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Background: Clinical thermography is a relatively novel technique in wide use in different medical fields because of its versatility and ease of application. It inflicts no pain and entails no contact with the pediatric patient, which assuages anxiety and fear in patients when undergoing diagnostic exploration. The use of infrared clinical thermography being suggested herein is to establish normality patterns, which have not been described in the relevant literature. These patterns may be extrapolated to pathologic study by means of future research lines., Methods: An observational, cross-sectional study (descriptive in nature) was performed with a sample population of 328 children divided into two age groups: 6 to 7 years and 13 to 16 years, all of them schooled in the province of Cáceres in Spain. The variables analyzed herein were age, sex, and temperature. A thermographic camera was used to study foot temperature., Results: Results show that the temperature varies among the different study areas established for the foot, although they remain constant bilaterally. In addition, the highest temperature was found in the area of the first metatarsal head (29.8°C), and the lowest at the heel (28.8°C)., Conclusions: It can be concluded that both feet have the same thermal behavior despite the variation in temperature among the different areas that were established in the foot for the purposes of this study.

Objective: The evaluation and treatment of perinatal testicular torsion is controversial. We performed a survey to assess practice patterns among pediatric urologists regarding treatment of perinatal torsion., Methods: An internet survey was administered to members of two pediatric urology societies. Cases of prenatal, postnatal and bilateral prenatal torsion were outlined. Respondents were asked about use of ultrasound, timing of surgery, incision, and management of the contralateral testicle. A case with a non-palpable testicle and blind ending vessels was also presented., Results: We had 121 respondents. In a neonate with prenatal torsion, 34% percent would operate immediately, 26% urgently within 72 h, 28% electively and 12% would not explore; 93% would perform a contralateral orchiopexy. In a neonate with postnatal torsion, 93% would operate immediately, 5% urgently, 1% electively and 1% would not explore; 96% would perform a contralateral orchiopexy. In both cases, 75% would use a scrotal incision and 25% would use an inguinal incision. When presented with bilateral prenatal torsion, 90% would operate immediately, 1% urgently, 2% electively and 7% would not operate. In the case of a non-palpable testicle with blind ending vessels 28% would perform a contralateral orchiopexy, 12% would explore the ipsilateral canal for a "nubbin", 56% would perform no intervention and 4% would perform some other form of management., Conclusion: We documented variability of timing for intervention of prenatal torsion and confirmed that most view postnatal torsion as a surgical emergency. Most perform a contralateral orchiopexy for prenatal torsion despite the fact that most cases are extravaginal. The surgical approach via a scrotal incision appears to be preferred at this time., (Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Tissue engineering strategies have shown promise for the repair of damaged organs, including bone. One of the major challenges associated with tissue engineering is how to scale up such processes for high throughput manufacturing of biomaterial scaffolds used to support stem cell culture. Generation of certain types of 3D biomaterial scaffolds, including chitosan-calcium phosphate blends, involves a slow fabrication process followed by a lengthy required freeze drying step. This work investigates the use of automated microwave vacuum drying technology as an alternative to traditional freeze drying as a method of fabricating chitosan-calcium phosphate scaffolds for supporting embryonic stem cell cultures. Scaffolds produced using both drying techniques possess similar properties when characterized using scanning electron microscopy and this paper is the first to report that both types of these scaffolds support undifferentiated embryonic stem cell culture as well as promote stem cell differentiation into osteogenic lineages when treated with the appropriate factors. Compared to existing scaffold manufacturing processes using freeze drying, the use of microwave vacuum drying will lead to faster production times while reducing the costs, enabling high-throughput manufacturing of biomaterial scaffolds for stem cell applications.

