Placebo pain medication. Ethical and practical considerations

The placebo effect on pain is a complex phenomenon. The unconsented use of placebo pain medication, however, raises concerns given the risks both to patient trust and to the medical profession's reputation in condoning deception, the inherent distastefulness of deception, the misuse of placebos that occurs, and the fact that the information obtained is often of negligible value. The main justification given for using placebos is based on the assumption that they are effective and beneficial to patients. We argue that placebo pain medication should be prescribed to patients only with their informed consent in scientifically rigorous single-patient studies. The results of such trials would constitute a particularly useful way of resolving uncertainty in the treatment of patients whose pain is poorly controlled.     

Presence of immunocytes and sulfidopeptide leukotrienes in the inflamed guinea pig distal colon

This study examined whether the immunocyte recruitment associated with a mild inflammatory state induced by acetic acid would produce detectable sulfidopeptide leukotriene (LT) levels from colonic tissues or in dialysates. Histological examination and measurements of peroxidase activities of inflamed tissues indicated edema, hyperplasia and neutrophil infiltration. Significant elevated LTB4 and prostaglandin E2(PGE2) levels were found but only slight elevations in sulfidopeptide LTs occurred. A slight elevation in eosinophil peroxidase indicated that eosinophil infiltration also occurred. The increase in sulfidopeptide LT levels appeared insufficient by itself to alter secretory responses in the distal colon. However, combined with other immunocyte products such as PGs, the sulfidopeptide LTs may influence the symptomology of inflammatory bowel disease.     

High-breakdown-voltage AlInAs/GaInAs junction-modulated HEMT's(JHEMT's) with regrown ohmic contacts by MOCVD

A technology for increasing both the two-terminal gate-drain breakdown and subsequently the three-terminal-off-state breakdown of AlInAs/GaInAs high-electron-mobility transistors (HEMTs) to record values without substantial impact on other parameters is presented. The breakdown in these structures is dependent on the multiplication of electrons injected from the source (channel current) and the gate (gate leakage) into the channel. In addition, holes are generated by high fields at the drain and are injected back into the gate and source electrodes. These phenomena can be suppressed by increasing the gate barrier height and alleviating the fields at the drain. Both have been achieved by incorporating a p⁺-2DEG junction as the gate that modulates the 2DEG gas and by utilizing selective regrowth of the source and drain regions by MOCVD. The 1-μm-gate-length devices fabricated have two-terminal gate-drain and three-terminal-off-state breakdown voltages of 31 V and 28 V, respectively     

Geographic variations in the composition of ivory of the African elephant (Loxodonta africana)

OBJECTIVES: The purpose of the present study was to compare the inclination of the occlusal plane with occlusal guidance as a contributing factor to masticatory movement. METHODS: Masticatory movements of 41 young adults were measured using a 3-D mandibular movement analysing system. The inclination of the occlusal plane was measured in the sagittal plane using a 3-D digitizer. The contribution of the occlusal guidance and the inclination of the occlusal plane to the direction of the masticatory path of closure was evaluated at various closing levels. RESULTS: The masticatory path of closure outside the intercuspal range was influenced mainly by the inclination of the occlusal plane, and the masticatory path of closure near the intercuspal range was only influenced by occlusal guidance. The so-called gliding type masticatory pattern was observed predominantly in subjects with a posteriorly inclined occlusal plane. In contrast, a chopping type masticatory pattern was observed predominantly in subjects with an anteriorly inclined occlusal plane. CONCLUSIONS: The contribution of the inclination of the occlusal plane to masticatory movement was greater than that of occlusal guidance throughout the closing phase except near the intercuspal range.     

Gender differences in FFM accumulation and architectural characteristics of muscle

OBJECTIVE: To characterize the existence and role of transforming growth factor-beta (TGF-beta) in otitis media with effusion (OME). STUDY DESIGN: Retrospective. METHODS: The levels of two major TGF-beta isoforms, TGF-beta1 and TGF-beta2, in the middle ear effusions (MEEs) of 44 children were evaluated using enzyme-linked immunospecific assays (ELISAs). Forty-eight MEEs were separated into three clinically relevant groups (i.e., serous, mucoid, and purulent), and TGF-beta levels were correlated with clinical parameters of disease for these MEEs. RESULTS: Both TGF-beta1 and TGF-beta2 were present in the samples. Mean levels of TGF-beta1 (920.36 +/- 437.75 pg/mg total protein) were generally 100-fold greater than those of TGF-beta2 (9.65 +/- 11.19 pg/mg total protein). TGF-beta1 levels were elevated in association with a history of previous tympanostomy tube placements (TTPs) (P = .029) and mucoid effusions (P = .042). TGF-beta2 levels were elevated in association with a history of previous TTPs (P = .100) and chronic (i.e., serous or mucoid) effusions (P = .003). CONCLUSIONS: TGF-beta1 is present in the MEEs of children with OME. Furthermore, TGF-beta1 and TGF-beta2 levels were elevated differentially in the presence of chronic disease indicators in OME, suggesting that these isoforms may have differing roles in the inflammatory processes that characterize OME.     

