Anatomic correction of transposition of the great vessels

We present a new approach for anatomic correction of transposition of the great arteries. The two coronary arteries, with a piece of the aortic wall attached, are transposed to the posterior artery. The two aortic openings are closed with a patch. The aorta and pulmonary artery are transected, contraposed, ant then anastomosed. The interventricular septal defect is closed with a patch, through a right ventriculotomy approach, because the right ventricle is no longer part of the systemic circulation. Two patients, aged 3 months and 40 days weighing 4,200 and 3,700 grams, respectively, were operated upon with deep hypothermia and total circulatory arrest. There was good recovery from the operation, with normal cardiocirculatory conditions. Renal failure developed in the first patient, and she died on the third postoperative day. During this time the cardiocirculatory conditions were good. The second patient made an uneventful recovery. Hemodynamic studies 20 days after the operation showed complete correction of the malformation. Five and one-half months after the operation, he weighs 7,500 grams, and his development is very good. We believe that this operation will be reproducible by most cardiovascular septal defect and pulmonary hypertension.     

An unusual case of large right atrial myxoma

A case of right atrial myxoma is described. The patient had vague and variable symptoms and it was not until five years after first presentation that she had developed clinical and electrocardiographic evidence of right atrial hypertrophy, and angiocardiographic evidence of a fist-sized myxoma which was subsequently removed surgically.     

Comparison of high-performance liquid chromatographic serum profiles of humans and dogs

The sera of 30 healthy male beagles were analyzed by reversed-phase high-performance liquid chromatography. The profiles were compared with those obtained from the sera of 30 healthy human donors. The chromatograms of each group were very reproducible; however, there were characteristic differences between the two groups. The compounds observed in both the human and canine profiles were identified as creatinine, uric acid, tyrosine, hypoxanthine, xanthine, kynurenine, inosine and tryptophan. Compounds present only in the canine profiles were identified as cytindine, riboflavin and 5-methyl-cytidine. Compounds present only in the human profiles include uridine, guanosine, hippuric acid and the dietary dependent compounds theobromine and caffeine. The compounds present in both human and canine sera were quantitated and compared statistically. The amounts of these compounds were very similar, except for uric acid.     

Reporting of zoonotic diseases

Departments of public health and agriculture in all 50 states of the United States and the District of Columbia were queried in 1977 to determine which of some selected zoonoses are reportable, the method of reporting and the diagnostic stage at which reporting is required. Fifty-three of the 62 diseases on the public health questionnaire were listed as reportable, with hepatitis A required by 49 of the 51 jurisdictions. Telephone reporting was required in nearly 19% of the disease-jurisdiction combinations and, in nearly 55%, reporting was required when the disease first was suspected. Thirty-three of the 41 diseases on the agriculture questionnaire were reportable, with anthrax most frequent. Telephone reporting was required in 30% of the reportable situations and suspected diagnoses were reportable in 54%. The disease lists varied markedly between the public health and agriculture agencies.     

An enhanced strain 3D element for large deformation elastoplastic thin-shell applications

In this work a previously proposed solid-shell finite element, entirely based on the Enhanced Assumed Strain (EAS) formulation, is extended in order to account for large deformation elastoplastic thin-shell problems. An optimal number of 12 enhanced (internal) variables is employed, leading to a computationally efficient performance when compared to other 3D or solid-shell enhanced elements. This low number of enhanced variables is sufficient to (directly) eliminate either volumetric and transverse shear lockings, the first one arising, for instance, in the fully plastic range, whilst the last appears for small thickness values. The enhanced formulation comprises an additive split of the Green-Lagrange material strain tensor, turning the inclusion of nonlinear kinematics a straightforward task. Finally, some shell-type numerical benchmarks are carried out with the present formulation, and good results are obtained, compared to well-established formulations in the literature.Funding by Ministério da Ciência e do Ensino Superior (FCT and FSE) (Portugal) under grant PRAXIS XXI/ BD/21662/99; as well as the funding by FEDER, under grant POCTI/EME/47289/2002, are gratefully acknowledged.     

Readmission discount factors in program evaluation. An output value analysis of an adult psychiatry program

The application of output value analysis, a type of benefit/cost analysis, to a psychiatric patient population is reported. A method for discounting the value of the program if a patient was readmitted within a year after discharge was introduced. The application of this discount factor reduces the value produced by the program and thereby reduces both productivity and effectiveness indices. When applied to groups known to differ in readmission rates, such as first admissions and readmissions or voluntary and involuntary admissions, the discount factor can accentuate group differences markedly. When selected diagnostic groups were compared, the discount factor could even reverse the relative standing of the groups.     

Growth of clinical isolates of anaerobic bacteria on agar media: effects of media composition, storage conditions, and reduction under anaerobic conditions

The quantitative growth, the colony size, and the rate of growth of 47 clinical anaerobic isolates were compared on five different media, namely Brucella agar, brain heart infusion agar, Columbia agar, Schaedler agar, and tryptic soy agar. There was no significant difference in the quantitative growth of the anaerobes inoculated onto the five media. Although no single medium was superior for the growth of all isolates, 12 of 22 isolates, inoculated onto media stored for 4 weeks or less, grew best on Schaedler agar. The effects of supplementation of the media with reducing agents and reduction of the media before use were also analyzed and were found to be affected by the composition and length of storage of the media, as well as the bacteria tested.     

Cytogenetic studies of the Australian rodent, Uromys caudimaculatus, a species showing extensive heterochromatin variation

The Australian rodent, Uromys caudimaculatus, consists of two chromosome races. a) The Southern Race is characterized by the possession of two to twelve B-chromosomes. These vary considerably in size, morphology, and C- and G-banding characteristics, they behave as univalent at meiosis and are inherited in a random manner. b) The Northern Race lacks B-chromosomes, but possesses large blocks of distal C-positive heterochromatin on between 18 and 28 of the 46 chromosomes. The C-blocks may be entirely G-positive entirely G-negative, or G-banded, suggesting heterogeneity with the C-blocks. There is extensive variation both between and within populations of the northern race in the number and size of the distal heterochromatic blocks. There is no apparent difference between the races in chiasma frequency. The northern race does have much higher proportion of interstitial versus distal chiasmata, although it is probable that this is merely a reflection of lack of crossing over in the heterochromatic blocks rather than an actual shift of chiasma localisation within the euchromatin. Despite the extensive differences between the races in the amount and organization of constitutive heterochromatin, hybrids show no abnormalities at meiosis and they are fully fertile.