Rice (Oryza sativa) takes up arsenite mainly through the silicic acid transport pathway. Understanding the uptake and sequestration of arsenic (As) into the rice plant is important for developing strategies to reduce As concentration in rice grain. In this study, the cellular and subcellular distributions of As and silicon (Si) in rice roots were investigated using high-pressure freezing, high-resolution secondary ion mass spectrometry, and transmission electron microscopy. Rice plants, both the lsi2 mutant lacking the Si/arsenite efflux transporter Lsi2 and its wild-type cultivar, with or without an iron plaque, were treated with arsenate or arsenite. The formation of iron plaque on the root surface resulted in strong accumulation of As and phosphorous on the epidermis. The lsi2 mutant showed stronger As accumulation in the endodermal vacuoles, where the Lsi2 transporter is located in the plasma membranes, than the wild-type line. As also accumulated in the vacuoles of some xylem parenchyma cells and in some pericycle cells, particularly in the wild-type mature root zone. Vacuolar accumulation of As is associated with sulfur, suggesting that As may be stored as arsenite-phytochelatin complexes. Si was localized in the cell walls of the endodermal cells with little apparent effect of the Lsi2 mutation on its distribution. This study reveals the vacuolar sequestration of As in rice roots and contrasting patterns of As and Si subcellular localization, despite both being transported across the plasma membranes by the same transporters.

By combining the capabilities of advanced sample preparation methodologies with the latest generation of secondary ion mass spectrometry instrumentation, we show that chemical information on the distribution of even dilute species in biological samples can be obtained with spatial resolutions of better than 100 nm. Here, we show the distribution of nickel and other elements in leaf tissue of the nickel hyperaccumulator plant Alyssum lesbiacum prepared by high-pressure freezing and freeze substitution., (© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.)

During hair coloring a number of disulfide bonds in cystine are oxidized (1) to create cysteic acid, forming binding sites for metal ions such as Ca(2+ )and Cu(2+ )from tap water (2). The increased uptake of these metals can have a detrimental impact on fiber properties-for example, reducing shine and causing a poor wet and dry feel (3). In addition, the increased uptake of copper can also contribute to further fiber damage during subsequent coloring due to its ability to take part in metal-induced radical chemistry (4). It is important to know where in the fibers these metals are located in order to either effectively remove these metals or control their chemistry. Nanoscale secondary ion mass spectrometry (NanoSIMS) has been used to locate the calcium and copper within hair that has been treated with a colorant and washed multiple times in tap water containing these ions. Untreated hair is used as a baseline standard material. Images with up to 50-nm spatial resolution of the preferential locations of calcium uptake were obtained, showing a high concentration of calcium in the cuticle region of colored hair, specifically in the sulfur-rich regions (A-layer and exocuticle).

Nasal symptoms of allergic rhinitis are an important cause of sleep disturbance. Reduction of nasal symptoms, particularly nasal obstruction, has been linked to improvements in self-reported sleep quality. The enhanced-affinity intranasal corticosteroid fluticasone furoate and the oral antihistamine fexofenadine were compared with respect to nighttime symptoms of seasonal allergic rhinitis. In two randomized, double-blind, double-dummy, parallel-group studies, patients received fluticasone furoate nasal spray (FFNS),110 microg (study 1, n = 312; study 2, n = 224); fexofenadine, 180 mg (study 1, n = 311; study 2, n = 227); or placebo (study 1, n = 313; study 2, n = 229) once daily for 2 weeks. Fluticasone furoate was more effective (p < 0.001) than fexofenadine and placebo in both studies with respect to the mean changes from baseline over the treatment period in the nighttime symptoms score, nighttime reflective total nasal symptom score, predose instantaneous nasal symptom score, and morning peak nasal inspiratory flow. Fluticasone furoate was more effective than placebo (p

