Ambulatory subcutaneous internal sphincterectomy]

The internal anal sphincterotomy operation represents the best therapy for the treatment of those anal lesions, above all anal fissures, which cause hypertrophy and spasms of the internal anal sphincter. The Authors report their experience of 253 operations of internal subcutaneous sphincterotomy carried out between 1989 and 1995 under local anaesthesia in the outpatient clinic. The excellent results achieved prove that the procedure can easily be carried out under local anaesthesia in an outpatient clinic and, therefore, it is preferable to the surgical technique of isolation of the internal sphincter, not only for its practicality but also for the improved results.     

The crystal structure of an Fe-superoxide dismutase from the hyperthermophile Aquifex pyrophilus at 1.9 A resolution: structural basis for thermostability

The incidence of stress fractures is increasing among competitive and recreational athletes as well as among children and the elderly. By understanding the continuum of bone's response to stress and maintaining an appropriate index of suspicion, the health care provider can diagnose these injuries appropriately. An accurate history and examination is essential and will differentiate stress fractures from other stress reactions. The more common stress fractures are discussed.     

Conservative surgery for stage I ovarian carcinoma in women of childbearing age

OBJECTIVE: To assess the results of a policy of tailored conservative surgical management for young women with stage I ovarian carcinomas. DESIGN: Retrospective study. PARTICIPANTS: Ninety-nine women aged 40 years or younger who underwent either primary surgery in our department or were referred after primary surgery performed elsewhere. METHODS: Of the 99 women in our study, 56 underwent fertility-sparing surgery and 43 more radical surgery. Minimal requirements for conservative management were adequate staging and complete information about the therapeutic options. Factors important in the choice of the treatment were, age, wish to preserve fertility, histologic type and grade, and the stage of the tumour. RESULTS: Conservative treatment was conducted in 84% of nulliparous and in 33% of parous women; 62% of grade 1 tumours, 48% of grade 2, and 50% of grade 3 were treated conservatively. With a median follow up of seven years, we observed five recurrences (9%) of carcinoma in women treated conservatively and five (12%) in those treated more radically. Two women (one in each treatment arm) were saved after recurrence. Two recurrences after conservative surgery involved the residual ovary (3.6%). Two women developed borderline tumour in the contralateral ovary and both were treated by surgery. CONCLUSION: After adequate staging and accurate information is given to the patient, conservative treatment may be safe in some women with early ovarian cancer. The risk of recurrence in the contralateral ovary is low. Conservative surgery may be also considered in some Stage I grade 3 tumours and in some women with stage JC tumours.     

Effect of annealing in an atomic-hydrogen atmosphere on the properties of amorphous hydrated silicon films and the parameters of p-i-n structures based on them

The decrease in the density of dangling silicon-silicon bonds in a-Si:H films as a result of annealing in an atomic-hydrogen atmosphere is determined by their density in the initial (nonannealed) film. The change in the total hydrogen density in a-Si:H films, annealed in an atomic-hydrogen atmosphere, is determined by the type of silicon-hydrogen bonds and the impurity content: The hydrogen content can decrease to 1 at. % in the presence of monohydride bonds (2020 cm⁻¹) and no change is observed in the hydrogen content in the presence of oxygen (≲0.1 at. %). A decrease in the defect density as a result of annealing in an atomic-hydrogen atmosphere is observed for all films. The Staebler-Wronski effect — AM-1 irradiation for 10 h — is observed for all films irrespective of the total hydrogen density, the type of silicon-hydrogen bonds, and the presence of oxygen. Fiz. Tekh. Poluprovodn. 32, 620–626 (May 1998)     

Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase: a report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation

The purpose of this study was to determine the long-term results of allogeneic bone marrow transplantation for chronic myeloid leukemia. A retrospective analysis was carried out of the outcome of 373 consecutive transplants performed at 38 European institutions between 1980 and 1988 and reported to the registry of the European Group for Blood and Marrow Transplantation. All transplants were carried out for first chronic phase of chronic myelogenous leukemia using unmanipulated marow cells from HLA-identical sibling donors. The probability of survival and leukemia-free survival at 8 years were 54% (95% CI: 49-59) and 47% (95% CI: 41-52) respectively. The probabilities of developing acute GVHD (II-IV) at 100 days and chronic GVHD at 4 years after transplant were 47% (95% CI: 41-53) and 52% (95% CI: 46-58) respectively. The probabilities of transplant-related mortality and leukemic relapse 8 years after BMT were 41% (95% CI: 36-48) and 19% (95% CI: 14-25), respectively. Transplant within 12 months of diagnosis was associated with reduced transplant-related mortality (34 vs 45%, P = 0.013) and resulted in improved leukemia-free survival (52 vs 44%, P = 0.03). The probability of relapse was significantly reduced in patients who developed chronic GVHD (RR = 0.33, P = 0.004). The probability of relapse occurring more than 2 years after transplant was increased more than five-fold in patients transplanted from a male donor (RR = 5.5, P = 0.006). Sixty-seven patients in hematologic remission were studied for residual disease by two-step RT/PCR for BCR-ABL mRNA and 61 (91%) tested negative. We conclude that bone marrow transplantation can induce long-term survival in approximately one-half of CML patients; the majority of survivors have no evidence of residual leukemia cells when studied by molecular techniques. The probability of late relapse is increased with use of a male donor.     

