ventas, Fuerza de Ventas, Trabajo en Equipo y Atención al Cliente. Según las Casas Comerciales de Línea Blanca la Auditoria Administrativa Funcional en el área de Ventas es de gran importancia, ya que es un factor relevante para el buen funcionamiento de ésta. El trabajo en equipo y la atención al cliente ayudan a lograr el éxito empresarial y a obtener un continuo aumento en las ventas. Al proporcionar un análisis sobre la importancia de la Auditoria Administrativa Funcional en el área de Ventas de las Casas Comerciales de Línea Blanca se plantea claramente que la función de ventas es decisiva en las empresas comerciales y todas las mejoras en la eficiencia de ésta, inciden directamente en la obtención de mejores resultados para la empresa; determinando la importancia de ésta auditoria, valorando el papel del trabajo en equipo y la atención al cliente en el área de Ventas de las Casas Comerciales de Línea Blanca es el primer paso para que las empresas se motiven y logren una mayor eficiencia día a día. Para la realización de ésta investigación se hizo uso del método empírico, a través de la aplicación de instrumentos como encuestas, entrevistas y cédulas para la obtención de la información primaria, también se hizo uso del método teórico mediante el análisis de la información bibliográfica de lo cual se obtuvo información secundaria. De acuerdo a los resultados obtenidos se encontró que ambas empresas realizan Auditoria Administrativa Funcional en el área de ventas, cada semestre, otorgándole un grado de importancia a ésta técnica del 99%, ya que el funcionamiento de esta área es el motor que da vida a estas empresas para mantenerse como lideres en el mercado y en el pensamiento de sus clientes

International audience; Facioscapulohumeral muscular dystrophy (FSHD) patients carry contractions of the D4Z4-tandem repeat array on chromosome 4q35. Decrease in D4Z4 copy number is thought to alter a chromatin structure and activate expression of neighboring genes. D4Z4 contains a putative double-homeobox gene called DUX4. We identified DUX4 mRNAs in cells transfected with genomic fragments containing the DUX4 gene. Using RT-PCR we also recognized expressed DUX4 mRNAs in primary FSHD myoblasts. Polyclonal antibodies raised against specific DUX4 peptides detected the DUX4 protein in cells transfected with D4Z4 elements. DUX4 localizes in the nucleus of cells transfected with CMV–DUX4 expression vectors. A DUX4-related protein is endogenously expressed in nuclei of adult and fetal human rhabdomyosarcoma cell lines. Overexpression of DUX4 induces cell death, induces caspase 3/7 activity and alters emerin distribution at the nuclear envelope. We propose that DUX4-mediated cell death contributes to the pathogenic pathway in FSHD.

In conclusion, the “old friends hypothesis” seeks to explain the increasing prevalence of many chronic inflammatory disorders as a failure of immunoregulation secondary to decreased exposure to certain microorganisms that have been present throughout our evolutionary history. It is argued that these organisms are effectively part of our physiology, and are recognised as harmless by the innate immune system, which then activates immunoregulatory circuits, including Treg and regulatory APCs. The “old friends” consequently act as adjuvants for other antigens such as self, allergens, and gut contents, and so limit chronic inflammatory immunoregulatory disorders. These mechanisms can be revealed by altering the microbial exposure, or by studying the presence of polymorphisms of the innate immune system, since these two factors provide a series of classical gene-environment interactions. An important consequence of this understanding is the fact that the enormous variability of animal models of inflammatory disorders in different laboratories can now be exploited to investigate these gene-environment interactions. Experiments based on these differences, perhaps involving collaborations between laboratories, or the use of gnotobiotic mice reconstituted with one or a few microbial species, can be applied to those animal models where variable microbial exposure is already known to exert a profound influence.