Efficacy and safety of fluticasone furoate nasal spray, administered using a unique side-actuated device, were evaluated in patients > or =12 years of age with seasonal allergic rhinitis to determine the optimal dose. A randomized, double-blind, parallel-group, placebo-controlled, dose-ranging study was performed on 641 patients who received placebo (n=128) or fluticasone furoate, 55 microg (n=127), 110 microg (n=127), 220 microg (n=129), or 440 microg (n=130), once daily for 2 weeks. Fluticasone furoate was significantly more effective than placebo for mean changes from baseline over the 2-week treatment period in daily reflective total nasal symptom score (primary end point; p < 0.001 each dose vs. placebo), morning predose instantaneous total nasal symptom score (p < 0.001 each dose versus placebo), daily reflective total ocular symptom score (p < or = 0.013 each dose versus placebo), and morning predose instantaneous total ocular symptom score (p < or = 0.019 for three highest doses versus placebo). The onset of action for fluticasone furoate nasal spray versus placebo was observed 8 hours after the first. dose of study medication in the 110 and 440 microg treatment groups (p < or = 0.032). The incidence of adverse events, results of clinical laboratory tests, and changes in 24-hour urinary cortisol values were similar between active treatment groups and placebo. The preliminary profile of fluticasone furoate is that of a rapidly effective therapy that confers 24-hour efficacy for both nasal and ocular symptoms with once-daily dosing. The 110-microg dose was chosen for phase III development because it achieved statistically significant and clinically meaningful results for all efficacy end points and provided the optimal risk-benefit ratio.

Background: Few studies have directly compared the efficacy of intranasal corticosteroids with that of leukotriene receptor antagonists for the treatment of daytime and nighttime symptoms of seasonal allergic rhinitis (SAR)., Objective: To compare fluticasone propionate aqueous nasal spray, 200 microg daily, with oral montelukast, 10 mg daily, for the relief of SAR symptoms., Methods: Patients with SAR 15 years or older were randomized to receive either fluticasone propionate (n = 367) or montelukast (n = 369) in this double-blind, double-dummy, parallel-group study. The primary efficacy measure was the mean change from baseline in daytime total nasal symptom scores (TNSSs) (the sum of 4 daytime individual nasal symptom scores [INSSs] assessing nasal congestion, itching, rhinorrhea, and sneezing), averaged across weeks 1 and 2. Secondary efficacy measures included the 4 daytime INSSs, nighttime TNSSs (the sum of 3 nighttime INSSs assessing congestion on awakening, difficulty going to sleep, and nighttime awakenings), and the 3 nighttime INSSs averaged across weeks 1 and 2., Results: Mean changes from baseline in daytime TNSSs (P < .001), all daytime INSSs (P < .001), nighttime TNSSs (P < .001), and all nighttime INSSs (P < or = .02) showed significant differences favoring fluticasone propionate over montelukast across 2 weeks of treatment., Conclusion: Compared with montelukast, fluticasone propionate provided significantly greater improvement in daytime and nighttime SAR symptoms.

Background/purpose: Since the discovery of the cystic fibrosis transmembrane regulator (CFTR) gene, cystic fibrosis has been an attractive target for gene therapy. Postnatal gene transfer in the respiratory epithelium has been difficult and particularly inefficient in the submucosal gland cells, the target cells for CFTR gene transfer. The authors hypothesized that during development, there is a favorable environment for fetal gene therapy with fewer physical barriers to efficient gene transfer and more accessible epithelial and submucosal gland precursor cells. The authors tested this hypothesis in a novel human fetal tracheal organ culture system using a serotype 2 recombinant AAV that contains an enhanced green fluorescent protein (eGFP) reporter gene (AAV-CMV-eGFP)., Methods: Human fetal tracheas at between 16 and 20 weeks' gestation age were used in this study. The distal end of each trachea was ligated and secured in an upright position with the open proximal end facing up. Only the ante-lumenal surface was exposed to culture media. 5 x 10(9) particles of AAV-CMV-eGFP were administered intratracheally through the open end. Fetal tracheas were maintained in tracheal organ culture media and harvested at either 2 weeks (n = 3) or 4 weeks (n = 7) after injection. The fetal tracheas were processed for routine H&E, standard electron microscopy (EM), and fluorescence microscopy for analysis of eGFP transgene expression., Results: Histology confirmed the preservation of structural integrity out to 4 weeks of fetal tracheal organ culture. EM showed intact tight junctions of the apical respiratory epithelium. At 2 weeks after AAV-CMV-eGFP injection, there was minimal transgene expression. However, at 4 weeks there was extensive transgene expression in not only the respiratory surface epithelium but also the submucosal gland cells of the human fetal tracheal organ culture. Transgene expression was seen in nearly all cells in the submucosal glands., Conclusions: AAV-mediated gene transfer in human fetal tracheal organ culture was highly efficient with excellent transgene expression at 4 weeks in both respiratory surface epithelium and submucosal gland cells. This highly efficient gene transfer may result from fewer physical barriers and more accessible target precursor cells. These results are consistent with more efficient gene transfer in fetal tracheobronchial epithelium and show the potential for fetal gene therapy using AAV for the treatment of congenital airway disease such as cystic fibrosis., (Copyright 2002, Elsevier Science (USA). All rights reserved.)

