Incidence of primary malignancies other than breast cancer among women treated with radiation therapy for benign breast disease

In addition to left ventricular pump failure and low cardiac output, structural and metabolic alterations of skeletal muscle are thought to contribute to exercise intolerance seen in patients with CHF. Studies using cardiac myocytes have implicated nitric oxide elaborated by inducible nitric oxide synthase (iNOS) as a potential agent associated with the genesis of dilated cardiomyopathy. The present study was designed to locate iNOS in the working skeletal muscle of patients with congestive heart failure. Specific antibodies were used to detect iNOS by immunohistochemistry in skeletal muscle biopsies (m. vastus lateralis) of 37 patients with left ventricular pump failure and 8 normal controls. The expression was restricted to skeletal muscle myocytes and was increased five- to ninefold in patients with chronic heart failure. There was no statistically significant difference in iNOS expression between patients with dilated cardiomyopathy and those with ischemic cardiomyopathy. The finding of a locally increased expression of iNOS and the experimental evidence that NO attenuates the contractile performance of the skeletal muscle suggest that the expression of iNOS may be responsible for the exercise intolerance seen in patients with chronic heart failure.     

Breast cancer screening with tomosynthesis--initial experiences

Experiences gained so far using tomosynthesis for breast cancer screening will be reported. A short summary of results from preparatory studies will also be presented. The sensitivity and specificity of breast tomosynthesis (BT) will be compared with conventional two-dimensional digital mammography (DM) for breast cancer screening in a population-based study. Over 2000 women have been examined so far with BT and DM. The BT reading is significantly more time-consuming than the DM reading. Preparatory studies have shown that BT has a higher diagnostic precision and higher accuracy of size measurements and stage determination than DM. There is potential to use lower compression force with BT compared with DM, without decreasing the diagnostic accuracy. BT might play an important role in clinical as well as screening mammography. A large-scale population-based study to investigate BT as a screening modality is underway.     

Excess radiation absorbed doses from non-optimised radioiodine treatment of hyperthyroidism

Radioiodine therapy is often the method of choice for treatment of hyperthyroidism because it is considered safe, is relatively inexpensive, and is convenient for the patient and except for occasional hypothyroidism, almost without side effects. Even though radioiodine treatment has been performed for over 50 years, the method of treatment differs from country to country and even from hospital to hospital within the same country. To illuminate such differences 187 radioiodine treatments for Graves' disease at Malm? University Hospital in Sweden have been analysed. Comparative dose calculations were carried out assuming that the individual patients had also been treated according to a number of other protocols in current use. The results show that the protocol used for calculating the administered activity in radioiodine therapy is far from optimised in many hospitals. Following the protocols where the absorbed dose to the thyroid is calculated without any uptake measurements after administration of a test activity, most of the patients were treated with an unnecessarily high activity, as a mean factor of 2.5 times too high and in individual patients up to eight times too high, leading to an unnecessary radiation exposure both for the patient, the family and the public. This is not in accordance with generally accepted radiation protection principles. Using higher activity than necessary will also prolong the patient's stay at the hospital and thus increase the costs for the care. Unnecessarily high activity will also necessitate more long-lasting radiation protection restriction relative to family members when the patient is back home.     

Doctors'' attitudes to fibromyalgia: a phenomenological study

BACKGROUND: Primary systemic amyloidosis is an uncommon disorder associated with the desposition of fragments of immunoglobulin light chains in a variety of tissues. Some patients present with peripheral neuropathy. The prognosis of these patients is not clear. METHODS: We searched the medical records of all patients seen at the Mayo Clinic between January 1, 1978 and December 31, 1994 with the diagnosis of amyloidosis. Twenty-six patients with sural nerve biopsy-proven amyloid neuropathy and a documented monoclonal protein in the serum or urine were studied. RESULTS: The most common symptoms that led to the diagnosis of primary amyloid neuropathy were paresthesias (81%), muscle weakness (65%), and numbness (58%). The median duration of symptoms before diagnosis was 29 months. Symptoms of autonomic neuropathy were present at diagnosis in 17 patients (65%). Other organs were involved in most patients. The monoclonal light chain protein detected was lambda in 18 patients (69%) and kappa in 8 (31%). The neuropathy was chronic, debilitating, and showed relentless progression. Twenty-two patients (85%) died (median survival 25 months) and 4 patients were alive at a median follow-up of 4.5 years. Progressive amyloidosis was the cause of death in most patients. Survival was significantly better in the patients with a serum albumin level >3 g/dL (median survival 31 months compared with 18 months; P <0.01, log-rank test). CONCLUSIONS: Patients with primary systemic amyloidosis in whom neuropathy is the dominant clinical manifestation often do not receive a diagnosis until years after the onset of symptoms. The prognosis is worse than previously indicated. Neuropathy does not improve with therapy.     

