BCG vaccination

The author expounds the fairly obscure history of BCG vaccination. Summarises the efficiency of accomplished vaccinations of different geographical areas. He accounts the diversity of results by the distinction of technical and methodical conditions and disparity in virulence of BCG strains. Overviews the Inland and European routine and the risk of possible complications. The favourable position of domestic childhood tuberculosis is due to the effective preventive arrangements. Considering the international and national epidemiology of tuberculosis in adults the administration of BCG vaccine, by chance in modified form, is recommended further on.     

Effects of sex steroids on sensory and motor spinal mechanisms

The male copulatory pattern uses muscles in the penis for erection and penile insertion, the lower trunk for pelvic thrusting, and the sex accessory organs for seminal emission. Organization of the nuclei controlling penile muscles is achieved through cell growth, dendritic arborization, and synaptogenesis, actions dependent on androgen but not estrogen. Testosterone (T) and dihydrotestosterone (DHT) but not estradiol (E2), stimulate pelvic thrusting vigor by synchronizing discharge of motoneurons innervating pelvic muscles. Pelvic thrusting rhythmicity, regulated by spinal interneurons, is produced in female rabbits by E2 or T but not by DHT. Reflex contraction of the seminal vesicles, due to penile insertion, is facilitated by androgen presumably by its effect on preganglionic neurons of the hypogastric nerve, located in the dorsal commissural nucleus.     

Intestinal obstruction and peritoneal carcinomatosis after endoscopic resection of transitional carcinoma of urinary bladder

Gut involvement in bladder tumours is low, even exceptional in the presence of surface, low-grade neoplasia. The authors explain their experience in the diagnosis and management of a patient treated endoscopically for a vesical surface tumour which subsequently exhibited peritoneal and gut metastatic seeding. The various mechanisms for gut dissemination of vesical neoplasias and the repercussion of their endoscopic management are discussed.     

Incidence of Lightspeed separation and the potential for bypassing

It is important for endodontic instruments to have a low fracture rate. If a fracture does occur, it would be desirable to have the ability to bypass the broken segment and complete the root canal treatment. One hundred sixty-two root canals in 52 maxillary and mandibular first molars were cleaned and shaped with Lightspeed instruments by three endodontists in their private practices. The canals were instrumented using the technique recommended by the manufacturer. All canals were instrumented to at least a size 45 at the working length. Six instruments separated during treatment. All six had been used more times than recommended by the manufacturer. Five of the six were easily bypassed and treatment completed.     

Circular stereotactic callosotomy: a preliminary report. Technical note

The authors propose a new method for performing stereotactic callosotomy, which they have named circular callosotomy. The operating device is the original Riechert-Mundinger's string electrode, which can be protruded through a side window and by rotating the probe it is possible to cut the commisural pathways to the extent required. The anatomical results of the operation can be checked using MRI scanning.     

Perturbation in the 240Pu/239Pu global fallout ratio in local sediments following the nuclear accidents at Thule (Greenland) and Palomares (Spain)

Diabetes complicates 2-3% of all pregnancies and is associated with an increase in both perinatal morbidity and mortality, though reasons for these adverse outcomes are unknown. Estrogen biosynthesis is a critical factor during pregnancy and is carried out in the placenta via aromatase (cytochrome P450 19A1), which catalyzes the conversion of C-19 androgens to C-18 estrogens. Previous studies have shown that hormones such as insulin-like growth factors and insulin regulate aromatase activity when studied in vitro. Interestingly, levels of these hormones are altered in patients with diabetes. Thus, we hypothesized that the presence of maternal diabetes may alter placental aromatase activity and thus estrogen biosynthesis, possibly serving as one factor in the adverse outcomes of babies born to mothers with diabetes. To this end, we measured the production of 19-hydroxyandrostenedione, 19-oxoadrostenedione and estrone in 30 placental tissues from diabetic patients, using [7-3H]androst-4-ene-3,17-dione as a model substrate for aromatase (P450 19A1). A statistical difference was detected in the percentage of 19-oxoandrostenedione formed between the overt and control groups (P < 0.05). Additionally, NADPH P450-reductase levels were measured in these same tissues to determine whether alterations in this enzyme necessary for aromatase activity could be affected by diabetes. No differences in reductase levels were detected among the patient groups. However, a statistical correlation was found between NADPH P450-reductase activity and the formation velocities of all three estrogen products (P < 0.05). Thus, it appears that the presence of diabetes does not affect placental aromatase activity.     

