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Optimization of control measures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in high-risk institutional settings (e.g., prisons, nursing homes, or military bases) depends on how transmission dynamics in the broader community influence outbreak risk locally. We calibrated an individual-based transmission model of a military training camp to the number of RT-PCR positive trainees throughout 2020 and 2021. The predicted number of infected new arrivals closely followed adjusted national incidence and increased early outbreak risk after accounting for vaccination coverage, masking compliance, and virus variants. Outbreak size was strongly correlated with the predicted number of off-base infections among staff during training camp. In addition, off-base infections reduced the impact of arrival screening and masking, while the number of infectious trainees upon arrival reduced the impact of vaccination and staff testing. Our results highlight the importance of outside incidence patterns for modulating risk and the optimal mixture of control measures in institutional settings.DisclaimerThe views expressed are those of the authors and should not be construed to represent the positions of the U.S. Army, the Department of Defense, or the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.

Introduction Pelvic organ prolapse is a common cause of morbidity and decreased quality of life among women and is treatable by laparoscopic sacrocolpopexy. Recent data suggest that absorbable sutures are a feasible and appealing option for mesh attachment given a potential decreased risk of complications related to mesh erosion. The aim of the present study was to demonstrate the non-inferiority of absorbable sutures to permanent sutures for laparoscopic sacrocervicopexy. Material and methods We performed a randomized, single-blinded, non-inferiority trial comparing late-absorbable sutures (group A) to non-absorbable sutures (group B) for anterior and posterior vaginal mesh fixation during laparoscopic sacrocervicopexy at a single center in Italy. The primary outcome was prolapse correction at 12 months after surgery, defined as the absence of a pelvic organ prolapse leading edge reaching or extending below the level of the hymen and the absence of bulge symptoms. Secondary outcomes included intraoperative parameters, postoperative characteristics, and long-term morbidity. Statistical analyses were performed using STATA version 16. Results A total of 150 patients with pelvic organ prolapse were prospectively randomized 1:1 into two groups (A or B). Baseline characteristics and intraoperative parameters including blood loss, operation time, and intraoperative complications were comparable between groups. The success rate was 100% in both groups and no differences in prolapse correction were observed. The rates of de novo urinary incontinence and persistent urinary incontinence were also similar between groups. The rate of mesh erosion at 12 months was 0% in group A and 4% in group B (P = .24). Conclusions Late absorbable sutures are non-inferior to non-absorbable sutures for laparoscopic sacrocervicopexy in terms of procedural success. Moreover we did not see any differences in terms of operative parameters, or intraoperative and postoperative characteristics, although the study was not powered to these outcomes.

Survival of patients with oral squamous cell carcinoma (OSCC) is generally low, with the likelihood of locoregional recurrence or disease progression (LR/DP). Knowledge of prognostic factors for survival is key to achieving an understanding and increased survival. The present study aimed to identify prognostic factors for patients with OSCC, especially the presence of DNA from human papillomavirus (HPV). Retrospective cohort study including 119 patients with OSCC treated at the National Cancer Institute in Mexico City (2009-2013). Clinical information was obtained from patient records including LR/DP. Formalin-fixed, paraffin-embedded tissues were obtained and used for detecting DNA from different types of HPV. Potential prognostic factors for Overall Survival (OS) were analyzed using the Cox proportional hazards model. After model adjustment, factors associated with longer OS were a pre-treatment platelet count above 400,000/mm3 (HR=0.09, p=0.026) and response to primary treatment (HR=0.26, p=0.001). HPV DNA was present in 23 (19.3%) of the patients and importantly, type 16 found in 19 of them. Although survival of HPV-positive patients was longer, difference was not significant. However, among patients with LR/DP, HPV positivity was significantly associated with increased survival (HR=0.23, p=0.034). Importantly, survival was significantly different for HPV-positive patients with LR/DP > 6 months (HR=0.20, p=0.002), had higher absolute lymphocyte count at start of treatment (HR=0.50, p=0.028) or had local rescue treatment (HR=0.24, p=0.019). Although HPV positivity was not associated with a longer OS of OSCC patients, a better prognosis was significantly associated with HPV positivity and recurring or progressing disease, particularly with HPV type 16.