On singular topologies in exact layout optimization

The causes of singular structural topologies, which prevent most iterative computational algorithms from reaching the global optimal solution, are explained in the light of the theory of exact optimal layouts. This theory is also used for deriving eight fundamental characteristics of singular topologies. The above findings are illustrated with case studies of exact optimal layouts for a single load and for two load conditions with stress constraints.     

Design of pole-assignment controller for systems with algebraic-equation constraint

In this paper we have studied the control of linear systems with algebraic-equation constraint. A pole-assignment controller with two-layer structure for such constrained systems has been presented. The objective of the controller is to assign the desired poles to constrained system and simultaneously force the corresponding closed-loop system to satisfy the constraint. The conditions for the existence of pole-assignment controller are discussed in different cases. The implementation algorithm of pole-assignment controller is also presented. An example is given to illustrate the validity of the method in this paper.     

Einfluß von Magnetisierungsart und Polbedeckungswinkel auf die Anzugsmomente permanenterregter Gleichstrommotoren

Übersicht Mittels der Feldtheorie wird das Luftspaltfeld eines zweipoligen dauermagneterregten Gleichstrommotors unter Berücksichtigung des Läuferfeldes bestimmt. Das Anzugsmoment ergibt sich durch Integration der Tangentialkomponente der Maxwellschen Spannung über eine frei gewählte kreiszylindrische Luftspaltfläche, die den Läufer vollständig einschließt.Die numerische Auswertung zeigt den Einfluß des Polbedekkungswinkels und der Magnetisierungsart der betrachteten Magneterregersysteme auf das Anzugsmoment.

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Influence of the kind of magnetisation and pole are extension on the starting torques in permanent magnet excited dc motors

Contents The field in the air gap of a two-pole permanent magnet excited dc motor is determined by means of field theory. The starting torque is obtained by integrating the tangential component of the Maxwell Stresses along an arbitrarily selected circular-cylindrical air gap surface which surrounds the rotor completely.The numerical evaluation shows the influence of pole arc extension and the kind of magnetisation of the considered magnetic field systems on the starting torque.

     

A broadly cross-protective monoclonal antibody binding to Escherichia coli and Salmonella lipopolysaccharides

During the last decade, episodes of sepsis have increased and Escherichia coli has remained the most frequent clinical isolate. Lipopolysaccharides (LPS; endotoxin) are the major toxic and antigenic components of gram-negative bacteria and qualify as targets for therapeutic interventions. Molecules that neutralize the toxic effects of LPS are actively investigated. In this paper, we describe a murine monoclonal antibody (MAb; WN1 222-5), broadly cross-reactive and cross-protective for smooth (S)-form and rough (R)-form LPS. As shown in enzyme-linked immunosorbent assay and the passive hemolysis assay, WN1 222-5 binds to the five known E. coli core chemotypes, to Salmonella core, and to S-form LPS having these core structures. In immunoblots, it is shown to react with both the nonsubstituted core LPS and with LPS carrying O-side chains, indicating the exposure of the epitope in both S-form and R-form LPS. This MAb of the immunoglobulin G2a class is not lipid A reactive but binds to E. coli J5, an RcP+ mutant which carries an inner core structure common to many members of the family Enterobacteriaceae. Phosphate groups present in the inner core contribute to the epitope but are not essential for the binding of WN1 222-5 to complete core LPS. Cross-reactivity for clinical bacterial isolates is broad. WN1 222-5 binds to all E. coli clinical isolates tested so far (79 blood isolates, 80 urinary isolates, and 21 fecal isolates) and to some Citrobacter, Enterobacter, and Klebsiella isolates. This pattern of reactivity indicates that its binding epitope is widespread among members of the Enterobacteriaceae. WN1 222-5 exhibits biologically relevant activities. In vitro, it inhibits the Limulus amoebocyte lysate assay activity of S-form and R-form LPS in a dose-dependent manner and it neutralizes the LPS-induced release of clinically relevant monokines (interleukin 6 and tumor necrosis factor). In vivo, WN1 222-5 blocks endotoxin-induced pyrogenicity in rabbits and lethality in galactosamine-sensitized mice. The discovery of WN1 222-5 settles the long-lasting controversy over the existence of anti-core LPS MAbs with both cross-reactive and cross-protective activity, opening new possibilities for the immunotherapy of sepsis caused by gram-negative bacteria.