Primary angiosarcoma of the breast

In order to study the effects of propylthiouracil (PTU) on the fetal thyroid and serum concentration, 9 women undergoing therapeutic abortion at the second trimester of pregnancy were given a single dose of 50, 100 and 150 mg PTU respectively. The concentrations of PTU in the maternal and fetal serum and those in the fetal thyroid tissues were determined with a high-performance liquid chromatographic method, the lowest limit of which was 25 micrograms/L. After an oral bolus of PTU, the PTU concentrations in the maternal serum reached a peak level after one hour and there was a wide individual variation of the peak value. The study showed PTU could be transferred through the placenta from the maternal blood to the fetal blood and highly accumulated in the fetal thyroid tissues. The fetal serum PTU concentrations correlated with those of their mothers at the same time (r = 0.7084, P < 0.02) and the concentrations in the fetal thyroid tissues could be evaluated by the maternal serum peak level after an oral bolus. PTU didn't inhibit the fetal thyroid peroxidase activity even when the maternal serum PTU concentration reached 4 mg/L, which is the lowest effective therapeutic concentration of PTU in adults.     

Intraabdominal carbon dioxide insufflation in the pregnant ewe. Uterine blood flow, intraamniotic pressure, and cardiopulmonary effects

BACKGROUND: Laparoscopic surgical procedures are being performed in pregnant women with increasing frequency. Maternal-fetal physiologic changes occurring during intraabdominal carbon dioxide insufflation are poorly understood, and maternal-fetal safety is of concern during carbon dioxide pneumoperitoneum. A previous pilot study using end-tidal carbon dioxide-guided ventilation resulted in maternal and fetal acidosis and tachycardia during carbon dioxide pneumoperitoneum. Using serial arterial PCO2 to guide ventilation, this study was designed to evaluate maternal-fetal cardiopulmonary status, uterine blood flow, and the intraamniotic pressure effects of intraabdominal carbon dioxide insufflation in singleton pregnant ewes between 120 and 135 days of gestation. METHODS: In a prospective randomized cross-over study, nine ewes were to receive either abdominal insufflation with carbon dioxide to an intraabdominal pressure of 15 mmHg (n = 9; insufflation group) or receive no insufflation (n = 9; control group). Anesthesia was induced with thiopental and maintained with end-tidal halothane (1 to 1.5 minimum alveolar concentration/100% oxygen). Mechanical ventilation was guided by serial maternal arterial blood gas analysis to maintain PaCO2 between 35 and 40 mmHg. Data from insufflated animals were collected during insufflation (60 min) and after desufflation (30 min). Control group data were collected and matched to similar time intervals for 90 min. Ewes were allowed to recover, and after a rest period (48 h) they were entered in the cross-over study. RESULTS: During insufflation there was a significant increase (P < 0.05) in maternal PaCO2 to end-tidal carbon dioxide gradient and minute ventilation, with concomitant decreases in maternal end-tidal carbon dioxide and PaO2. Intraamniotic pressure increased significantly during insufflation. No significant changes were observed in maternal hemodynamic variables, fetal variables, or in uterine blood flow during the study. There were no fetal deaths or preterm labor in any of the animals during the experiment. CONCLUSIONS: During the 1-h insufflation, a marked increase in PaCO2-to-end-tidal carbon dioxide gradient was observed, suggesting that capnography may be an inadequate guide to ventilation during carbon dioxide pneumoperitoneum in the pregnant patient. No other significant circulatory changes were observed.     

Practical aspects of faculty practice. A model for excellence

The aim of the study was to determine the intrasubject variability of the pressure-transmission ratio (PTR) with various cough intensities in subjects with genuine stress incontinence. Thirty-six patients with genuine stress incontinence underwent multichannel urodynamics and had a series of pressure-transmission ratios (PTRs) determined with the urethral transducer placed at the point of the maximal closure pressure. Patients were asked to cough with increasing intensities and three to four different cough-induced PTRs were recorded for each subject. The data were analysed using regression analysis, repeated measures analysis of variance and comparison of variance. The PTRs showed a high degree of variability within subjects. The mean within subject standard deviation was 18.5%. The effect of parity, maximal urethral closure pressure and age were insignificant on the variability. Cough intensities of greater than 90 cmH2O have a lesser degree of variability. The mean PTR across all cough intensities was fairly constant in the 82%-87% range. It was concluded that the PTR in an individual has a high degree of variability independent of cough intensity, and cannot be relied upon as a diagnostic measure in subjects with genuine stress incontinence. However, the PTR for the population as a whole was consistent across all cough intensities.     

