Postoperative outcome of Crohn's disease in 30 children

BACKGROUND: Thirty children operated on for Crohn's disease (CD) were reviewed (1975-1994). The aim of the study was to assess their postoperative outcome. PATIENTS: 19 boys and 11 girls, aged 15.3 (2) years (range 11.3-20) at surgery were studied. RESULTS: Surgical indications were acute complications of CD and chronic intestinal illness. Six months after surgery, 11 of 12 patients had been weaned off steroids, and 22 of 23 patients were weaned off nutritional support; 17 patients without recurrence had a mean (SD) weight gain of 2.1 (8) kg and a height gain of 3.36 (3) cm. During 3.1 (2.7) years follow up, 12 patients (40%) had a recurrence of the disease after 19.4 (14) months (means (SD)): supra-anastomotic recurrence (six), severe perianal disease (two), and chronic illness (four). Six of 14 patients who were treated with mesalazine (13) or azathioprine (one) had recurrences. The postoperative recurrence rate was 50% at two years. CONCLUSION: Surgical treatment modifies the immediate outcome of severe or complicated CD, but does not prevent recurrence, despite localised resection or prophylactic postoperative treatment. Extension of the disease before surgery seems to be a major risk factor for postoperative recurrence in children.     

Rectal hemorrhage as a first sign of renal cell adenocarcinoma

We present a 3-year-old patient with stenotic kinking of the left internal carotid artery (ICA) who developed an ischaemic infarction of the left brain hemisphere followed by severe neurological sequelae after a prolonged generalized seizure. At time of the seizure the boy was in biological remission of a nephrotic syndrome and received prednisolone and cyclosporin A (CsA) treatment. The haemodynamic consequences of inborn kinking of the ICA is discussed controversely in the literature. The presented case shows that stenotic kinking of the ICA may significantly impair the blood flow towards the homolateral hemisphere and therefore may result in an ischaemic infarction. The influence of CsA on seizure activity is discussed. CONCLUSION: This case provides clinical and radiological evidence supporting an association between stenotic kinking of the carotid artery and homolateral hemispheric brain infarction.     

Effects of different thermal treatments and storage on the proximate composition and protein quality in canned tuna

The purpose of this project was to study the modifications in nutrient composition, amino acid content, and protein quality of white tuna preserves after each of the thermal treatments involved in the canning process. Also the influence that a three years storage period at room temperature has on the nutritional quality of canned tuna was studied. The biological assays used for the study of the protein utilization were carried out on Wistar rats, fed on semi-synthetic diets for 12 days varying only the protein source, casein or tuna provided as follows: raw, cooked in brine, steamed, sterilized tuna, and canned tuna stored for three years. The sterilization process and storage time led to a great increase in the lipid content of the canned tuna and to a porcentual decrease in protein, and moisture content. Amino acid composition of canned and cooked tuna did not show great modifications compared to raw tuna. Neither protein digestibility nor biological value of the cooked, canned, and stored tuna showed any deterioration. The protein quality of white tuna meat preserves has been compared with preserves made up of red and white tuna meat.     

Effectiveness of short exposures of propylene oxide alone and in combination with low pressure or carbon dioxide against Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae)

Toxicity of the fumigant propylene oxide (PPO) alone and in combination with low pressure (100 mm Hg) or 92% CO₂ to all life stages of Tribolium castaneum using short exposure times (4 and 8 h) at 30°C was studied. Results indicated that PPO was moderately toxic with Ct products ranging from 120 to 608 mg h/l required to obtain complete mortality of the different life stages. A marked difference in susceptibility between life stages was recorded. Eggs were the most sensitive with a LD₉₉ value of 30.1 mg/l for 4 h, whereas pupae were the most tolerant with a LD₉₉ value of 146.5 mg/l. It was shown that an increase in exposure time from 4 to 8 h resulted in 23%, 42%, 48% and 47% reductions of LD₉₉ values for eggs, larvae, pupae and adults, respectively.There was no or very limited mortality of all stages except the egg (53% to 62%), when exposed to either 100 mm Hg or 92% CO₂ for 4 h. However, when 100 mm Hg or 92% CO₂ were combined with PPO, the LD₅₀ and LD₉₉ values for PPO in all stages except the egg were significantly reduced. Combinations of PPO with 100 mm Hg or 92% CO₂ produced equal reductions in the LD₉₉ value from 146.5 to about 22 mg/l for the most tolerant pupal stage. Both combinations also produced significant reductions in the LD₉₉ values for larvae and adults (6.3- to 6.6-fold) compared with those exposed to PPO alone. These results indicated that 100 mm Hg and 92% CO₂ each had a synergistic effect on the toxicity of PPO to T. castaneum. The combination of PPO with vacuum or CO₂ can thus provide a potential alternative to methyl bromide.     

