The incidence of large venous emboli during total knee arthroplasty without pneumatic tourniquet use

The T4 phage capsid accessory protein genes soc and hoc have recently been developed for display of peptides and protein domains at high copy number (Ren et al., 1996. Protein Science 5, 1833-1843; Ren et al., 1997. Gene 195, 303-311). That biologically active and full-length foreign proteins can be displayed by fusion to SOC and HOC on the T4 capsid is demonstrated in this report. A 271-residue heavy and light chain fused IgG anti-EWL (egg white lysozyme) antibody was displayed in active form attached to the COOH-terminus of the SOC capsid protein, as demonstrated by lysozyme-agarose affinity chromatography (>100-fold increase in specific titer). HOC with NH2-terminal fused HIV-I CD4 receptor of 183 amino acids can be detected on the T4 outer capsid surface with human CD4 domain 1 and 2 monoclonal antibodies. The number of molecules of each protein (10-40) bound per phage and their activity suggest that proteins can fold to native conformation and be displayed by HOC and SOC to allow binding and protein-protein interactions on the capsid.     

Elevation of arterial pressure during surgery with a pneumatic tourniquet: an independent action of renin?

The aim of this study was to evaluate the effectiveness of captopril for the prevention of the increase of arterial pressure during orthopaedic surgery requiring the application of lower limb tourniquets with balanced anaesthesia. Twenty consecutive patients were included in the study and were randomly divided into two groups. The first (n = 10) received 50 mg captopril orally together with the preanaesthetic medication, the second (n = 10) received a placebo at the same time. The different variables studied (arterial pressure, heart rate) were continuously measured. This study demonstrated that the pretreatment with captopril did not prevent an increase of the arterial pressure during the application of a tourniquet. The means of the systolic and diastolic arterial pressures at the end of the application of the tourniquet were 128/86 and 128/81 in the captopril group and the placebo group, respectively. This result shows that the renin-angiotensin system does not significantly contribute to the increase of the arterial pressure induced by a tourniquet.     

Palliative cholangiojejunostomy on the duct of hepatic segment III. Our experience

BACKGROUND: Aim of the paper is to prove that indications for cholangiojejunostomy, in cases when a mean and long term palliation may be expected, are better than those offered by the use of prostheses, without the well known and early bile duct complications. METHODS: Between 1984 and 1995, 12 patients with obstructive jaundice due to malignancy at the hepatic hilum were treated by segment III Roux-en-y or omega cholangiojejunostomy. In 1 patient with no communication between right and left lobe of the liver, biliary-enteric bypass to segment VI duct was also undertaken; in another with neoplastic stenosis of pylorus gastrojejunostomy was performed. Seven patients had carcinoma of the gallbladder, three hilar cholangiocarcinoma, one gastric carcinoma and one recurrent pancreatic carcinoma. RESULTS: There were two postoperative deaths, one for myocardial infarction and one for biliary peritonitis. Six patients had complications: four biliary fistulas with spontaneous resolution and two wound infections. Seven of the ten surviving patients experienced complete resolution of jaundice for at least 4 months. The mean survival of surviving patients was 9.7 months. Nine patients developed recurrent jaundice. CONCLUSIONS: Segment III cholangiojejunostomy is a good palliative treatment in most patients with malignant hilar obstruction.     

型煤气力输送系统运行问题的技术对策

描述了宝钢股份罗泾炼铁厂型煤气力输送系统运行中频繁堵管、子循环输送时间长和小时处理能力低等问题.针对存在的问题进行分析,改造破碎机反击板,降低粉煤+3 mm粒度比例,增加稳压罐,稳定氮气输出压力,降低1段垂直管和水平管高度,提高水平段初始速度,改造除尘器,增大除尘能力,优化一次气、三次气和助吹气开度等技术对策,使得严重堵管、子循环输送时间等参数得到明显改善,提高了气力输送系统运行的可靠性.     

Review of respiratory mechanics in animals. 3. Methodical and physiologic aspects of the use of the impulse oscilloresistometry system (OIS)

The impulse oscillometry system (IOS) which was originally developed for human medicine was found to be suitable for analysing respiratory mechanics in spontaneously breathing animals. This technique is non-invasive. METHODOLOGICAL ASPECTS: In order to use the IOS-technique in animals, a tightly fitting face mask is necessary. Furthermore, a flexible tube needs to be inserted into the measuring system. While the tube does not influence the measured results significantly, the face mask may affect the measurements. Therefore, its influence on the measured respiratory impedance must be taken into account. To prevent methodological errors, the head and body position of the animal should be standardised during the IOS-measurement. Since the methodological variability of the system is very small, the measuring results are highly reproducible. PHYSIOLOGICAL ASPECTS: In growing subjects, all parameters of respiratory mechanics depend on body weight. Since respiratory physiology is influenced by circadian rhythms, measurements of different days are only comparable when they have been done each day at the same hour. Comparing the respiratory impedance of different animals of similar age and body weight, a considerable inter-individual variability was observed. Due to the low level of physiological intra-individual variability, the method seems to be especially useful for studying influences on the respiratory system (i.e. pharmaceutics, therapeutics) in long-term studies using the same group of subjects.     

Measuring death anxiety: Conceptual, psychometric, and factor-analytic aspects.