Parents' opinions concerning possible causes of cerebral palsy

This study surveys parents of children with cerebral palsy. The purpose of the study is to report the parents' opinions concerning possible causes of cerebral palsy. All parents of children with cerebral palsy who attended the United Cerebral Palsy centers in North Carolina were asked to respond to a survey concerning their opinions of possible causative factors related to cerebral palsy. Parents of children with cerebral palsy participating in this study reported agreement with several possible causative factors of cerebral palsy. Though the opinions of these parents largely reflect knowledge that is consistent with the literature, there is also confusion concerning some factors that have been associated with cerebral palsy. There is a need for more study of causative factors related to cerebral palsy.     

A population-based study of the usefulness of screening for neuroblastoma

BACKGROUND: Neuroblastoma has many characteristics which suggest that preclinical detection might improve outcome. The Quebec Neuroblastoma Screening Project was initiated to determine whether mass screening could reduce mortality in a large cohort of infants. As an early endpoint, we report whether screening could reduce the incidence of poor-prognosis neuroblastoma in children with advanced-stage disease over 1 year of age. METHODS: All 476,603 children born in the province of Quebec during the 5-year period of May 1, 1989, to April 30, 1994, were eligible for urinary assay of homovanillic acid and vanillylmandelic acid at 3 weeks and 6 months of age. Children with a positive screen were referred to one of four paediatric cancer centres in the province for uniform evaluation and treatment if necessary. Standardised incidence ratios (SIRs) were calculated for neuroblastoma in the province and two similar population-based controls, the state of Minnesota and the province of Ontario, during the same period of time and with similar ascertainment procedures. FINDINGS: Compliance with screening in Quebec province was 91% at 3 weeks (n = 425,816) and 74% at 6 months (n = 349,706). Through July 31, 1995, with a follow-up of the birth cohort of 15-75 months, 118 cases of neuroblastoma were diagnosed, 43 detected preclinically by screening, 20 detected clinically before screening at 3 weeks of age, and 55 detected clinically after 3 weeks of age having normal screens (52) or never screened (3). Retrospective analysis of stored samples confirmed that 49 of 52 patients missed by screening had levels of catecholamine metabolites that were too low to be detected at 6 months or earlier. Based on US Surveillance, Epidemiology and End Results data, 54.5 cases of neuroblastoma would have been expected in Quebec province during the study period, for an SIR of 2.17 (95% CI 1.79-2.57, p < 0.0001). For the two control groups, 43 and 80 cases of neuroblastoma were detected, respectively, compared with 37.9 and 85.4 expected, overall SIR 1.00 (not significant). SIRs for Quebec province by age at diagnosis in yearly intervals show a marked increased incidence under 1 year of age (SIR 2.85, 2.26-3.50), with no reduction in incidence in subsequent years. Limiting analysis to only patients diagnosed over 1 year of age with advanced-stage disease, 22 cases were detected in Quebec province versus 14.4 expected (SIR 1.52, 0.95-2.23). Data in the two control groups show no significant increase or decrease in any-stage disease in children under or over the age of 1 year, except for an increase in early-stage disease in Minnesota children over 1 year: 10 versus 3.8 expected (SIR 2.67, 1.27-4.58). INTERPRETATION: Screening for neuroblastoma increases the incidence in infants without decreasing the incidence of unfavourable advanced-stage disease in older children. It is unlikely that screening for neuroblastoma in infants will reduce mortality for this disease.     