Many species of seahorses and pipefishes (family Syngnathidae) are traded for medicinal purposes and aquaria; some are also sold as souvenirs or curiosities. Brazil is one of the main suppliers of seahorses for the international aquarium trade, nevertheless, little is known about the magnitude of that trade in the country. With regards to pipefishes, virtually nothing is known about their captures for ornamental purposes in Brazil. The present study assesses the magnitude of captures and trade of seahorses and pipefishes, based on data obtained through a collaborative monitoring program established with the main retailer of marine ornamental organisms in the State of Bahia. The syngnathid fishery is conducted in shallow waters never exceeding 7 m, generally by breathhold diving. Both seahorses and pipefishes are mostly caught by hand, and only rarely hand-nets or plastic bags are used. From January/1997 to June/2005, 152 fishers recorded their daily catches of syngnathids. Two species of seahorses, Hippocampus reidi and H. cf. erectus (9,793 specimens captured from 1997 to 2005) and three species of pipefishes, Cosmocampus albirostris, Micrognathus sp. and Syngnathus sp. (143 specimens captured from 1999 to 2005) were traded. H. reidi was the most heavily exploited species. Muitas espécies de cavalos-marinhos e peixes-cachimbo (família Syngnathidae) são comercializadas para fins medicinais e de aquarismo; algumas são também vendidas como suvenires ou curiosidades. O Brasil é um dos maiores fornecedores de cavalos-marinhos para o comércio aquarista internacional, porém pouco se sabe sobre a magnitude das capturas no país. Com relação aos peixes-cachimbo, praticamente nada se conhece acerca das suas capturas para fins ornamentais no Brasil. O presente estudo avalia a magnitude das capturas e do comércio de cavalos-marinhos e peixes-cachimbo para fins ornamentais, a partir de dados obtidos através de um programa de monitoramento desenvolvido em colaboração com o principal comerciante de organismos ornamentais marinhos no estado da Bahia. A pesca de cavalos-marinhos e peixes-cachimbo é realizada em águas rasas, nunca excedendo 7m de profundidade, geralmente em apnéia. Tanto cavalos-marinhos como peixes-cachimbo são coletados manualmente, e apenas raramente redes ou sacos plásticos são usados. Entre Janeiro de 1997 e Junho de 2005, 152 pescadores registraram suas capturas diárias de cavalos-marinhos e peixes-cachimbo. Duas espécies de cavalos-marinhos, Hippocampus reidi e H. cf. erectus (9.793 espécimes capturados entre 1997 e 2005) e três espécies de peixes-cachimbo, Cosmocampus albirostris, Micrognathus sp. e Syngnathus sp. (143 espécimes capturados entre 1999 e 2005) foram comercializados. H. reidi foi a espécie mais fortemente explorada.

We conducted a prospective study to compare sonography, color Doppler sonography, and contrast-enhanced sonography for the detection and characterization of portal and hepatic vein thrombosis complicating hepatic malignancies.Three hundred sixteen patients with biopsy-proved hepatic tumors were studied at baseline and 3 months later with sonography, color Doppler sonography, and contrast-enhanced sonography. Thrombosis was defined as the presence of intraluminal echogenic material at sonography, absence of intraluminal color signals at color Doppler sonography, and presence of nonenhancing intraluminal area at contrast-enhanced sonography. Thrombi were considered malignant if they displayed continuity with tumor tissue at sonography, intrathrombus color signals at color Doppler sonography, and enhancing signals at contrast-enhanced sonography, both having arterial waveforms at Doppler spectral examination. Definitive diagnoses were obtained by sonographically guided biopsy except for thrombi displaying at conventional sonography unequivocal continuity with tumor tissue.Thrombosis was detected in 79 (25.0%) of 316 patients at baseline and in 83 (26.3%) of 316 patients after 3 months. Eighty-one (97.6%) of the 83 thrombi were malignant. Definitive diagnosis was performed by imaging in 60 (72.3%) of the 83 cases and by biopsy in 23 cases (27.7%). For thrombus detection, contrast-enhanced sonography displayed significantly higher sensitivity than color Doppler sonography (p = 0.004) and borderline superiority over sonography (p = 0.058). For thrombus characterization, contrast-enhanced sonography was significantly more sensitive than color Doppler sonography (p0.0005) and conventional sonography (p = 0.02).Contrast-enhanced sonography is superior to sonography and color Doppler sonography for the detection and characterization of portal and hepatic vein thrombosis complicating hepatic malignancies.

A test structure employing a one-step lithography process has been built for measuring the complex impedance of ferroelectric capacitors at microwaves. The measurements are compared to the results of a finite element analysis with the aim of developing an electrical model of the test structure in which parasitic elements appear. These elements can be experimentally measured and partially de-embedded. The purpose of this paper is the characterization of strontium-bismuth tantalate (SBT) capacitors for microwave ICs or SoCs.