Direct precipitation on demand at large Scandinavian WWTPs reduces the effluent phosphorus load

On demand use of direct precipitation of wastewater has been successfully implemented at several large Scandinavian wastewater treatment plants (WWTPs) as a cost-efficient method of treating wastewater bypassing secondary treatment. During wet weather situations or when the capacity of secondary treatment is reduced excess wastewater can be treated through efficient direct precipitation. This increases the total capacity of the WWTP to remove phosphorus during these periods. This treatment strategy allows the WWTPs to meet stringent effluent phosphorus limits without extending secondary treatment of the main plant, despite high wet weather flows. The gain in terms of reduced phosphorus emissions varies depending on local conditions such as climate, collection system and secondary treatment capacity. It also varies from year to year depending on the weather and reductions of capacity due to planned refurbishing or unplanned breakdown of equipment. Operating chemical precipitation on demand has proved to contain challenges to operation and organisation of the WWTP. These challenges include logistics of start-up, training of staff and maintaining the system between occasions of operation. Sufficient up-stream storage capacity, reliable weather forecasts and good contracts with suppliers of chemicals are keys of success.     

Note: Fire test data available for your purpose

The EUREFIC (European Reaction to Fire Classification) has produced many fire test data made available through a Data Converting System (DCS). DCS is a simple PC-based program which transfers data logger files into a standard fire test data format, given by FDMS (Fire Data Management System). DCS is also capable of transferring standard data files into data formats of common spreadsheets. The EUREFIC programme has made two models for assessing large-scale performance of test materials. These models are integrated into a PC program called CT (Cone Tools).     

A Swedish version of the Women's Health Questionnaire. A measure of postmenopausal complaints

We wanted to provide details on the psychometric documentation of the Swedish version of the Women's Health Questionnaire (WHQ), a patient based measure of postmenopausal complaints. The results of two clinical trials in Sweden in which the WHQ had been used as one out of several measurement tools were used to document the reliability, the validity and the responsiveness to change of the WHQ. More than 350 women suffering from postmenopausal complaints were included in the two trials. A factor analysis, using the baseline values of all women in each study, showed that the Swedish version of the WHQ was very close to the English original. The internal consistency reliability was excellent. The clinical validity was confirmed by a significant correlation between change in E2 levels and change in the WHQ during estrogen therapy. A high construct validity was established by the agreement between the WHQ and other quality of life scales. For use in clinical trials the WHQ was sensitive to treatment-induced changes, and added important information to the clinical effect variables.     

Noncontact surface roughness measurement of engineering surfaces by total integrated infrared scattering

As precision engineering surfaces are gaining in importance in industry, so are the surface quality requirements. These surfaces have rms roughness typically ranging from some nanometers up to a few micrometers. Although numerous techniques exist for rough surface characterization, from traditional line-scanning stylus profilometers to modern three-dimensional (3-D) measurement instruments, there is a need for a fast, area-covering technique. An efficient method for the characterization of smooth surfaces is elastic light scattering. At visible wavelengths, the limits on roughness range and spatial frequency range make the method unsuitable for characterizing engineering surfaces. By increasing the wavelength of the incident light from the visible to the infrared, elastic light scattering turns out to be applicable for engineering surfaces. We have used total integrated scattering at 10.6 μm wavelength to measure rms roughness up to two micrometers. In this paper, the instrument design and properties are reviewed. We also present results from measurements on ground steel surfaces. Excellent correspondence with mechanical stylus measurements exists for surfaces with rms roughness in the range from 0.1–1.7 μm. The technique shows potential for rapid quality inspection of engineering surfaces.     

Cavern roof stability—mechanism of arching and stabilization by rockbolting

For stabilizing of rock cavern roof arches, tensioned rockbolts should be used with caution since they may have a negative influence on the stability of the arch. A proper design of rockbolts should therefore be based on a clear understanding of both the features of rockbolt reinforcement and the mechanism of the rock roof arch structure. For this purpose the mechanism of a rock cavern roof arch is studied and effects of different types of rockbolts are evaluated. Numerical modeling of rockbolt support of the Xiaolangdi powerhouse cavern as well as application of arching theory are carried out with the objective to study the effects of fully grouted rockbolts and tensioned cable anchors in reinforcing the cavern roof and walls, and on the forming of the roof arch.