Background Rural surgeons face unique challenges when managing patients with high-grade (III-V) blunt splenic injury (BSI) given limited access to interventional radiology and blood products. Patients therefore may require transfer for splenic artery embolization (SAE) when resuscitation may still be ongoing. This study aims to evaluate current resource utilization in a rural trauma population with limited access to SAE and blood products. Methods Retrospective analysis of adult patients with high-grade BSI at one Level 1 trauma center and two Level 2 trauma centers was performed. Patients were evaluated for resources used after transfer to the regional trauma center. Primary outcomes measured were SAE, operative management (OM), and blood product utilization. Secondary outcomes measured included injury severity score (ISS) and mortality. Results Final analysis included 134 transferred patients. 16% underwent SAE, 16% underwent OM, and 69% were treated successfully with nonoperative and non-procedural management (NOM). 52% of the SAE patients had sustained a grade III splenic injury, 38% grade IV, and 10% grade V. 84% of patients required Discussion The majority of patients with BSI transferred to a tertiary trauma center from a rural facility were successfully managed without SAE and required minimal transfusion of blood products. In the absence of other injuries necessitating transfer to a tertiary trauma center, rural surgeons should consider management of high grade splenic injuries at their home institution.

Students consider physics to be one of the most prevalent and troublesome topics since they find physics to be a challenging course in high school and become more deceptive when they have it as an undergraduate course. The Rizal Technological University (RTU) in the Philippines offers undergraduate and graduate academic programs in astronomy. The university utilizes physics diagnostic tests to classify students’ suitability towards the course as RTU houses the Philippines’ most advanced optical telescopes and the Center for Astronomy Research and Development. The latter was established through the Department of Science and Technology to promote a research hub in the field of astronomy and space science, as well as providing support for research funding and scholarships. The study performed causal-comparative research design and correlational analytics toward students’ attitude and motivation, study habits, learning styles, professor factors, social factors, and academic grades in physics and astronomy. The study explored the links between physics and astronomy and revealed their faith in their study habits in both astronomy and physics. The findings of this study provide evidence of the link of physics and astronomy education in students’ academic programs and its value from the previous learnings of students and teaching of teachers as a critical role in predicting student performance. The increased enrolment in the academic program demonstrates the validity of the above-mentioned statements, as it enticed students to pursue astronomy as their scientific career. Other efforts are discussed in detail in this paper.

To evaluate possible alterations of a major determinant of energy expenditure, the resting metabolic rate (RMR), in women with polycystic ovary syndrome (PCOS) compared with age-BMI similar controls. To assess whether the hormonal milieu, the body fat distribution and the insulin metabolism may affect energy consumption in these patients. This is a monocentric observational prospective cohort study, including 109 Caucasian PCOS subjects and 31 healthy control women. (Median age PCOS 26.0 ± 9.2 years, controls 25.5 ± 8.5 years; median BMI-body mass index PCOS 26.4 ± 9.4 kg/m2, controls 27.2 ± 12.8 kg/m2). RMR was evaluated by the SenseWear Armband (SWA), a reliable and validated metabolic holter, never previously used in the PCOS population to this purpose. Hormonal assessment, insulin metabolism evaluated by HOMA-IR and OGTT, anthropometric features (BMI and WHR) were also assessed. Median RMR resulted similar in PCOS and control women: 1520.0 ± 248.00 kcal/day vs 1464.0 ± 332.70 kcal/day (p = 0.472), even after adjusting for BMI, fat distribution, insulin metabolism parameters. RMR resulted significantly correlated with BMI, WHR, estradiol levels, SHBG, total cholesterol, triglycerides, basal glycaemia, basal insulinemia, AUC insulin 240’, and HOMA. In the subgroup of patients with WHR > 0.85, PCOS women showed a significantly lower RMR compared with controls. The higher prevalence of obesity, which negatively influences the reproductive and general health of PCOS women, could be related to factors other than an intrinsic alteration of the RMR. Further studies are needed to clarify the possible role of the visceral fat in modulating the energy balance in PCOS. clinicaltrials.gov Identifier NCT03132545.