The World Health Organization (WHO) estimates that as many as 80% of the world's more than six billion people rely primarily on animal and plant-based medicines. The healing of human ailments by using therapeutics based on medicines obtained from animals or ultimately derived from them is known as zootherapy. The phenomenon of zootherapy is marked both by a broad geographical distribution and very deep historical origins. Despite their importance, studies on the therapeutic use of animals and animal parts have been neglected, when compared to plants. This paper discusses some related aspects of the use of animals or parts thereof as medicines, and their implications for ecology, culture (the traditional knowledge), economy, and public health.

Summary Background Coexistence with harmless microorganisms such as lactobacilli, saprophytic mycobacteria and some helminths, throughout evolution, may have shaped the host immune system. Exposure to such organisms may have therapeutic benefits by triggering immunoregulatory mechanisms that control inappropriate immune responses to self, gut contents or allergens. Objective We determined whether treatment with Mycobacterium vaccae by gavage influences the host immune response both locally and systemically. We also investigated whether delivery by this route prevents severe symptoms of disease in a murine model of pulmonary allergic inflammation. Results A single intragastric administration of M. vaccae induced a transient increase in the production of IL-10 and IFN-γ by mesenteric lymph nodes cells and splenocytes. In addition, in a mouse model of pulmonary allergic inflammation, a single treatment with M. vaccae by gavage not only diminished the total cellular infiltrate and the eosinophilic component induced by subsequent intratracheal allergen challenge, but also biased local and systemic cytokine production towards IL-10. Delivery of M. vaccae by gavage was as effective as subcutaneous treatment. Conclusion This is the first report to suggest that heat-killed mycobacteria can down-regulate symptoms of allergic inflammation by the intragastric route. These data suggest an alternative route of treatment with M. vaccae for patients with allergic conditions.

In order to identify indirect molecular biomarkers of anabolic treatments in veal calves, an animal experiment was performed using two combinations of growth promoters (consisting of boldenone undecylenate and estradiol benzoate, and of testosterone enantate and estradiol benzoate). We selected a set of 12 genes that are known to be androgen responsive in other mammalian species. The expression profile of this set of genes was analysed on prostate samples of veal calves using a real-time RT-PCR approach. For each selected gene the corresponding bovine sequence was obtained and a gene specific real-time assay was optimised and validated. The amplification was shown to be highly specific, linear and efficient. High reproducibility (

An architecture for an integrated circuit to perform LPC-based feature measurement in real time has been developed for speech recognition applications. The integrated circuit architecture is suitable for both isolated word recognition, in which the pattern matching occurs after the end of the utterance, and connected word recognition, where the pattern matching proceeds in synchrony with the speech input. A major feature of this architecture is the presence of stored program control which implements the LPC-based feature extraction algorithm on a single set of computational resources. Preliminary timing analysis indicates that a portion of real time remains unused. Thus, in addition to performing standard LPC-based feature analysis in real time, through program modification and memory addition, the architecture is expected to support more advanced concepts in speech recognition such as vector quantization. To aid in program development, software tools which include an assembler and a simulator and run on the UNIX* operating system have been developed. The projected chip complexity is approximately 20,000 transistors of random logic, 40,000 bits of ROM, and 2,500 bits of RAM.

For over three decades, scientists have been puzzled by the observation of cryptic filamentous structures in the cytoplasm of filamentous fungi. This chapter describes major developments in the characterization of 8 to 10-nm in diameter cytoplasmic filaments from Neurospora crassa. We review the studies that demonstrated that these structures are made of the tetrameric protein pyruvate decarboxylase (PDC), a key enzyme catalyzing the branch-point step between the respiration and fermentation pathways in fungi. Similar arrangements of PDC have been found in N. tetrasperma, Podospora anserina and Sordaria macrospora, showing that PDC filaments are ubiquitous structures in fungi. A complex array of signals, and possibly alternative splicing, modulate the expression of the genes cfp-1 and cfp-2 encoding PDC in N. crassa. Challenging future studies should address the relationship between the supramolecular organization and function of PDC in filamentous fungi.

O artigo não apresenta resumo.