Electrophysiological properties and cholinergic responses of rat ventral oral pontine reticular neurons in vitro

This study analyses the relationship between the use of rotating instruments, the production of a smear layer and the presence of alterations to enamel microstructures. The rotating instruments used were carbide (8-12 blade) and diamond tipped (30-15 m) cutters. Cavities were made in extracted teeth. Subsequently, half the sample was analysed using the rugosimeter before and after the application of ortophosphoric acid at 35% for 15 and the other half suing a Scansion Electronic microscope (SEM). The results obtained showed on the one hand that carbide cutters leave a smoother surfacer than diamond tipped cutters, and on the other that the smear layer is eliminated better by carbide cutters compared to diamond tipped cutters. Moreover, there are no major traumatic-type alterations at the level of the enamel affecting the microstructure after the use of carbide cutters.     

Fueguian cranial morphology: the adaptation to a cold, harsh environment

Craniometric data from the three extinct tribes that inhabited Tierra del Fuego (Selk'nam, Yámana, and Kawéskar) were gathered following Howell's measurement technique. We studied 180 skulls preserved at thirteen different institutions. Analysis of variance (ANOVA) between groups showed that morphological similarities among Fueguian groups are far more important than some differences between marine (Yámana and Kawéskar) and terrestrial (Selk'nam) groups. A principal component analysis (PCA) generated from the correlation matrix shows that Fueguians fall as outliers with respect to the typical Mongoloid morphology. In addition, a UPGMA tree generated from a squared Euclidean distance matrix indicates that Fueguian groups have a morphological pattern that is very distinct from that of other present-day Amerindian groups, with the exception of the Eskimos. One of the variables that contributes substantially to the differentiation of Eskimos and Fueguians is the nasal height. This suggests that nasal morphology in both groups could be a response to adaptive pressures related to the cold environment. However, other morphological particularities of Fueguian skulls, such as craniofacial robustness and variables of craniofacial width, can be attributed to a large masticatory stress. As a whole, the morphological features of Fueguian groups can be regarded as a general adaptive response to a very harsh environment, along with the retention of some plesiomorphic features. Assuming that the initial entry in Tierra de Fuego took place around 10,000 years BP, before the disappearance of the last land bridges in the Magellan Straits, then this adaptation might have arisen in a relatively short period, hastened by the extreme environmental conditions.     

Nonoperative management of esophageal perforations. Is it justified?

OBJECTIVE: Experiences obtained with nonoperative treatment (NOT), i.e. total prohibition of per oral food intake for a minimum of 7 days, administration of combinations of broad-spectrum antibiotics, and parenteral hyperalimentation, are described in the management of esophageal perforations. SUMMARY BACKGROUND DATA: The place, value, and indication of NOT in the management of esophageal perforation has not yet been unequivocally defined. As a result, contradictory data have been published regarding the outcome of NOT. METHODS: During the past 15 years (1979 to 1994), 20 of 86 patients (23.3%) with esophageal perforation have been treated nonoperatively from the outset. In this group, perforations were located to the upper, middle, and lower third of the esophagus in 50%, 30%, and 20%, respectively. In the operative management group (OT)--in which conservative (drainage, endeprothesis), reconstructive (suture, reinforced suture), and radical (resection) surgical methods were applied--lesions were preponderantly located in the lower one third of the esophagus (56.1%--37/66). As to the interval between the perforation and the onset of treatment, 14 patients had been diagnosed within 24 hours, whereas in 6 cases treatment had been begun beyond 24 hours. RESULTS: NOT could be successfully carried out in 16 patients; the decision to use NOT had to be revised in 4 other cases (Table 1). Two patients were lost; the mortality rate was 10% (2 of 20). The rate of complications was lower in the NOT group (20%, or 4 of 20) than in the OT group (50%, or 33 of 66). CONCLUSIONS: NOT can be suggested for the treatment of intramural perforations. In the case of transmural perforation, this approach should be taken into consideration if the esophageal lesion is circumscribed, is not in neoplastic tissue, is not in the abdominal cavity, and is not accompanied by simultaneous obstructive esophageal disease; in addition, symptoms and signs of septicemia should be absent.