Purpose: People living with HIV have higher rates of malignancies than the general population in the era of active antiretroviral therapy (ART). Genotoxic effects of HIV infection and/or ART that can induce neoplastic development are not yet well known. A prospective cohort study to investigate DNA damage measured through the micronuclei (MN) frequency in HIV-patients has been performed. Methods: Peripheral blood mononuclear cells (PBMC) were isolated from 52 HIV-patients treated with ART and 55 healthy controls. Results: By the comparison of MN frequency, a significant difference between HIV-patients (15.5±9.8) and controls (6.0±3.6) (p, Journal of Preventive Medicine and Hygiene, Vol 60 No 3 (2019): 2019603

Fatigue is a common complaint in the civilian population and may be a presenting symptom of more serious physical and mental disorders. Data from the Defense Medical Surveillance System (DMSS) were utilized to characterize the incidence and burden of fatigue in active component military members from 1 January 2007 through 31 December 2016. A subanalysis of 3 years within this surveillance period (2012-2014) was also conducted to assess the burden of comorbidities related to incident fatigue and the strength of the association between fatigue and selected comorbidities. The study identified 211,213 incident cases of fatigue with an overall incidence rate of 18.1 per 1,000 person-years between 2007 and 2016. Mental disorders and musculoskeletal disease accounted for about 35% of all medical encounters and about 40% of all hospital days within a year for those diagnosed with fatigue in 2013. The adjusted odds ratio for fatigue was highest in those with male hypogonadism, thyroid disorder, and sleep problems. These results show that fatigue is a common diagnosis with high incidence and burden among active component U.S. military. By focusing on the conditions that frequently occur and are highly associated with fatigue, more rapid diagnosis and treatment of the underlying cause of service member fatigue is possible.

Objective. To investigate the effect of trans-resveratrol from Polygonum cuspidatum/magnesium hydroxide complex, trademark Revifast®, plus D-chiro-inositol (DCI) and Myo-inositol (MI) during spontaneous pregnancies in overweight patients in a pilot study. Study design. A one-year, prospective, randomized, doubleblinded, placebo-controlled single center clinical study was carried out on overweight pregnant women. 110 patients were randomized in 3 groups to receive: Revifast® with DCI/MI (group I), DCI/MI alone (group II) or control group (group III) for 30 and 60 days. The main outcomes were to explore the lipid profile (total cholesterol, LDL, HDL, TG) and glucose levels, after 30 and 60 days of therapy. Results. No difference in systolic and diastolic parameters among 3 groups during study. All blood chemistry parameters improved compared to placebo at 30 days already, but significantly to 60 days, respect placebo. By comparing the two treatment groups, group I demonstrates significantly improved lipid and glucose parameters than group II, which are at 30 to 60 days of treatment. Conclusion. The supplementation of Trans-resveratrol, Revifast® in addition to DCI/MI in overweight pregnant woman with an elevated fasting glucose improves glucose levels, Total Cholesterol, LDL and TG.

Hemangiopericytomas of the head and neck are rarely found in the parapharyngeal space. We report the case of a 53-year-old woman who presented with a globus sensation in her throat. Imaging detected a left submucosal oropharyngeal mass that extended into the prestyloid parapharyngeal space. The tumor was surgically excised en bloc. Histopathologic examination identified it as a hemangiopericytoma. We discuss the diagnosis and management of this rare entity.

This rejoinder to Patrick Love’s article, “Informal Theory: The Ignored Link in Theory-to-Practice,” which appears earlier in this issue of the Journal of College Student Development , was written at the invitation of the Editor. In the critique, we point out the weaknesses of many of Love’s arguments and propositions. We provide an alternative point of view regarding application of theory in practice and encourage further discourse on the definition and role of informal theory in student affairs practice.

Introduction: Weight loss amongst women with polycystic ovary syndrome (PCOS) is crucial to reduce the risk of endocrine, reproductive and metabolic complications including hirsutism, menstrual disturbances and cardiovascular disease. With approximately 50% of women with PCOS being overweight or obese, effective dietary management of weight in PCOS is essential. However, there is inconsistent evidence as to whether specifically modified diets (e.g. reduced carbohydrate diets) are more effective at achieving weight loss amongst women with PCOS than are conventional healthy hypocaloric diets. Material and Methods: A systematic review and meta-analysis of randomized controlled trials that had compared weight and BMI between women with PCOS who had undergone either a specifically modified diet or a conventional healthy hypocaloric diet were performed. Six electronic databases were searched, a manual search of the reference lists of the included studies was carried out and authors were contacted for additional information. Nine studies with a total of 395 participants (all with a body mass index [BMI] ≥30) were included in the meta-analysis. The effect size used was the mean difference in post-intervention weight and BMI between participants who had undergone a specifically modified diet and participants who had undergone a conventional healthy hypocaloric diet. Results: There were no differences between groups in post-intervention weight (mean difference 1.26, 95% confidence interval (CI) -0.92 to 3.43, p = .26; heterogeneity I2 = 50%, p = .04) or BMI (mean difference 0.15, 95% CI -0.93 to 1.23, p = 0.79; heterogeneity I2 = 44%, p = 0.10). Subgroup analyses according to the presence of a dietary run-in period (a period at the start of the study during which all participants are placed on an identical diet in order to equalize them on variables influenced by diet), intervention duration and type of diet and a sensitivity analysis according to study quality were not significant. Conclusions: Whilst the results should be interpreted in light of the moderate heterogeneity observed, they suggest that specifically modified diets offer no added benefit for weight loss in women with PCOS over conventional healthy hypocaloric diets. The findings of this meta-analysis may promote the unification of guidelines for the dietary management of PCOS and allow clinicians to be confident in prescribing conventional healthy hypocaloric diets for weight loss amongst their PCOS patients.