Direct association with and dephosphorylation of Jak2 kinase by the SH2-domain-containing protein tyrosine phosphatase SHP-1

SHP-1 is an SH2-containing cytoplasmic tyrosine phosphatase that is widely distributed in cells of the hematopoietic system. SHP-1 plays an important role in the signal transduction of many cytokine receptors, including the receptor for erythropoietin, by associating via its SH2 domains to the receptors and dephosphorylating key substrates. Recent studies have suggested that SHP-1 regulates the function of Jak family tyrosine kinases, as shown by its constitutive association with the Tyk2 kinase and the hyperphosphorylation of Jak kinases in the motheaten cells that lack functional SHP-1. We have examined the interactions of SHP-1 with two tyrosine kinases activated during engagement of the erythropoietin receptor, the Janus family kinase Jak-2 and the c-fps/fes kinase. Immunoblotting studies with extracts from mouse hematopoietic cells demonstrated that Jak2, but not c-fes, was present in anti-SHP-1 immunoprecipitates, suggesting that SHP-1 selectively associates with Jak2 in vivo. Consistent with this, when SHP-1 was coexpressed with these kinases in Cos-7 cells, it associated with and dephosphorylated Jak2 but not c-fes. Transient cotransfection of truncated forms of SHP-1 with Jak2 demonstrated that the SHP-1-Jak2 interaction is direct and is mediated by a novel binding activity present in the N terminus of SHP-1, independently of SH2 domain-phosphotyrosine interaction. Such SHP-1-Jak2 interaction resulted in induction of the enzymatic activity of the phosphatase in in vitro protein tyrosine phosphatase assays. Interestingly, association of the SH2n domain of SHP-1 with the tyrosine phosphorylated erythropoietin receptor modestly potentiated but was not essential for SHP-1-mediated dephosphorylation of Jak2 and had no effect on c-fes phosphorylation. These data indicate that the main mechanism for regulation of Jak2 phosphorylation by SHP-1 involves a direct, SH2-independent interaction with Jak2 and suggest the existence of similar mechanisms for other members of the Jak family of kinases. They also suggest that such interactions may provide one of the mechanisms that control SHP-1 substrate specificity.     

Microwave-assisted reflux synthesis of Tungsten-doped BiVO4 for improved photocatalytic activity

Given its favorable physical and chemical properties, Bismuth vanadate (BiVO₄) is a commonly studied metal oxide semiconductor for photocatalytic applications. However, BiVO₄ shows a high recombination rate of photogenerated charges and limited charge transport capacity, which can be addressed by doping it with tungsten. To develop a highly efficient tungsten-doped BiVO₄-based (W-BiVO₄) photocatalyst, it is necessary to control the dopant content, crystal structure, and morphology. These properties are, in turn, governed by the synthesis conditions. This work describes a pioneering method of microwave-assisted reflux synthesis of W-BiVO₄, using ethanol as solvent and polyvinyl pyrrolidone (PVP) as a capping agent. Thus, it is possible to perform the synthesis procedure in only 30 min at 78°C, obtaining extremely regular monoclinic W-BiVO₄ nanosquares. Furthermore, the experiments showed that the most efficient photocatalyst contains 3% tungsten as the dopant. Moreover, the direct oxidation of rhodamine B by the photogenerated holes plays a crucial role in the degradation mechanism. Finally, we observed that although the addition of PVP promotes control of the morphology, it results in a poorly efficient material. This low efficiency may be related to the formation of a polymeric coating on the surface of the catalyst or to a high amount of oxygen defects. Finally, we show that the unique interaction of microwaves with the species present in the reaction media influences nanoparticle growth.     

Prediction of global bending stiffness of timber beams by local sampling data and visual inspection

The results of visual inspection according to UNI 11119:2004 and bending tests made on 20 old chestnut (Castanea sativa Mill.) beams according to EN 408:2010 were statistically analyzed in order to provide a consistent and feasible procedure to predict their modulus of elasticity (MOE) in bending. Local data obtained from smaller size specimens was used for the prediction of the global mechanical properties of full structural size members and compared with the results of mechanical tests. The prediction models took into account the visual strength classes and the influence of defects on the determination of the MOE. Moreover, random sampling was considered in order to demonstrate the possibility of using smaller representative samples, thus avoiding excessive need of removal of on-site samples and allowing for a smaller number of mechanical tests. The models using random sampling predicted the behavior of full size scale elements accurately, with strong correlations to the experimental results (coefficient of determination r ² ranging from 0.70 to 0.79) and a percentage error lower than 20 %, thus allowing a reliable estimation of mechanical characteristics of existing timber members with a combination of visual inspection and local sampling.