Absence of neuropathic pelvic pain and favorable psychological profile in the surgical selection of patients with disabling interstitial cystitis

PURPOSE: We evaluated the results among patients with disabling interstitial cystitis treated by cystectomy, urethrectomy and creation of a continent colonic urinary reservoir (the Florida pouch). The value of psychological evaluation and pain localization techniques, as well as the use of a team approach in the evaluation of these patients were assessed. MATERIALS AND METHODS: The 20 women and 2 men who underwent surgery for disabling interstitial cystitis ranged from 31 to 75 years old (mean age 48). The duration of symptoms ranged from 2 to 14 years (mean 7). All patients had undergone multiple prior therapies, including vesical hydrodistension, instillations, laser treatments, and use of tranquilizers and a variety of pain medications. Patients underwent a clinical, cystoscopic (with bladder biopsies) and urodynamic evaluation as well as examination by a gynecologist with expertise in vaginal ultrasonography. The last 5 patients underwent psychological evaluation and pain localization techniques. RESULTS: Among the clinical parameters, the presence of a small capacity bladder with the patient under anesthesia (less than 400 cc) was associated with the best surgical results. Among 11 patients evaluated only clinically success was achieved in 64%, while all 5 (100%) who also underwent pain localization techniques and psychological evaluation had a successful outcome postoperatively. The overall surgical success rate in the 22 patients was 73%. Two patients undergoing psychological evaluation and pain localization techniques were not considered to be surgical candidates. Among 7 surgical failures 4 patients underwent postoperative psychological evaluation and pain localization techniques, and they would not have been considered candidates for surgery with the new parameters. CONCLUSIONS: A team approach is essential in the evaluation of these patients. Following the initial selection of patients who had a small bladder capacity while under anesthesia, psychological evaluation and pain localizing techniques may assist surgeons in selecting those who would benefit from a radical operation.     

Mercury species in the liver of ringed seals

Four types of mercury species, namely, methylmercury, organic mercury other than methylmercury, inorganic mercury, and insoluble mercury, deemed to be mercuric selenide (HgSe), were found in the liver of 45 ringed seals from the Canadian Arctic. On average, methylmercury, at 2%, made up the smallest fraction of the total mercury in the liver of these animals. Of the total mercury concentration in seal liver, 53% was insoluble mercury, estimated to be largely mercuric selenide. Other workers have found this compound to be present in mammalian liver and identified it to be HgSe. Organic mercury other than methylmercury made up 4%, and inorganic mercury 42% of the total mercury in the liver. The sum of the independently determined mercury species agreed well with the total mercury concentration in the liver. Species other than mercuric selenide are known to be toxic. Mercuric selenide, considered to be a stable end product of the demethylation process of methylmercury, although not readily eliminated from the liver, is inert and apparently non-toxic. Only approximately half of the total mercury in the liver was potentially toxic mercury. All four mercury species were positively correlated with the age of animals, the regression slope on age being 20 times larger for insoluble Hg (HgSe) than for methylmercury. A number of reported observations, such as the long half-life of Hg in liver (> or = 10 years), the dependence of Hg on age, and the often-observed one-to-one relationship between Hg and Se (on a molar basis), are readily explained by the temporal accumulation of HgSe in the liver. In the future, a more accurate assessment of the health risk to animals and humans from the consumption of contaminated animal tissues will be possible, by measuring all mercury species rather than just total mercury or methylmercury. Total mercury alone in the liver is an inadequate indicator of toxicity to animals. Methylmercury was analyzed by capillary gas-liquid chromatography with ECD detection, and the other species were operationally/experimentally defined using physical/chemical methods.     

Effects of aging on the biomechanics of slips and falls

Although much has been learned in recent decades about the deterioration of muscular strength, gait adaptations, and sensory degradation among older adults, little is known about how these intrinsic changes affect biomechanical parameters associated with slip-induced fall accidents. In general, the objective of this laboratory study was to investigate the process of initiation, detection, and recovery of inadvertent slips and falls. We examined the initiation of and recovery from foot slips among three age groups utilizing biomechanical parameters, muscle strength, and sensory measurements. Forty-two young, middle-age, and older participants walked around a walking track at a comfortable pace. Slippery floor surfaces were placed on the track over force platforms at random intervals without the participants' awareness. Results indicated that younger participants slipped as often as the older participants, suggesting that the likelihood of slip initiation is similar across all age groups; however, older individuals' recovery process was much slower and less effective. The ability to successfully recover from a slip (thus preventing a fall) is believed to be affected by lower extremity muscle strength and sensory degradation among older individuals. Results from this research can help pinpoint possible intervention strategies for improving dynamic equilibrium among older adults.     