To assess whether characterization of solid focal liver lesions could be improved by using ultrasonographic (US) contrast-specific modes after sulfur hexafluoride-filled microbubble contrast agent injection, as compared with lesion characterization achieved with preliminary baseline US.Four hundred fifty-two solid focal hepatic lesions that were considered indeterminate at baseline gray-scale and color Doppler US were examined after microbubble contrast agent injection performed by using low-acoustic-power contrast-specific modes during the arterial (10-40 seconds after injection), portal venous (50-90 seconds after injection), and late (100-300 seconds after injection) phases. Two readers independently and retrospectively reviewed baseline and contrast material-enhanced US scans and classified each depicted lesion as malignant or benign according to standard diagnostic criteria. Sensitivity, specificity, accuracy, and positive and negative predictive values and areas under the receiver operating characteristic curve (Az) were calculated by considering histologic analysis (317 patients) or contrast-enhanced helical computed tomography followed by serial US 3-6 months apart (135 patients) as the reference standards.Different contrast enhancement patterns were observed according to lesion characteristics. During the late phase, benign lesions were predominantly hyper- or isoechoic relative to the adjacent liver parenchyma, whereas malignant lesions were predominantly hypoechoic. Review of the contrast-enhanced US scans after baseline image review yielded significantly improved diagnostic performance (P.05). Overall diagnostic accuracy was 49% before versus 85% after review of the contrast-enhanced scan for reader 1 and 51% before versus 88% after review of the contrast-enhanced scan for reader 2. Diagnostic confidence-that is, the Az-was 0.820 before versus 0.968 after review of the contrast-enhanced scan for reader 1 and 0.831 before versus 0.978 after review of the contrast-enhanced scan for reader 2.The use of contrast-specific modes with a sulfur hexafluoride contrast agent led to improved characterization of solid focal liver lesions.

In general, both chemical composition and surface features of implants affect cell response. The aim of this study was to evaluate the effect of titanium (Ti) passivation on the response of rat bone marrow cells, considering cell attachment, cell morphology, cell proliferation, total protein content, alkaline phosphatase (ALP) activity, and bonelike nodule formation.Cells were cultured on both commercially pure titanium (cpTi) and titanium-aluminium-vanadium alloy (Ti-6Al-4V) discs, either passivated or not. For attachment evaluation, cells were cultured for 4 and 24 hours. Cell morphology was evaluated after 4 days. After 7, 14, and 21 days, cell proliferation, total protein content, and ALP activity were evaluated. Bonelike nodule formation was evaluated after 21 days. Data were compared by analysis of variance and the Duncan multiple range test.Cell attachment, cell morphology, cell proliferation, total protein content, ALP activity, and bonelike nodule formation all were unaffected by Ti composition or passivation.Although the protocol for passivation used here could interfere with the pattern of ions released from Ti-6Al-4V and cpTi surfaces, the present study did not show any effect of this surface treatment on in vitro biocompatibility of Ti as evaluated by osteoblast attachment, proliferation, and differentiation.

In general, cell response is affected by both chemical composition and surface roughness of implant materials. The aim of this study was to evaluate the effect of titanium (Ti) chemical composition and surface roughness on the response of rat bone marrow cells, examining cell attachment, cell proliferation, total protein content, alkaline phosphatase (ALP) activity, and bone-like nodule formation. Cells were cultured on both commercially pure titanium (cpTi) and titanium-6-aluminum-4-vanadium alloy (Ti-A) discs with four different average roughnesses (Ra). For attachment evaluation, cells were cultured for 2 h. After 14 days, cell proliferation, total protein content, and ALP activity were evaluated. Bone-like nodule formation was evaluated after 21 days. Data were compared by anova and Duncan's multiple range test when appropriate. Cell attachment and total protein content were affected by neither Ti chemical composition (P = 0.201, and P = 0.639, respectively) or surface roughness (P = 0.972, and P = 0.660, respectively). Proliferation, ALP activity, and bone-like nodule formation were affected only by Ti chemical composition (P = 0.0001, P = 0.064, and P = 0.0001, respectively). These results suggest that cpTi would optimize osteoblastic differentiation by rat bone marrow cells, including reduced cell proliferation, and increased ALP activity and bone-like nodule formation, while surface roughness, within the Ra parameters used, would not affect significantly the rat bone marrow cell response.

