Surveillance after colorectal cancer surgery

Early diagnosis of local and distant recurrences of colorectal cancer remains difficult and there is no agreement on the effectiveness of follow-up in these patients. The aim of this study is to assess the value of our method of follow-up. We consider 239 patients with colorectal cancer and at least 2 years follow-up following radical resection. A local recurrence appeared in 26 patients (10.9%), a distant metastasis in 41 (17.1%), while in seven (2.9%) local and distant recurrences appeared simultaneously. Local recurrence was detected because of an increase in carcinoembryonic antigen (CEA) level in 15 patients (57.7%), during a scheduled endoscopy in four (15.4%) and because of symptoms in seven (26.9%). In seven patients (26.9%) a radical resection was possible. Distant metastases were detected by CEA levels in 20 patients (48.8%), by ultrasonography (U.S.) in 12 (29.3%) and by chest X-ray in five (12.2%). In 13 of 26 patients with liver metastases a resection was performed. This study shows that few patients benefit from follow-up and only CEA levels and liver U.S. performed intensively between 15 and 36 months after surgery are useful in early detection of recurrences. A modification of the follow-up to the single patient, according to the stage, location and grading of cancer, could improve the results, so lowering the costs of this expensive practice.     

Calculation of the acoustical characteristics of gas transport equipment of the unit type in the design stage

Translated from Khimicheskoe i Neftyanoe Mashinostroenie, No. 11, pp. 28–30, November, 1993.     

The effect of grain-size on the stress and velocity fields ahead of a crack in a material which deforms by Coble creep

The stress and velocity fields ahead of a grain-boundary crack in a material which deforms by Coble creep are investigated for a series of grain sizes using the numerical analysis technique established by Cocks [1–3]. The numerical results are compared with the linear viscous fields obtained by the boundary element method and the finite element method. It is demonstrated that a detailed knowledge of the micromechanical processes of material transport and deformation are required to determine the stress and displacement fields for the grains which immediately surround the crack tip. But the response of the surrounding material can be adequately described from a conventional linear viscous analysis of the problem.     

T cell responsiveness correlates differentially with antibody isotype levels in clinical and asymptomatic filariasis

To establish the relationships among T and B cell responses, active infection, and clinical manifestations in lymphatic filariasis, filarial-specific lymphocyte proliferation, IgG antibody isotypes, and IgE levels were determined in an exposed population: 31 asymptomatic amicrofilaremics, 43 microfilaremics, 12 symptomatic amicrofilaremics, and 52 elephantiasis patients. Lymphocyte proliferation was higher in elephantiasis patients and asymptomatic amicrofilaremics than in microfilaremics (P < .004). A proportion of asymptomatic amicrofilaremics (32%), elephantiasis patients (37%), and symptomatic amicrofilaremics (58%) showed antigen-specific lymphocyte unresponsiveness, and lymphocyte proliferation to filarial antigens correlated negatively with specific IgG4 levels (rho = -0.315, P < .001). As elevated specific IgG4 is an indicator of active infection, it is argued that active infection may result in lymphocyte hyporesponsiveness irrespective of clinical category. Of those with elevated specific IgE levels and high T cell proliferative responses, 70% had elephantiasis, suggesting these factors have a role in pathology. However, the existence of a proportion of elephantiasis patients with low anti-filarial IgE and T cell unresponsiveness to filarial antigens suggests that elephantiasis can be caused by distinct processes.     

Elbow flexion strength curves in untrained men and women and male bodybuilders

The mechanical response of intervertebral joints is deeply influenced by disc degeneration. The phenomenon is expressed in terms of variations in the biomechanical properties of the material, whose compressibility characteristics change because of the liquid content loss in the tissue and, what is even more important, to prolapse. In this work, the problem is investigated by means of a computational mechanics approach; a coupled material and geometric non-linear model is developed, representing vertebra, annulus and nucleus submitted to an axial load. A transversely isotropic law is assumed for cortical bone in the vertebral body and an isotropic law for the cancellous portion; a hyperelastic formulation is assumed for the disc, allowing effective interpretation of the mechanical characteristics of degeneration. The results obtained are reported with regard to bony endplate and annulus behaviour; interaction phenomena between bony endplate and nucleus are emphasized.     