Student affairs professionals benefit from understanding paradigms, worldviews, and ways of being among diverse faculty, staff, and students. It is challenging to understand core differences of paradigms, design student affairs practice and research in congruence with or across specific philosophies, and work effectively with individuals operating in paradigms different from our own. For most, it is more comfortable to develop practice and research within our worldview, hoping what works for us will work for everyone. This article summarizes, illustrates, and critiques underlying paradigms in research and practice including positivism; feminism and embodied; racialized/border/liminal; critical; cultural; blended perspectives; and constructivism.

The incubation of a solution of the human growth hormone releasing factor analog, [Leu27] hGRF(1-32)NH2 at pH 7.4 and 37 degrees, resulted in extensive degradation of the sample. The major degradation products were identified as the peptides [beta-Asp8, Leu27] hGRF(1-32)NH2 and [alpha-Asp8, Leu27] hGRF(1-32)NH2, produced by deamidation of the Asn8 residue. When tested as growth hormone (GH) secretagogues in cultured bovine anterior pituitary cells, [beta-Asp8, Leu27] hGRF(1-32)NH2 was estimated to be 400-500 times less potent than the parent Asn8 peptide, while [alpha-Asp8, Leu27] hGRF(1-32)NH2 was calculated to be 25 times less potent than the parent Asn8 peptide. Three additional analogs of [Leu27] hGRF(1-32)NH2 containing either Ser or Asn at positions 8 and 28 were prepared and evaluated for their GH releasing activity and stability in aqueous phosphate buffer (pH 7.4, 37 degrees). Based on disappearance kinetics, [Leu27] hGRF(1-32)NH2 had a half-life of 202 h while the other analogs had the following half-lives: [Leu27, Asn28] hGRF(1-32)NH2 (150 h); [Ser8, Leu27, Asn28] hGRF(1-32)NH2 (746 h); and [Ser8, Leu27] hGRF(1-32)NH2 (1550 h). After 14 days, incubated samples of the Asn8 analogs lost GH releasing potency, while the Ser8 analogs retained full potency. The potential for loss of biological activity brought about by deamidation of other engineered peptides and proteins should be considered in their design.

Il presente articolo si pone l'obiettivo di analizzare la Proposta della Commissione europea e l'attuale contesto normativo e operativo. La proposta sul nuovo regolamento per lo sviluppo rurale 2014-2020 conferma l'orientamento della Commissione, chiaramente emerso durante i lavori preparatori, di prevedere nel II Pilastro della Politica Agricola Comunitaria (PAC) risorse dedicate alla gestione dei rischi in agricoltura, incluso quello di reddito. In particolare, la Comunicazione della Commissione del 18 novembre 2010 (1) ha evidenziato, in diversi passaggi, l'esigenza di irrobustire la strumentazione disponibile agli agricoltori europei per fronteggiare un'esposizione ai rischi istituzionali, naturali e di mercato, che nel corso di questi ultimi anni si è progressivamente ampliata.

