Neonate and infant heart transplantation

OBJECTIVE: To establish the prevalence of anticoagulant (AC) treatment, the indications, and the quality of care in primary health care. DESIGN: A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records. SETTING: Eight Finnish health centres with a total population of 182091 inhabitants. RESULTS: A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmonary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges. CONCLUSION: The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practitioner's responsibility functions well. The quality of care is good, even in older age groups.     

Long-term maintenance of weight loss: do people who lose weight through various weight loss methods use different behaviors to maintain their weight?

Obtaining high-quality radiographs of the proximal aspect of equine limbs is difficult because of the large muscles in these regions. The use of scintigraphy may provide further information. Abnormal bone scan findings of the ischial tuberosity or the third trochanter were found in 29 adult horses with obscure hind limb lameness between 1986 and 1996 at the Large Animal Clinic of the University of Bern. Each had abnormal radiopharmaceutical uptake but not all had radiographic changes. Radiopharmaceutical uptake ratios between the ischial tuberosity and the greater trochanter were calculated. The uptake ratio in a control group of 11 clinically sound horses was lower than in 11 lame horses with subjectively enhanced radiopharmaceutical uptake.     

Thermal-stress stability of yttrium oxide as a buffer layer of metal-ferroelectric-insulator-semiconductor field effect transistor

The effect of thermal stress on the electrical properties of ferroelectric/semiconductor structure was investigated when introducing Y₂O₃ film as a barrier layer in the structure. Two different thermal stress states could be obtained by fast (400 °C/min) or slow (30 °C/min) cooling of sputter-deposited Y₂O₃ films on silicon wafer from 800 °C. The formation of interfacial layer containing Y-Si-O and SiO₂ layers while annealing could be characterized by using a spectroscopic ellipsometry. The introduction of strain-induced defects from thermal stress of the fast cooled sample showed a soft breakdown at low applying voltage. In the capacitance-voltage relation, a flat band voltage shift, hysteresis, and stretch-out phenomena were also observed. Nd₂Ti₂O₇ was spin deposited using sol-gel procedure on the Y₂O₃/Si to form a metal-ferroelectric-insulator field effect transistor structured sample. These Nd₂Ti₂O₇/Y₂O₃/Si samples were also furnace-annealed at 800 °C and cooled down to room temperature fast or slowly. One order lower value of leakage current, 1E−8 A/cm² was observed with these samples when comparing with the Y₂O₃/Si samples. A soft breakdown of the fast cooled sample seemed to have the same origin as the fast cooled Y₂O₃/Si sample, i.e., the strain-induced defects in the interfacial layer containing Y-Si-O and SiO₂ phases. Hysteretic gaps of the Nd₂Ti₂O₇/Y₂O₃/Si samples showed a possibility to be used as a memory window for ferroelectric gate.     

Adenomatoid odontogenic tumours in Ibadan, Nigeria

Only a few reports of adenomatoid odontogenic tumour (AOT) in Africans have been published. Clinical, histological and radiographic features as well as treatment results of thirteen new cases of AOT seen at the University College Hospital, Ibadan were reviewed. This lesion constituted 12.1% of odontogenic tumours. This study shows a male: female ratio of 1.2:1. This contrasts with the reported male: female ratio of 1:3 in the United States, Britain, Sri Lanka and Japan. The higher male incidence may be peculiar to Nigeria. Although the peak incidence was in the second decade of life, four patients were over 20 years of age. The mean age was 23.2 years for all patients. None of the patients presented with recurrence on follow up.     

Multiple forms of complement C3 in trout that differ in binding to complement activators

In all other species analyzed to date, the functionally active form of complement component C3 exists as the product of a single gene. We have now identified and characterized three functional C3 proteins (C3-1, C3-3, and C3-4) in trout that are the products of at least two distinct C3 genes. All three proteins are composed of an alpha-and a beta-chain and contain a thioester bond in the alpha-chain. However, they differ in their electrophoretic mobility, glycosylation, reactivity with monospecific C3 antibodies, and relative ability to bind to various surfaces (zymosan, Escherichia coli, erythrocytes). A comparison of the partial amino acid sequences of the three proteins showed that the amino acid sequence identity/similarity of C3-3 to C3-4 is 87/91%, while that of C3-3 and C3-4 to C3-1 is 51.5/65.5% and 60/73% respectively. Thus, trout possess multiple forms of functional C3 that represent the products of several distinct genes and differ in their ability to bind covalently to various complement activators.     

Distinct exocytotic responses of intact and permeabilised chromaffin cells after cleavage of the 25-kDa synaptosomal-associated protein (SNAP-25) or synaptobrevin by botulinum toxin A or B

Botulinum neurotoxin (BoNT) types A and B are Zn2+-requiring endoproteases which potently block neurotransmitter release by cleavage of a 25-kDa synaptosomal-associated protein (SNAP-25) and synaptobrevin, respectively. Synaptobrevin is important for the exocystosis of catecholamines from dense-core granules and evidence is presented here for the involvement of SNAP-25 in this process in neuroendocrine cells. The effects of BoNT/A and BoNT/B on regulated secretion were compared in intact bovine chromaffin cells to investigate the consequences of cleavage of the different targets. Catecholamine secretion elicited by Ba2+, by elevated K+ concentrations or by nicotine was prevented by each toxin. A very good correlation was observed between the extents of SNAP-25 cleavage or synaptobrevin cleavage and inhibition of secretion by BoNT/A or BoNT/B, respectively, which indicates the importance of SNAP-25 and synaptobrevin in regulated exocytosis. Despite truncation of almost the entire SNAP-25 pool by exposure of the cells to BoNT/A, a residual fraction of secretion persisted that was induced by 20microM Ca2+ (and to a lesser extent by 1 mM Ba2+) following permeabilisation. Addition of more BoNT/A failed to reduce this level of secretion. Inclusion of Mg.ATP, which greatly enhanced secretion from permeabilised cells, was required for Ca2+-stimulated or Ba2+-stimulated BoNT/A-resistant secretion. Furthermore, synaptobrevin is essential for this response because the response was not observed in BoNT/B treated cells. In view of the ability of BoNT/E to abolish secretion from permeabilised cells and to delete 26 amino acids from the C-terminus of SNAP-25, it can be deduced that cleavage of only nine residues by BoNT/A does not prevent the resultant truncated form exhibiting attenuated activity under the conditions created by permeabilisation. This identification of a novel component of secretion from permeabilised cells should facilitate investigation of the functional interaction of SNAP-25 with other proteins involved in regulated exocytosis.     

Spontaneous esophageal perforation in an acute burn patient

Spontaneous perforation of the esophagus is an uncommon and catastrophic event accompanied by extremely high morbidity and mortality. In a burn patient, diagnosis may be delayed because of painful burns that may mask the underlying problem. Diagnosis is dependent on a high index of suspicion and by inclusion of this entity in the differential diagnosis of chest pain. The authors report on a 45-year-old male who developed a spontaneous perforation of the esophagus while hospitalized for treatment of an 11% total body surface area burn. Diagnosis and initiation of appropriate treatment resulted in salvage of this patient. The pathophysiology of this disease and a review of the literature are presented.