Intrauterine transfusions influence fetal leukocyte counts and subsets

Histamine is an important mediator in allergic reactions, gastric acid secretions, and neurotransmission in the central nervous system. Basophils and mast cells are the main sources of histamine, which is formed from L-histidine by histidine decarboxylase (HDC). However, the regulatory mechanism of HDC in these cells remains unclear. We examined the regulation of HDC activity and gene expression using a unique human mast cell line, HMC-1, after stimulation with phorbol 12-myristate 13-acetate (PMA) or ionomycin. HDC activity was increased from 52.1+/-0.4 (mean+/-standard deviation) to 154+/-6.9, or 105.6+/-6.2 pmol/min/mg protein (n = 3), 4 hours after stimulation with PMA (10 ng/mL) or ionomycin (10[-6] M). Although actinomycin D had no effect on this increase, cycloheximide completely inhibited the increase caused by these stimuli. The population of HMC-1 cells containing HDC protein was increased after stimulation with either PMA or ionomycin as evaluated by immunocytochemical analysis with anti-HDC antibody as a marker. HMC-1 constitutively expressed HDC mRNA, and its level was not increased with these stimuli. These results suggest that the increase of HDC activity in HMC-1 induced by PMA or ionomycin is regulated at the translational level.     

Neurological complications of radiotherapy and chemotherapy

Neurological complications of radiotherapy and chemotherapy can affect the central or peripheral nervous system. Most are dose-dependent and constitute a limiting factor in the administration of treatments. Radiation-induced neurological complications are classified as acute, early-delayed or delayed. The most important are radionecrosis and cognitive dysfunction/leukoencephalopathy. Neurotoxicity of chemotherapy is frequent and depends upon dose, type of drugs (especially cisplatin and methotrexate) and their combination with radiotherapy.     

Arterial blood pressure response to transient arousals from NREM sleep in nonapneic snorers with sleep fragmentation

STUDY OBJECTIVES: To assess the hemodynamic effects of graded arousals during nonrapid eye movement (NREM) sleep in patients with partial upper airway obstruction during sleep without obstructive sleep apnea/hypopnea, overnight beat-to-beat BP was recorded in six patients. SETTING: At the end of each nonapneic obstructive event, EEG responses were graded as follows: grade 2, grade 1, and grade 0 were defined as increased high-frequency EEG lasting >15 s, 3 to 15 s, and no EEG arousals according to the American Sleep Disorders Association, respectively. MEASUREMENTS AND RESULTS: The following were observed during grade 0, 1, and 2 EEG patterns (mean+/-SD): systolic pressure increased by 7.1+/-1.5, 11.7+/-1.9, and 14.2+/-3.4 (p<0.005), respectively; diastolic pressure increased by 4.6+/-0.6, 6.7+/-1.7, and 9.4+/-3.0 (p<0.005), respectively; heart rate increased by 2.9+/-0.4, 3.9+/-2.2, and 8.6+/-4.6 (p<0.005), respectively. CONCLUSIONS: We conclude that nonapneic-nonhypopneic obstructive events are followed by arterial systemic pressure increases whose magnitude varies with the grade of the arousal.     

A vertically integrated tool for automated design of /spl Sigma//spl Delta/ modulators

We present a tool that starting from high-level specifications of switched-capacitor (SC) /spl Sigma//spl Delta/ modulators calculates optimum specifications for their building blocks and then optimum sizes for the block schematics. At both design levels, optimization is performed using statistical techniques to enable global design and innovative heuristics for increased computer efficiency as compared with conventional statistical optimization. The tool uses an equation-based approach at the modulator level, a simulation-based approach at the cell level, and incorporates an advanced /spl Sigma//spl Delta/ behavioral simulator for monitoring and design space exploration. We include measurements taken from two silicon prototypes: (1) a 16 b @ 16 kHz output rate second-order /spl Sigma//spl Delta/ modulator; and (2) a 17 b @ 40 kHz output rate fourth-order /spl Sigma//spl Delta/ modulator. Both use SC fully differential circuits and were designed using the proposed tool and manufactured in a 1.2 /spl mu/m CMOS double-metal double-poly technology.<>     

β-Si3N4Whiskers Embedded in Oxynitride Glasses: Interfacial Microstructure

Interfacial microstructures in βP-Si₃N₄( w )-Si-Al-Y-O-N-glass systems were investigated by systematically varying the nitrogen content and the Al:Y ratio of the glass matrix. High-resolution and analytical transmission electron microscopy (HREM and AEM) studies revealed that the interfacial microstructure is a function of the glass composition. No interfacial phases were formed in glasses with low Al:Y ratios and in glasses with high Al:Y ratios and low nitrogen content, whereas epitaxial growth of an interfacial layer (100–200 μm thick) on the βP-Si₃N₄( w ) occurred in a glass matrix with high Al:Y ratio and high nitrogen content. The interfacial layer was identified to be a β'-SiAION phase. Interfaces containing the SiAION layer exhibited high debonding energy compared to Si₃N₄( w )–glass interfaces. HREM studies indicated that the lattice-mismatch strain in the SiAION layer was relieved by dislocation formation at the SiAION–Si₃N₄( w ) interface. The difference in interfacial debonding energy was, hence, attributed to the local atomic structure and bonding between the glass-β-Si₃N₄ and the glass–β'-SiAION phases. This observation was clear evidence of the strong influence of glass chemistry on the interfacial debonding behavior by altering the interfacial microstructure.