An energy-loss model of gas-fired domestic boilers operating at partial loads and providing heating and tap water permits the calculation, using experimental parameters, of their cyclic efficiencies, including the effects of tank losses. These results agree with experimental values obtained by testing a prototype combined boiler characterized by a high nominal output (35 kW) and capable of maintaining high efficiency when it operates at loads required by heating installation (below 14 kW). This system gives high-efficiency values on both services. >

A flexible pipe is a composite structure, built up of several steel and plastic layers, which has been increasingly used in floating offshore petroleum production systems. It is characterized by presenting low bending stiffness and high capacity with regard to internal and external pressure and tension. In order to determine some physical properties of a flexible pipe specimen, which is useful for a global analysis, and to better understand the behaviour of its tensile armour layers, when the pipe is submitted to low tension loads, a series of experimental tests were performed by COPPE/UFRJ and CENPES/PETROBRAS. In this context, bending tests, with internal pressure variation, were carried out on a 4” internal diameter flexible pipe. In some specific cross sections, the outer plastic sheath of the specimen was removed to enable the installation of electrical extensometers in the tensile armour layer. Some experimental results were compared to those obtained through analytical models, and the discrepancies are discussed.Copyright © 2003 by ASME

Limb-girdle muscular dystrophy 1A (LGMD1A [MIM 159000]) is an autosomal dominant form of muscular dystrophy characterized by adult onset of proximal weakness progressing to distal muscle weakness. We have reported elsewhere a mutation in the myotilin gene in a large, North American family of German descent. Here, we report the mutation screening of an additional 86 families with a variety of neuromuscular pathologies. We have identified a new myotilin mutation in an Argentinian pedigree with LGMD1 that is predicted to result in the conversion of serine 55 to phenylalanine (S55F). This mutation has not been found in 392 control chromosomes and is located in the unique N-terminal domain of myotilin, only two residues from the T57I mutation reported elsewhere. Both T57I and S55F are located outside the alpha-actinin and gamma-filamin binding sites within myotilin. The identification of two independent pedigrees with the same disease, each bearing a different mutation in the same gene, has long been the gold standard for establishing a causal relationship between defects in a gene and the resultant disease. As a description of the second known pedigree with LGMD1A, this finding constitutes that gold standard of proof that mutations in the myotilin gene cause LGMD1A.

Hyperplasia of Paneth and intermediate cells is a recently described component of the response of the small intestine of mice to infection with the nematode Trichinella spiralis. To investigate whether this hyperplasia is parasite specific or represents a generic intestinal response to infection, mice were infected with T. spiralis, Nippostrongylus brasiliensis, Heligmosomoides polygyrus or Schistosoma mansoni and tissue samples taken at various time-points post-infection to determine Paneth and intermediate cell numbers. All infections induced Paneth and intermediate cell hyperplasia, but the patterns of response varied between the parasite species concerned, reflecting differences in their relationships with the host. Increases in the numbers of these cells appeared to correlate with known patterns of T-helper-2 immune responses.

The design, synthesis and characterization of infinite one-, two- and three dimensional coordination polymers have attracted increasing attention in chemistry and material science research due to their potential applications as drug deliver, magnetic and optical sensors [1]. In particular, a series metal-organic frameworks MOFs - (a coordination polymer subclass) with different topological nets such as honey-comb, brick wall, ladder, herringbone, diamondoid and rectangular grids have been comprehensively discussed by Yaghi, Kitagawa and their co-workers [2] and it was observed that the type of metal ion and organic bridge ligand determines the dimensionality and the topology of the network. In this work we report a new 2D coordination polymer obtained by from ZnSO4.7H2O and 5-aminoisophtalic acid (5AIF), using the base diffusion method (DMSO as solvent). The crystal structure was determined from single crystal X-ray diffraction data collect in a Gemini-Oxford diffractometer. The Zn atom is tetrahedrally coordinated with two oxygen and one nitrogen from three different 5AIF molecules and one oxygen from DMSO molecules. The molecular packing indicates the formation of a 2D parallel to (010) forming hydrophilic cavities along [001]. The 2D network is stabilized by intermolecular hydrogen bonds involving the donor hydroxyl group (O3-H3) and the acceptor nitrogen atom (N1). The geometrical features of this new 2D coordination polymer were are all in agreement with similar fragments deposited in CSD [3].