Contact dermatitis is a common condition that can be categorized as irritant dermatitis and allergic contact dermatitis. Although each of these conditions may have a similar presentation, allergic contact dermatitis is immunologically mediated, whereas irritant contact dermatitis is not. Contact dermatitis can be acute, subacute, or chronic, and each of these phases may progress into the next. Almost any substance may induce a cutaneous reaction, depending on its concentration, the duration of contact, and the condition of the contacted skin. It is estimated that there are more than 6 million chemicals in the environment; approximately 3000 are potential sensitizers. A careful history may identify the responsible agent. If the contactant is identified and eliminated, the contact dermatitis can be a self-limited, mild condition. If the exposure is not discontinued, a cycle of itching, scratching, and skin disruption occurs, which leads to chronic changes in the skin. The history of presentation, including occupational exposures, and distribution of the rash are important in identifying the offending agent. More severe cases may require more extensive evaluation, possibly including patch testing, to determine the offending agent. This article reviews treatment, including antihistamines, topical and oral steroids, physical measures such as cold water compresses, and the treatment of secondary infection.

This multicenter, double-blind, placebo-controlled trial evaluated the efficacy and safety of levocabastine nasal spray, a potent and selective H1-receptor antagonist, in the control of histamine-mediated symptoms of seasonal allergic rhinitis. Adults with > or = 2 year history of allergic rhinitis due to Mountain Cedar were randomized to treatment with levocabastine nasal spray (0.2 mg twice daily) or placebo for 28 days during the 1994-1995 Mountain Cedar allergy season. Patients assessed the severity of their rhinitis symptoms on a four-point scale twice daily. At the end of the trial, patients also performed a global evaluation of treatment efficacy on a five-point scale. Overall for the 4-week treatment period, levocabastine nasal spray significantly reduced major nasal (runny nose and sneezing) and primary rhinitis (runny nose, sneezing, and itchy/gritty eyes) symptoms compared with placebo on both repeated measures (p = 0.023; p = 0.01) and ANOVA (p = 0.003; p < 0.001) analyses. Global evaluations of treatment efficacy at the end of the trial significantly favored levocabastine over placebo (p = 0.002). Overall, the incidence of adverse events was similar for both treatment groups. In general, most adverse events were mild in intensity, with sinusitis (17% each group), headache (17% placebo, 14% levocabastine), and rhinitis (8% placebo, 2% levocabastine) most commonly reported. Levocabastine nasal spray 0.2 mg twice daily was significantly more effective than placebo in the relief of histamine-mediated symptoms in patients with seasonal allergic rhinitis and was well tolerated over the 28-day treatment period.