Developed a brief, reliable, and valid questionnaire for measuring attitudes toward death and dying. In Stage 1, 4 groups of 30–82 yr old Ss (34 psychology and 27 gerontology graduate students, 25 senior-citizen-center attendees, and 14 nursing home residents) completed the Death Anxiety Questionnaire (DAQ), Taylor Manifest Anxiety Scale, and the Albert Einstein College of Medicine Depression Scale (a revised version of the Self-Rating Depression Scale). During Stage 2, results on these scales were cross-validated on a new sample of 70 gerontology students, and the Death Anxiety Scale and Death Concern Scale were also completed. Internal consistency of the DAQ was .83, and test–retest reliability was .87. No significant sex or age differences were found. A principal-components factor analysis suggested 4 independent dimensions of death anxiety: Fear of the Unknown, Fear of Suffering, Fear of Loneliness, and Fear of Personal Extinction. Recommendations for future research include an investigation of the degree to which scores on these 4 dimensions might differentiate sex, age, personality, affective, and diagnostic groups. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Phones, phonies, and psychologists: III. Professional problems and progress.

A table indicates the percentage of American Psychological Association (APA) members among individual listings in the classified telephone directories for 20 major cities from 1947 to 1962 as follows: 1947, 18.5%; 1949, 35.5%; 1953, 46.7%; 1957, 55.8%; and 1962, 76.9%. Problems considered involve listings by persons identifying themselves as hypnotists; dianetic auditors; those who promise memory power, marriage and tranquility development, relief from sexual problems, etc.; and organizations using display advertisements despite the APA Code statement that "Display advertising is not acceptable practice." The effects of certification are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the ability of residents to manage oncologic problems

BACKGROUND: Administration of angiotensin converting enzyme (ACE) inhibitors to patients with congestive heart failure (CHF) is associated to a decrease in the abnormal vasoconstrictor neurohormonal activity. This contributes to the sustained benefits of these drugs on symptoms and survival of patients with CHF. There is little information, however, regarding the effects of ACE inhibition on vasodilator and natriuretic hormones. AIM: To evaluate the chronic effects of enalapril, in addition to digitalis and diuretics in patients with chronic cardiac failure. PATIENTS AND METHODS: Nine patients with an idiopathic dilated cardiomyopathy (8 male, aged 48 to 76 years old) under treatment with digitalis and diuretics, received enalapril 20 mg bid during eight weeks. Before and after this treatment period resting left ventricular ejection fraction, functional class, plasma levels of atrial natriuretic factor and bradykinins (BK) and urinary excretion of kalikreins (BK) and prostaglandin E2 (PGE2) were measured. RESULTS: After enalapril therapy, there was a significant increase in maximal O2 consumption (14.8 +/- 1.2 to 18.6 +/- 1.5 ml/kg/min, p < 0.05) and radionuclide LV ejection fraction (27.4 +/- 1.1 to 31.4 +/- 0.9% p < 0.05). This was associated with a significant decrease in plasma ANP levels (559 +/- 158 to 178 +/- 54.8 pg/ml) and UK (391 +/- 112 to 243 +/- 92 Cu/24 h). CONCLUSIONS: The decrease in ANP levels, which is a well known marker of prognosis in CHF, could contribute to explain the sustained clinical benefits observed with ACE inhibitors in patients with CHF.     

Measuring quality of life in after-care of tumor surgery. Methods, problems and applications

The present paper deals with the feasibility and applications of quality of life measurement in the routine of a tumor follow-up clinic. 61 patients filled out the EORTC-30 questionnaire plus additional scales. Filling out the questionnaire constituted no burden for patients. Patients' responses were computed in a way as to allow for graphically presenting individual QL-profiles, as well as to compare different groups of patients. Considerations concerning the role of QL-measurement in clinical practice, in medical decision making, and in future research endeavours were brought forward.     

Anthropological aspects of alcohol consumption and alcohol related problems

Authors believe that drinking alcoholic beverages can be associated with customs and habits specific to small communities, societies and even entire nations. The primary family, as the foundation of customs and habits of the first generation, has a role in stimulating drinking and alcoholism. The authors have examined some sociocultural factors, mostly taking into consideration relations in the primary family, by means of a questionnaire filled out by alcoholics (N = 200) and non-alcoholics (N = 100). The alcoholics usually have their first drink earlier, start drinking regularly earlier, and in the primary family there is a high tolerance towards the use of alcoholic beverages. The authors believe that the prevention should be directed primary towards the primary family with a view to changing their customs and habits as well as attitudes towards the use of alcoholic beverages.     

Clinical investigation of the menstrual cycle. III. Clinical, endometrial, and endocrine aspects of luteal defect

This study was intended to correlate different clinical and biologic parameters to better define luteal insufficiency (LI) and to contribute to a better understanding of its origin. Endometrial patterns were used as the basis for classification of clinical cases. Of 328 outpatients with menstrual disorders and/or infertility, 88 were considered to have LI. Their cycles were compared with 79 normal cycles. Two different principal endometrial patterns of LI are described: pure LI, when the endometrium is more than 2 days out of phase; and LI with persistent estrogenic influence, when the histologic estrogenic stigmata are excessive during the luteal phase. Basal body temperature charts demonstrated menstrual cycle disturbances: either ovulation delay or a slow increase in temperature (longer than 2 days). Plasma steroid concentrations also demonstrated a perturbation of the entire menstrual cycle: progesterone levels were statistically significantly lower in LI than in normal cycles and this defect was worse when the estrogenic influence was persistent; the preovulatory estradiol peak was disturbed in all circumstances, as was the concentration of endometrial steroid receptors. These simultaneous abnormalities strongly suggest a central origin of LI.