Four 1-cm2 fragments of polypropylene mesh were implanted in the subcutaneous tissue of each of 10 albino rats to evaluate biocompatibility. A straight longitudinal incision was made on the back of these animals and histological analysis was carried out at 7, 15 and 30 days. At 7 days, there was a mild inflammatory reaction around the implanted material. On day 15, the inflammatory process continued being discrete. The inflammatory reaction decreased significantly by day 30, when mild inflammation with cell infiltrate was observed, as well as the formation of a layer of fibrous tissue surrounding the implanted mesh. These results show the biocompatibility of the polypropylene mesh and support its use in oral and maxillofacial surgery.

This paper investigates the occurrence of potentially avoidable perinatal deaths by associating failures in obstetric care with structural deficiencies in four maternity hospital comprising the local health care system in a city in Greater Metropolitan Rio de Janeiro in 1994. Information sources were a questionnaire, interview, observation, and hospital records. A theoretical organizational model was applied in data analysis. The four maternity hospitals showed problems in the three groups of factors used in this study: physical infrastructure, services, and equipment; organizational and administrative characteristics; and professional organization. In two maternity hospitals, the delay in cesarean deliveries was explained by deficiencies in the group of factors that includes facilities, services, and equipment. Health care failures directly associated with the physician were explained by high percentages of negative predisposing factors (mainly in the two private hospital), skill-related problems (more clearly in the two public hospitals), and by absence of measures for redirecting practice.

The transforming growth factor-beta (TGF-beta) family of cytokines regulates diverse cellular processes through control of the expression of target genes. Smad proteins are a recently identified family of signal transducers for members of the TGF-beta family. Smads act as transcriptional regulators through binding to DNA and interacting with a variety of transcription factors. Here, we identified a kappaB site as a TGF-beta-responsive region in the 3'-downstream junB promoter region. We also demonstrate that kappaB sites alone are sufficient to mediate immediate transcriptional activation by TGF-beta. Transactivation of kappaB sites by TGF-beta requires an intact NF-kappaB pathway, cooperates with known activators of this pathway, and is mediated by Smad family members. Furthermore, we show that Smad3 interacts with p52 in vivo. These data expand the model in which Smad proteins undergo multiple interactions with several transcription factors that could induce either activation or repression of gene expression.

The aim of this study was to investigate the effect of several drug combinations (atropine, xylazine, romifidine, methotrimeprazine, midazolam, or fentanyl) with ketamine for short term anesthesia in cats. Twelve cats were anesthetized 6 times by using a cross-over Latin square protocol: methotrimeprazine was combined with midazolam, ketamine, and fentanyl; midazolam and ketamine; romifidine and ketamine; and xylazine and ketamine. Atropine was combined with romifidine and ketamine, and xylazine and ketamine. Temperature, heart rate, and respiratory rate decreased in all groups. Apnea occurred in 1 cat treated with methotrimeprazine, romifidine, and ketamine, suggesting that ventilatory support may be necessary when this protocol is used. Emesis occurred in some cats treated with alpha 2-adrenoceptor agonists, and this side effect should be considered when these drugs are used.

This paper presents a proposal for operationalization of access and decentralization in a health systems analytical model. It supports the hypothesis that decentralization of health systems fosters better access by users. This proposal is intended to contribute to a closer link between these categories and observed reality.

Nucleoli were studied in circulating myeloblasts of myeloblastic (FAB M1, M2), promyelocytic (FAB M3) and myelomonocytic (FAB M4) acute myeloid leukemias (AMLs) using a cytochemical procedure for the demonstration of RNA. In patients untreated with cytostatic chemotherapy, myeloblasts of myeloblastic acute leukemias possessed less frequently "active large" nucleoli and more frequently "inactive" micronucleoli in comparison with other investigated types of AMLs. When myeloblasts were classified according to the presence of functionally dominant nucleoli, the higher percentage of "terminal" myeloblasts containing only micronucleoli in this type of AML was significantly reduced in patients treated with the cytostatic chemotherapy. In patients suffering from promyelocytic leukemia treated with cytostatic chemotherapy, the decreased percentage of myeloblasts containing functionally dominant active large nucleoli was accompanied by the increased incidence of myeloblasts with functionally dominant "resting" ring shaped nucleoli. In myelomonocytic AML no significant differences were noted between patients untreated or treated with the cytostatic chemotherapy in the incidence of main nucleolar types in myeloblasts and myeloblasts classified according to the presence of functionally dominant nucleoli. Thus a further biological specificity might exist among leukemic blasts in various types of AMLs which should be considered for a rational approach to the therapy of these malignancies. In addition, the cytostatic chemotherapy did not influence incidence of the nucleolar asynchrony in myeloblasts of all investigated types of AML.