Normal human diploid fibroblasts have a finite replicative lifespan in vitro, which has been postulated to be a cellular manifestation of aging in vivo. Several studies have shown an inverse relationship between donor age and fibroblast culture replicative lifespan; however, in all cases, the correlation was weak, and, with few exceptions, the health status of the donors was unknown. We have determined the replicative lifespans of 124 skin fibroblast cell lines established from donors of different ages as part of the Baltimore Longitudinal Study of Aging. All of the donors were medically examined and were declared "healthy," according to Baltimore Longitudinal Study of Aging protocols, at the time the biopsies were taken. Both long- and short-lived cell lines were observed in all age groups, but no significant correlation between the proliferative potential of the cell lines and donor age was found. A comparison of multiple cell lines established from the same donors at different ages also failed to reveal any significant trends between proliferative potential and donor age. The rate of [3H]thymidine incorporation and the initial rates of growth during the first few subcultivations were examined in a subset of cell lines and were found to be significantly greater in fetal lines than in postnatal lines. Cell lines established from adults did not vary significantly either in initial growth rate or in [3H]thymidine incorporation. These results clearly indicate that, if health status and biopsy conditions are controlled, the replicative lifespan of fibroblasts in culture does not correlate with donor age.

Background: Intranasal corticosteroids and oral antihistamines are both effective in the treatment of seasonal allergic rhinitis, although the therapeutic value of administering the two types of agents concurrently has rarely been evaluated. This study was designed to compared the efficacy, safety, and impact on quality of life of fluticasone propionate aqueous nasal spray (FP ANS), loratadine, FP ANS plus loratadine, and placebo (an aqueous nasal spray plus tablet) in the treatment of seasonal allergic rhinitis during the mountain cedar allergy season in south central Texas., Methods: Six hundred patients with seasonal allergic rhinitis were treated for 2 weeks with either FP ANS 200 microgram once daily, loratadine 10 mg once daily, the FP ANS and loratadine regimens combined, or placebo in a multicenter, randomized, double-blind, double-dummy, parallel-group study., Results: Clinician- and patient-rated total and individual nasal symptom scores after 7 and 14 days of therapy and overall evaluations were significantly lower (P < .001) in the FP ANS and FP ANS plus loratadine groups compared with the loratadine only and placebo groups. Loratadine was not statistically different from placebo in clinician and patient symptom score ratings nor in overall clinician and patient evaluations. FP ANS plus loratadine and FP ANS monotherapy were comparable in efficacy in almost all evaluations; for some patient-rated symptoms the combination was found superior. Mean score changes in the Rhinoconjunctivitis Quality of Life Questionnaire from baseline to day 14 showed significantly greater improvement (P < .001) in quality of life in the FP ANS group than in the group of patients receiving loratadine only or placebo and no significant benefit was demonstrated in the FP ANS plus loratadine group over the FP ANS monotherapy group. No serious or unusual drug-related adverse events were reported. Combining loratadine with FP ANS did not alter the adverse events profile or frequency.

Senescent human diploid fibroblasts have an undefined arrest state partially characterized by the differential expression of cell cycle-regulated genes and a failure to complete the mitogen-stimulated cascade of signalling events that lead to DNA synthesis. We present evidence that this arrest state precludes the entry of senescent fibroblasts into a normally reversible G0 or quiescent state. Both nuclear association kinetics and quinacrine dihydrochloride nuclear fluorescence show chromatin condensation patterns consistent with arrest in late G1 and exclusion of senescent cells from the G0 phase of the cell cycle. Steady-state thymidine kinase mRNA levels indicate that some of the signalling cascades initiated from a functional G0 state may be intact in senescent cells, at least qualitatively, and that this expression may represent an abortive attempt to complete pathways required for DNA replication. Taken together, the evidence suggests that growth arrest in senescent cells likely occurs in a physiologic state fundamentally distinct from that of the G0, quiescent state that is achieved by nonproliferating young cells. A full response to serum or growth factor addition, leading from quiescence to DNA synthesis, may require cells to initiate this traverse from a true G0 state. If so, senescent cells would be excluded from this pathway.