The effect of vegetation on morphological soil features was examined by characterizing twenty-six sites in southwest Neuquén province, Argentina. Thirteen sites were under native vegetation Nothofagus forest and thirteen under Pinus ponderosa Dougl. Four representative soil profiles were compared, under both conditions, to establish it there were any relationships between vegetation change and soil porosity, soil water retention and soil structure. For each horizon, three samples were plotted for bulk density and three undisturbed samples for water characterization. Hydric constants were determined for disturbed and undisturbed samples. Hydric contents at low tension were made with tension tables, and others with a pressure plate extractor. Total porosity and pore size distribution (macropores and micropores) were determined. A change in soil structure from granular to massive was observed under ponderosa pine at all sites. No significant changes in bulk density and total porosity were detected between the vegetation conditions. The change in soil structure reflected the change in pore size distribution, increasing microporosity and decreasing macroporosity under ponderosa pine., Se caracterizaron veintiséis sitios, trece bajo vegetación nativa de bosque de Nothofagus y trece bajo vegetación implantada con Pinus ponderosa Dougl. para determinar el electo que la vegetación pueda tener sobre las características morfológicas del suelo en el sudoeste de la Provincia del Neuquén, Argentina. En cuatro perfiles representativos se compararon estructura y porosidad bajo esas dos condiciones, para establecer si existe relación entre el tipo de vegetación y la porosidad, la retención hídrica y la estructura. Se tomaron tres muestras por horizonte para densidad aparente y tres muestras no disturbadas para la caracterización hídrica. El contenido de humedad a bajas tensiones se determino en mesas de tensión y las demás con la placa extractora por presión. Se calculó la porosidad total y la distribución por tamaño de poros (macroporos y microporos). Se observó un cambio de estructura en todos los sitios bajo pino ponderosa, pasando de granular a masivo. No se encomió diferencia significativa en la densidad aparente, y la porosidad total se mantuvo bajo las dos condiciones de vegetación. El cambio en la estructura refleja el cambio de la distribución del tamaño de poros, amentando la microporosidad y disminuyendo la macroporosidad bajo pino ponderosa.

In Cupressus sempervirens the association between seed insects and tree pathogens has resulted in optimal exploitation of the cones. A fungus-infected cone can be inhabited by the nymphs of a true seed bug (Orsillus maculatus), the adults of which may carry a heavy spore load at emergence. Cones are infected when eggs are laid within the cone, most frequently via the emergence holes of a seed wasp (Megastigmus wachtli). This symbiotic association evolved with the nonaggressive fungus Pestalotiopsis funerea within the natural range of the cypress. When the aggressive cypress canker disease (Seiridium cardinale) was introduced into Europe, it was transmitted by O. maculatus to cones usually colonized by Pestalotiopsis funerea, with disastrous consequences for the regeneration and survival of C. sempervirens in the entire Mediterranean area.http://link.springer. de/link/service/journals/00114/bibs/9086010/90860479.htm/HEA

In order to evaluate the acute insulin response after i.v. injection of glucagon in polycystic ovary syndrome (PCOS), 35 women affected by PCOS and 11 normo-ovulatory controls underwent a 75 g oral glucose tolerance test (OGTT) and, 2 days later, a glucagon test (1 mg i.v.). Patients were analysed according to their degree of obesity; the insulin release after glucagon injection for lean PCOS subjects and control women was not statistically significantly different. Conversely obese PCOS patients had higher insulin secretion after both i.v. glucagon and OGTT when compared to the other groups. Moreover the insulin secretory patterns were heterogeneously represented in lean and obese PCOS women. When the patients were analysed according to their insulinaemic response to OGTT, normo-insulinaemic PCOS women and control subjects had a similar insulin response to i.v. glucagon whereas the hyper-insulinaemic PCOS group had a higher insulin response (P < 0.0001). Moreover, a highly significant relationship was found between the insulin response to OGTT and to glucagon administration in the PCOS population (P < 0.0001; r = 0.73), which was maintained also after controlling for obesity. Our results are consistent with the hypothesis that PCOS patients could have an insulin hyper-response to glucagon administration, that is partially independent from obesity and related to their insulinaemic status. Moreover, the glucagon test could represent an effective alternative to OGTT in screening insulin disorders of PCOS patients (at least in the absence of other risk factors), due to its reliability, simplicity, and speed of performance.

