Man, nutrition and mobility: a comparison of teeth and bone from the Medieval era and the present from Pb and Sr isotopes

Naturally occurring isotopic systems, such as strontium (Sr) and lead (Pb), are very useful for characterizing different sources and to produce background information. Norwegian teeth from the Medieval era have 206Pb/204Pb ratios between 18.8 and 18.2, in comparison with present day ratios of between 18.0 and 17.6 showing the impact of Pb from modern industrialization and from traffic. Sr analyses of Medieval teeth show that an individual living in a coastal town on the west coast of Norway can easily be distinguished from one in a rural area at that time. The Sr signature shows that Medieval people lived on local products while present people to a greater degree live on imported or domestic industrially processed food. Medieval and modern teeth from one site give similar Pb signatures and concentrations indicating no increase in pollution over time. However, the impact of industrial pollution can be seen from Pb analyses on contemporary teeth, so that the method can be used to monitor emission of heavy metals from local industry. Whilst the Pb and Sr natural isotopic systems individually provide valuable information, a combination of the two techniques is a very powerful tool in environmental and archaeological research.     

Average charges for cholecystectomies in the United States, 1996

During 1996 average total charge for an in-hospital laparoscopic cholecystectomy (LC) was $13,940 and $15,380 for an open cholecystectomy (OC). Per diem charges averaged $4,130 for the LCs and $2,510 for the OCs. Among the 18 study states, Florida, Illinois and California each had total in-hospital LC charges more than 20 percent above the average, whereas North Carolina and Ohio reported charges 26 and 20 percent lower. Average length of stay for an LC was 3.37 days and ranged from 4.14 days in Tennessee to 2.51 days in Connecticut. The hospital portion of the total charge averaged 70 percent but ranged from 52 percent in New York to 78 percent in Arizona. The doctors' charges in New York and New Jersey were 39 and 26 percent, respectively, higher than the U.S. average of $4,120. Those in Michigan and Arizona were 29 and 20 percent, respectively, below the norm. The hospital and physician total charge for an OC was the highest in Florida and California, 40 percent above the U.S. average, and lowest in Tennessee, Missouri and Virginia, 32 to 24 percent below. The hospital stay for an open cholecystectomy averaged 6.12 days but varied from 8.71 days in New York to 4.84 days in Arizona. Per diem charge was $2,510 and ranged from $3,890 in California (55 percent above the average) to $1,620 in Tennessee (35 percent below). The hospital charges accounted for 76 percent of the total and ranged from 80 percent in Pennsylvania, Florida and Arizona to 66 percent in New Jersey. The physicians' charges averaged $3,750 but were $5,410 in New Jersey, $5,370 in New York vs. $2,720 in Missouri. In contrast, the average professional charge for an LC performed in an outpatient setting was $1,480. This total varied by 31 percent and was the highest in the Middle Atlantic area. The Pacific area reported the lowest regional charge ($1,250), 16 percent below the norm. Among the 16 states with 20 or more outpatient LCs, the average ambulatory LC charge was the highest in New York and Ohio and lowest in Kentucky and Kansas.     

Green light is effective and less painful than red light in photodynamic therapy of facial solar keratoses

Photodynamic therapy (PDT) with topically applied delta-aminolevulinic acid (ALA) is increasingly employed to treat patients with multiple solar keratoses and superficial skin tumors. For these indications, ALA-PDT has been shown to be highly efficient. Treatment of multiple or extended lesions, however, is substantially hampered by the fact that ALA-PDT is associated with burning pain during the irradiation procedure. The standard irradiation devices commonly used for ALA-PDT emit red light around 630 nm. In the present half-side comparison study we have observed that ALA-PDT employing a green light irradiation device (543-548 nm) is equally effective, as compared with standard red light ALA-PDT. In contrast to red light ALA-PDT, however, green light ALA-PDT caused only little tingling and burning but no pain. These observations indicate that green light ALA-PDT is superior to standard ALA-PDT, because it is associated with less unwanted side effects.