Fluticasone propionate aqueous nasal spray is an intranasal corticosteroid for the treatment of patients with allergic rhinitis. This double-masked, double-dummy, parallel-group study was conducted to confirm that the efficacy of fluticasone propionate nasal spray is attributable to topical rather than systemic effects. A total of 304 patients with documented seasonal allergic rhinitis were randomly assigned to receive fluticasone propionate nasal spray 200 micrograms once daily (n = 77), oral fluticasone propionate 5 mg once daily (n = 73), oral fluticasone propionate 10 mg once daily (n = 77), or placebo (n = 77) for 14 days. Plasma fluticasone propionate concentrations were determined at baseline and after 14 days of treatment (day 15). Nasal symptoms were recorded daily by patients and assessed weekly by clinicians. On day 15, more patients in the oral fluticasone propionate 5-mg or 10-mg groups, compared with patients in the fluticasone propionate nasal spray group or the placebo group, had detectable plasma fluticasone propionate concentrations, and mean concentrations were higher in the oral fluticasone propionate groups. Both clinician- and patient-rated total and individual nasal symptom scores for obstruction, rhinorrhea, sneezing, and itching were significantly lower in the fluticasone propionate nasal spray group compared with either of the oral fluticasone propionate groups or the placebo group. With few exceptions, oral fluticasone propionate (5 mg or 10 mg) was not significantly different from placebo on any measures of efficacy. These findings indicate that the efficacy of fluticasone propionate nasal spray (200 micrograms once daily) in the treatment of allergic rhinitis results from direct topical effects rather than from indirect effects after systemic absorption.

Background: We compared the efficacy and tolerability of the intranasal corticosteroid fluticasone propionate with that of the antihistamine terfenadine in patients with seasonal allergic rhinitis., Methods: Two hundred thirty-two adults and adolescents with seasonal allergic rhinitis received intranasal fluticasone propionate (200 micrograms once daily), terfenadine tablets (60 mg twice daily), or placebo for 2 weeks in a double-blind, randomized, parallel-group study. Main outcome measures were clinician- and patient-rated individual and total nasal symptom scores (based on ratings of nasal obstruction, sneezing, nasal itching, and rhinorrhea); clinician-rated overall response to therapy; changes in nasal inflammatory cell counts; adverse events; and morning plasma cortisol concentrations., Results: Both clinician- and patient-rated total and individual nasal symptom scores were significantly lower in the fluticasone group than in either the terfenadine group or the placebo group at nearly every measured time point throughout the treatment period. After 2 weeks of therapy, clinician-rated total nasal symptom scores decreased by 49% in the fluticasone group compared with 27% in the terfenadine group and 19% in the placebo group. In general, therapy with terfenadine was not statistically distinguishable from that with placebo based on patient-rated total or individual nasal symptom scores. According to clinician ratings, 64% of fluticasone-treated patients compared with 49% and 44% of patients treated with terfenadine and placebo, respectively, experienced significant or moderate improvement. A greater percentage of fluticasone-treated patients compared with either terfenadine- or placebo-treated patients experienced reductions in intranasal eosinophil and basophil counts after 2 weeks of therapy. No unusual or serious drug-related adverse events were reported. Morning plasma cortisol concentrations after 2 weeks of therapy did not differ among groups., Conclusion: Fluticasone aqueous nasal spray, a well-tolerated corticosteroid preparation that can be administered once daily, is more effective than terfenadine tablets or placebo in controlling symptoms of seasonal allergic rhinitis.