Social class, political power, and the state: their implications in medicine--part III

This is the third part of an article on the distribution of power and the nature of the state in Western industrialized societies and their implications in medicine. Parts I and II were published in the preceding issue of this Journal. Part I presented a critique of contemporary theories of the Western system of power; discussed the countervailing pluralist and power of elite theories, as well as those of bureaucratic and professional control; and concluded with an examination of the Marxist theories of economic determinism, structural determinism, and corporate statism. Part II presented a Marxist theory of the role, nature, and characteristics of state intervention. Part III focuses on the mode of that intervention and the reasons for its growth, with an added analysis of the attributes of state intervention in the health sector, and of the dialectical relationship between its growth and the current fiscal crisis of the state. In all three parts, the focus is on Western European countries and on North America, with many examples and categories from the area of medicine.     

Input-output statistical independence in divisive normalization models of V1 neurons

Simoncelli and co-workers have proposed statistically-derived nonlinear divisive normalization models of the primary visual cortex (V1) that are consistent with the hypothesis that sensory systems are adapted to the signals to which they are exposed. In this paper, we present a more rigorous mathematical formulation and analysis of these statistically-derived models in terms of mutual information as a metric for statistical independence. We prove that the ad hoc choice of divisive normalization parameters proposed by Simoncelli and co-workers does not guarantee statistical independence between the output responses, but interestingly such choice does guarantee that each output response is statistically independent of almost all the linear inputs. This holds for the two different models of natural image statistics analysed theoretically, and is consistent with empirical results obtained on a set of natural images.     

Guidance on individual monitoring programmes for radioisotopic techniques in molecular and cellular biology

The radioisotope techniques used in molecular and cellular biology involve external and internal irradiation risk. The personal dosemeter may be a reasonable indicator for external irradiation. However, it is necessary to control the possible internal contamination associated with the development of these techniques. The aim of this project is to analyse the most usual techniques and to establish programmes of internal monitoring for specific radionuclides (32P, 35S, 14C, 3H, 125I and 131I). To elaborate these programmes it was necessary to analyse the radioisotope techniques. Two models have been applied (NRPB and IAEA) to the more significant techniques, according to the physical and chemical nature of the radionuclides, their potential importance in occupational exposure and the possible injury to the genetic material of the cell. The results allowed the identification of the techniques with possible risk of internal contamination. It was necessary to identify groups of workers that require individual monitoring. The risk groups have been established among the professionals exposed, according to different parameters: the general characteristics of receptor, the radionuclides used (the same user can work with one, two or three radionuclides at the same time) and the results of the models applied. Also a control group was established. The study of possible intakes in these groups has been made by urinalysis and whole-body counter. The theoretical results are coherent with the experimental results. They have allowed guidance to individual monitoring to be proposed. Basically, the document shows: (1) the analysis of the radiosotopic techniques, taking into account the special containment equipment; (2) the establishment of the need of individual monitoring; and (3) the required frequency of measurements in a routine programme.     

LaCOLLA: Middleware for Self-Sufficient Online Collaboration

The LaCOLLA middleware makes it possible for collaborators to interact using their own resources without depending on centralized regimes. By contributing their own resources, group members can organize and communicate using a federated peer-to-peer model. This lets the group function regardless of whether a member removes resources and despite network or node failures or disconnection. In turn, this capacity for self-organization, together with location transparency, lets application developers create self-sufficient applications for collaborative activity