Disordered gastric motility and emptying are well known complications of diabetes mellitus (DM), but the pattern of intragastric distribution of food has not been extensively studied in diabetics. We examined the partition of a liquid nutrient meal between the proximal and distal stomach and the relationships between intragastric distribution of food and gastric emptying (GE) and the symptoms in DM patients with and without autonomic neuropathy (AN). Fourteen healthy volunteers and 20 DM patients (13 with AN; 9 with dyspepsia symptoms) ingested a liquid nutrient meal (250 ml; 437 kcal) labeled with [99mTc]phytate. Anterior and posterior serial images of the stomach were taken for 90 min with a gamma camera. Regions of interest for the proximal and the distal halves of the stomach and for the total gastric area were defined. Counts from each region along time allowed estimation of GE and the proportion of activity retained in the proximal stomach after meal ingestion (initial) and throughout GE (mean). GE half-times in controls (median; range: 66 min; 29-90 min) were not significantly different from diabetics (76 min; 5-150 min, P0.10), but abnormal GE was found in 11 DM patients (seven delayed and four rapid). In DM patients, initial retention in the proximal stomach (42%; 16-79%) was significantly lower (P0.02) than in controls (55%; 44-71%). Mean retention in the proximal stomach throughout emptying also was significantly lower (P0.05) in DM patients (43%; 18-58%) than in controls (51%; 32-69%). There were no differences between subgroups of patients with normal, delayed, or rapid gastric emptying regarding mean meal retention in the proximal stomach. Patients with evidence of AN or with dyspepsia symptoms had significantly decreased retention of food in the proximal stomach throughout gastric emptying. We concluded that patients with diabetes mellitus have abnormally decreased retention of gastric contents in the proximal stomach after a liquid meal, which seems to be related to the occurrence of autonomic neuropathy and dyspepsia symptoms, but not to disordered gastric emptying.

Cystoid macular oedema (CME) is an important cause of visual impairment in diabetic patients and its treatment is an unsolved problem for ophthalmologists.The typical polycystic aspect of the diabetic CME may be caused either by extramacular exudation or by a leakage from the perifoveal capillaries. Generally, it is reported that grid or focal laser photocoagulation is able to improve the fluorangiographic aspect of CME but this often fails to improve the visual acuity significantly1-6. On the other hand it is reported that CME may resolve spontaneously or fluctuate for months or years before causing severe loss of vision7. When the visual acuity tends to decrease to less than 0.5 a perifoveal grid photocoagulation should be performed8,9. here we present our experience about the use of a perifoveolar laser grid extended to the edge of the foveal avascular zone (FAZ) in reducing CME.

To determine whether Lyme disease spirochaetes (Borrelia burgdorferi) within vector ticks (lxodes dammini) sampled from enzootic sites comprise single or mixed populations, we compared their reactivity to a polyclonal rabbit immune serum with that to a battery of monoclonal antibodies (mAb) against OspA, OspB and flagellin. More spirochaetes were recognized by the polyclonal antibody than with the mAbs. Spirochaetes from field-sampled ticks reacted poorly to mAbs against OspB. No such differences in reactivity to polyclonal or monoclonal antibodies were observed for the N40 strain of B. burgdorferi from BSK cultures and infected laboratory-reared vector ticks. We conclude that in nature each tick may be infected by an antigenically heterogeneous mixture of spirochaetes.

This study reports the problems and difficulties perceived by parents and teachers of epileptic children, who have been attended in the Neurological ward of a hospital located in a medium-size cite of the state of São Paulo, Brazil. The goals of this work are: 1. To characterize problems and needs detected by parents and teachers of epileptic children under convulsive crises. 2. To characterize the assistance that parents and teachers have been giving in order to meet the specific needs of epileptic children. 3. To propose alternatives that can help mothers and teachers, particularly in the situation of convulsive crises. The sample of this study was formed by mothers and teachers of 10 epileptic children, male or female from 7 to 14 years old.