A spectral technique for effectively and accurately measuring acoustic attenuation over a wide frequency range is reported. The spectral technique for phase measurement developed by W. Sachse and Y.H. Pao (1978) was used to determine the acoustic dispersion. For acoustic waves, a very simple and useful Kramers-Kronig relationship was previously derived by M. O'Donnell, E.T. Jaynes, and J.G. Miller (1981). The attenuation was calculated, using this relationship, from the measured dispersion and then compared with the attenuation that was measured independently. Dispersion was deduced from the measured attenuation and compared with the measured dispersion. The results of two highly attenuative specimens are presented. The agreement between the calculated attenuation and measured attenuation is excellent. The deduced dispersion also agrees well with the measured one. This agreement verifies the simple Kramers-Kronig relationship used. It further shows the accuracy of the spectral techniques for attenuation and dispersion measurements over a wide frequency range.

The effect of prolonged exposure to either positive or negative small air ions was studied in nine patients with bronchial asthma, of whom seven had reported increased respiratory symptoms in association with weather changes. On consecutive days, while grounded, patients were exposed for six hours to approximately 10,000/cc of either positive or negative ions. Pulmonary function, pulse and blood pressure were measured throughout the exposure. Questionnaires to assess emotional state and physical symptoms were completed after 15 minutes and five hours each day. Urinary 5-hydroxy indoleacetic acid (5HIAA) excretion was measured. Patients were continued on theophylline but adrenergics and corticosteroids were withheld. No patient experienced an exacerbation of asthma. Symptoms, pulmonary function, pulse and blood pressure, urinary 5HIAA excretion and the response to the questionnaires did not differ significantly between the two ion exposures. Thus moderately long exposure to positive or negative small air ions did not influence the clinical condition of these patients, many of whom reported exacerbations with weather changes. The findings do not support a significant role of small air ions in exacerbations or treatment of bronchial asthma.

The distribution and structure of the ureteric nerves in a small series of mammals was compared with that previously demonstrated in the rat. There was marked interspecies variation in the extent to which the nerves penetrated the wall of the ureter and in the degree of development of the deep submucous plexus. In animals with a highly developed deep submucous plexus, terminal arterioles frequently passed through the muscle coat before breaking up into capillaries. These vessels were surrounded by a fine periarteriolar plexus and were accompanied in their course through the muscle coat by one or more branches of the adventitial nerves. Intramuscular nerves not related to arterioles contained few axons with terminals classifiable as either adrenergic or cholinergic, and in animals in which the muscle cells were arranged in fascicles rather than in sheets, the nerves were typically interfascicular in position. As in the rat, only the periarteriolar plexuses contained large numbers of adrenergic axons. Cholinergic axons were generally few, but were not uncommon in the deep submucous plexus when this was well-developed. The majority of the terminals encountered in the intramural nerves contained variable and usually small numbers of both clear and large dense-cored vesicles. The relationship between these terminals and those defined in the submucous nerves of the rat ureter was discussed and it was suggested that the marked variations in the diameter of the axons in the terminal areas and in the number of vesicles in the terminals were related to the effects of the mechanical and other derangements which occur during processing.

This article presents an approach to total documentation of clinical laboratory methods that is practical and comprehensive. Primary reference documents including the bench method, all aspects of instrumentation, calibration, quality control, safety, results, and reporting conventions and back-up research data are entered into a matrix by section. This system has proved to be of great utility particularly in meeting regulatory demands and for the use and orientation of staff technologists.