SURF1, encoding a factor involved in the biogenesis of cytochrome c oxidase, is mutated in Leigh syndrome

A drug with cationic characteristics such as procaine can be conveyed in a Carbomer hydrogel in two different ways: (i) in the form of salt in solution in the aqueous phase, and (ii) in the base form salified with the same polymer. Introduction of the drug into the hydrogel with different concentrations of polymer produced, in both cases, a reduction in viscosity in relation to drug concentration. The gels with procaine salified with the polymer showed greater viscosity. The drug release rate, in general, diminished with the increase in polymer concentration. Nevertheless, when this concentration was maintained, there was no variation in release rate when the viscosity produced as a consequence of drug concentration was changed. Gels with procaine salified with the carboxyvinylic polymer had a faster release rate than those with procaine in the hydrochloride form dissolved in the aqueous phase. These results have also been confirmed by a simulated absorption test.     

Use of highly overcoupled couplers to detect shifts in Braggwavelength [strain sensors]

The authors present a technique for detecting Bragg wavelength shifts using highly overcoupled couplers (HOCC). An HOCC of 60%/nm was fabricated with 626 cycles. With our HOCC, a 5 μW LED and a 95% reflective Bragg grating we were able to detect 10 μstrain (Δλ=0.01 nm)     

Comments on “Learning convergence in the cerebellar modelarticulation controller”

The commenter refers to the paper by Wong-Sideris (ibid. vol.3, p.115-21 (1992)) claiming that the original Albus CMAC (or binary CMAC) is capable of learning an arbitrary multivariate lookup table, the linear optimization process is strictly positive definite, and that the basis functions are linearly independent, given sufficient training data. In recent work by Brown et al. (1994), however, it has been proved that the multivariate binary CMAC is unable to learn certain multivariate lookup tables and the number of such orthogonal functions increases exponentially as the generalization parameter is increased. A simple 2D orthogonal function is presented as a counterexample to the original theory. It is also demonstrated that the basis functions are-always linearly dependent, both for the univariate and the multivariate case, and hence the linear optimization process is only positive semi-definite and there always exists an infinite number of possible optimal weight vectors.     

Influence of Neotyphodium coenophialum on copper concentration in tall fescue

Poor performance of livestock that graze tall fescue (Festuca arundinacea Schreb.) has been associated with the endophyte fungus Neotyphodium coenophialum [Morgan-Jones and Gams] Glenn, Bacon, and Hanlin). Recent evidence suggests lowered Cu status and a depression of Cu-related immune function in steers that graze endophyte-infected (E+) tall fescue. Greenhouse and field studies investigated relationships between the endophyte and Cu concentrations in tall fescue. Seventeen infected 'Kenhy' clones were divided, and one plant of each pair was treated three times with Benomyl to remove the endophyte (E-). Plants were watered with nutrient solution in a greenhouse for 6 mo before sampling. Copper concentrations were greater (P < .001) in E- than in E+ clones (3.4 vs 2.8 microg/g; SE, .06). In the second greenhouse experiment, genetically similar E+ and E- 'Kentucky'-31 (KY-31) and 'Georgia Jessup' were grown from seed and fertilized with nutrient solution to produce mature plants. Copper concentrations were higher (P < .05) in E- than in E+ tall fescue (8.6 vs 7.6 microg/g; SE, .3). In a field plot experiment in Texas, E+ and E- KY-31 were grown with 0, 50, and 100% replacement of potential evapotranspiration. By September, Cu concentrations were higher (P < .05) in E- than in E+ tall fescue (7.3 vs 6.6 microg/g; SE, .2). In pasture experiments, KY-31 E+ (> 70% infection level) and E- (< 5% infection level) tall fescue were grown in Virginia at two locations with three rates of N fertilizer. Copper concentrations were higher (P < .05) in E- than in E+ tall fescue (4.8 vs 4.5 microg/g; SE, .1) and increased (P < .01) linearly in response to N. Our data demonstrate that the presence of the endophyte is associated with lower Cu concentrations in tall fescue, which may contribute to lowered Cu status in animals and thus contribute to the etiology of fescue toxicity.