Hyperinsulinemia secondary to a poorly characterized disorder of insulin action is a feature of polycystic ovarian disease (PCOD). On the other hand, being generally admitted that opioids may play a role in glycoregulation and that opioid tone is altered in PCOD, an involvement of the opioids in determining the hyperinsulinemia of PCOD patients could be suggested. The aim of this study was to evaluate the effect of a chronic opioid blockade on insulin metabolism and peripheral insulin sensitivity in PCOD hyperinsulinemic patients. Twenty-three women with PCOD were studied. An oral glucose tolerance test (OGTT) and a clamp study were performed at baseline (during the follicular phase) and after 6 weeks of naltrexone administration (50 mg/d orally). Based on the insulinemic response to the OGTT, 16 women were classified as hyperinsulinemic and seven as normoinsulinemic. Naltrexone treatment significantly reduced fasting (P < .05) and area under the curve (AUC) (P < .02) plasma insulin levels only in the hyperinsulinemic group. Moreover, hyperinsulinemic patients showed similar C-peptide incremental areas after naltrexone treatment, whereas in the same patients the fractional hepatic insulin extraction calculated from the incremental areas of insulin and C-peptide was found to be increased after chronic opioid blockade by naltrexone. For peripheral insulin sensitivity, the hyperinsulinemic group showed significantly lower (P < .01) total-body glucose utilization (M) compared with the normoinsulinemic group. No change in the M value was found after treatment in both groups. These data suggest that the insulin sensitivity and hyperinsulinemia after an OGTT are two distinct deranged features of the insulin disorder of PCOD patients.

There are many individuals who work within the court system. Judges, attorneys, administrative staff, security personnel, and counselors are just a few. This entry will explore some of the most popular positions and careers within the court system. These positions can be everything from entry-level positions to positions requiring some type of very specialized graduate education and/or experience. Keywords: court; education; justice; law

There are many careers in forensic science available to fit almost any interest one may have. With proper schooling and training, one can become a medical examiner, forensic pathologist, forensic odontologist, or forensic nurse, to name a few. Many forensic scientists will testify in court during their careers. Forensic scientists are oftentimes the voice of the victim, when the victim may no longer be able to communicate with the world. Keywords: cause and effect; criminal law; DNA; evidence; forensics

The relationship between insulinaemia and obesity and glucose tolerance and the impact of pregnancy as risk factor for carbohydrate abnormalities were investigated in 91 consecutive patients with polycystic ovary syndrome (PCOS) aged 26-32 years. Fifteen normoglycaemic patients became pregnant within 6 months of the pregestational study using pharmacological induction of ovulation. Plasma concentrations of insulin and glucose after an oral glucose tolerance test (OGTT) were determined by immunoradiometric assay and glucose oxidase technique respectively. OGTT patients were classified according to their response as normoinsulinaemic (n = 46) or hyperinsulinaemic (n = 45). Impairment of glucose metabolism occurred in 12.1% (n = 11, 10 obese and one lean) of all PCOS subjects. Based on insulin secretion, 6.5% of normoinsulinaemic and 13.3% of hyperinsulinaemic patients had an impaired glucose tolerance and 2.3 and 2.2% respectively a non-insulin-dependent diabetes mellitus. Obese patients had higher values for area under the curve for insulin response to OGTT (I-AUC values) than lean patients, and the percentage above ideal body weight was greater in hyperinsulinaemic than in normoinsulinaemic patients. All hyperinsulinaemic (7/15) subjects who became pregnant developed an impairment of glucose metabolism during pregnancy. It is concluded that the PCOS population was at higher risk of developing carbohydrate abnormalities than the normal population of a similar reproductive age. Furthermore, those with abnormal insulin secretion at the pregestational stage may, during pregnancy, develop an impaired gestational glucose tolerance or gestational diabetes.

The potential role of nitric oxide (NO) was investigated in the pathophysiology of liver injury after priming with 20 min hepatic ischemia-reperfusion and administration of .5 mg/kg Salmonella enteritidis endotoxin. Liver injury during the early reperfusion phase of 4 h was characterized by severe vascular oxidant stress, lipid peroxidation (LPO), neutrophil infiltration, and a 33% reduction of the microvascular blood flow in the liver. Inhibition of NO synthesis with N omega-nitro-L-arginine methyl ester hydrochloride (L-NAME) aggravated liver injury by 90%, reduced LPO, and did not affect liver neutrophils but further impaired microvascular blood flow. Treatment with the NO-donor spermine-NONOate or L-arginine did not affect these parameters in postischemic animals, however, treatment did restore all values of L-NAME-treated animals back to disease control levels. These data suggest that endogenous NO formation is sufficient to limit ischemic liver injury during reperfusion but inhibition of NO synthesis will result in additional ischemic damage. NO may also be involved in scavenging of superoxide in the vasculature and in inducing LPO.