In these difficult times we must not lose the sense of purpose and the personal drive that makes it possible to achieve excellence. We can be exasperated with reduced funding, burdened with excuses, debilitated with confusion about budgetary cuts, and even be stubborn about alternatives, but we must be serious about excellence and quality. It is natural that during these times we will face those with conflicting views, negative ideas, and erratic long-term goals, but that in itself should rouse us, as professionals, toward the pursuit of quality health care services. With better scheduling of tests and procedure, improved discharge planning, more careful review of the need for patient hospitalization, and a more careful examination of the number, mix, and quality of services furnished during a patient's hospital stay, we, as a health care team, can and will reduce unnecessary utilization of all services. Well-managed laboratories must operate around a return on investment threshold, from which all products, services, and expenditures are ranked. On this basis, management decisions will be made to add to service, reduce service, improve or sustain quality, change technology, or discontinue the business altogether. Given the mandate embodied in the DRG regulations, laboratories have become cost centers. New ideas, new technology, and creative efforts must now be used to improve laboratory productivity while sustaining quality health care services. It is argued philosophically that the DRGs or other major measures to reduce funding adversely affect quality of service. This may be true under the traditional definition of services, but there must be "a new order of things." Today's complex problems indicate that orthodox solutions no longer apply, and in our quest to answer who should pay versus who should receive, and how much is enough, we must ensure quality of all services offered. This new order of doing things could result in far greater savings than has previously been predicted. The patient's length of stay in the hospital has already been reduced. There will continue to be decreases in laboratory utilization and consumption of resources necessary to provide laboratory services. Cost competitiveness coupled with the laboratory's need for increased productivity will further expand savings. To summarize, the laboratory manager in the mid-1980's will have the following goals. To provide quality, cost-efficient, and timely laboratory services. To sustain and nurture the growth of the clinical laboratory profession as dictated by the needs of society and new scientific trends and discoveries.(ABSTRACT TRUNCATED AT 400 WORDS)

The fine structure and distribution of the nerves in the submucosa of the middle part of the ureter were studied in the adult rat. As in the rabbit, the nerves were concentrated on the inner surface of the muscle and beneath the epithelium. The nerves beneath the epithelium were smaller than those on the surface of the muscle, but they were much more numerous. They gave off small branches which ran for only short distances in the subepithelial connective tissue before terminating. Axonal varicosities were common and almost all appeared to represent the terminals of a single type of axon. The varicosities contained clusters of clear vesicles and variable numbers of larger dense-cored vesicles. The dense-cored vesicles were unaffected by short-term treatment with 6-OHDA and in this and other respects compared well with those of the terminals classified by Burnstock (1972) as purinergic. The possibility that the axons are sensory, and are the source of impulses which are recognized as being painful in nature, is discussed.

Mammalian Schwann cells in rat, rabbit and human fetal nerves were studied using several cryoprotective agents for electron microscopic study of freeze-fracture replicas. The findings in fixed and unfixed tissue reveal surface plasmalemma caveolar specializations and the outer layer membrane junctional complexes found in non-mammalian species. The plasmalemma also reveals a complex arrangement of contours outlining cytoplasmic channel networks distinct from the long-recognized Schmidt-Lanterman incisures and paranodal cytoplasmic loops. A specialized interconnected channel system in the outer "loose" myelin layer displays relatively uniform dimensions comparable in diameter to nodal microvilli, paranodal loops and some incisures. An adaxonal tubular channel system constituting the "axon-Schwann network" is found in the internodal region in addition to other variants of the adaxonal Schwann plasmalemma. The several forms of sequestration of Schwann cell cytoplasm presumably underlie the specialized needs of cytoplasmic continuity in a dynamic functional entity in which large domains of cytoplasm have been displaced by the formation of compact myelin.

The development of skin lesions in patients with dermatitis herpetiformis after the withdrawal of their dapsone therapy was studied with the electron microscope. In control biopsies from patients prior to cessation of treatment, membrane-bound vacuoles were found beneath the basal lamina of the epidermis as previously described. After dapsone withdrawal, there was an apparent increase in the number of vacuoles and occasionally several vacuoles appeared to have coalesced forming an early blister. At this stage, the basal lamina and associated hemidesmosomes were normal although in places there were small discontinuities in the basal lamina. Where the reaction was more intense, vacuoles and cells, mainly eosinophils, were embedded in fibrin de posits. Above this, the basal lamina was usually disrupted with involvement of the basal epidermal cells. These results suggest that the vacuoles do play a part in the formation of the pathological lesion in dermatitis herpetiformis. In addition, the basal lamina is shown to be only secondarily involved. The nature of the vacuoles has still to be elucidated.