The study of aluminum soap-hydrocarbon systems: Effect of additives and metathesis

Summary Many additives have pronounced and manifold effects on the behavior of aluminum soaps-hydrocarbon systems. Some additives accelerate the formation of jellies, other retard it. Some thicken the jellies, others liquefy them. The mechanism of the action of additives is probably manifold, too. One of the many possible mechanisms is that of metathesis between the fatty acid radical of the soap and acidic additives. The actual occurrence of such metathesis is demonstrated by both qualitative observations of a variety of systems and by the preparation in benzene of aluminum dibenzoate from the dilaurate. Presented before the Division of Colloid Chemistry at the 113th meeting of the American Chemical Society, April 19, 1948, in Chicago, Illinois. Study conducted under Contract OEM-1057 between Stanford University and the Office of Emergency Management, recommended by Division 11.3 of the National Research Council, and supervised by Prof. J. W. McBain.     

Presence and implications of chemical contaminants in the freshwaters of the Canadian Arctic.

Hydrocarbons, stable organochlorines, metals and radionuclides are widespread in the freshwaters of the Canadian Arctic. Petroleum-associated hydrocarbon sources include natural seepage, wastes and effluents from exploration, production and refining at Norman Wells and spills. Hydrocarbons also originate from combustion of carbon-based fuels, generally at lower latitudes and then reach the Arctic with air movements. Organochlorine compounds also move throughout the hemisphere by aerial pathways and have become distributed widely in Arctic fish. The organochlorine at highest concentration in Arctic freshwater is alpha-HCH, while those generally at highest concentrations in the fish are toxaphene, PCBs and chlordane. Metals are ubiquitous in Arctic freshwaters, with inputs of several metals by precipitation superimposed on natural geologic backgrounds. Mercury is found in muscle of fish from Arctic freshwaters at concentrations up to about 0.5 ppm. Radionuclides are also widespread at levels below those acceptable in food, with some local elevations near former mines. The implications of these contaminants for the northern ecosystems and the people dependent upon them are still not clear. Preliminary studies of inducible enzymes in fish suggest that the thresholds for biological damage have not been reached.     

Genome-wide expression monitoring in Saccharomyces cerevisiae

The genomic sequence of the budding yeast Saccharomyces cerevisiae has been used to design and synthesize high-density oligonucleotide arrays for monitoring the expression levels of nearly all yeast genes. This direct and highly parallel approach involves the hybridization of total mRNA populations to a set of four arrays that contain a total of more than 260,000 specifically chosen oligonucleotides synthesized in situ using light-directed combinatorial chemistry. The measurements are quantitative, sensitive, specific, and reproducible. Expression levels ranging from less than 0.1 copies to several hundred copies per cell have been measured for cells grown in rich and minimal media. Nearly 90% of all yeast mRNAs are observed to be present under both conditions, with approximately 50% present at levels between 0.1 and 1 copy per cell. Many of the genes observed to be differentially expressed under these conditions are expected, but large differences are also observed for many previously uncharacterized genes.     

Double-blind placebo-controlled trial of methylphenidate in the treatment of adult ADHD patients with comorbid cocaine dependence.

In this 12-week double-blind placebo-controlled trial of methylphenidate (MTP) versus placebo in 48 cocaine-dependent attention-deficit/hyperactivity disorder (ADHD) adults, the authors sought to determine whether MTP would be safe, control ADHD symptoms, and affect cocaine use. Efficacy indexes revealed significantly greater ADHD symptom relief in the MTP group. There were no group differences in self-reported cocaine use, urinalysis results, or cocaine craving. Because of the relatively small sample size, the results are preliminary. However, the authors found that MTP improved subjective reports of ADHD symptoms and did not worsen cocaine use while participants were in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of Detector Intrinsic Spatial Resolution Characteristics for Sensor on the Entrance Surface and Conventional Readout Designs

We report on a high resolution, monolithic crystal PET detector design concept that provides depth of interaction (DOI) positioning within the crystal. Our design utilizes a novel sensor on the entrance surface (SES) approach combined with a maximum likelihood positioning algorithm. We compare the intrinsic spatial resolution characteristics (i.e., X, Y and Z) using our SES design versus conventional placement of the photo-sensors on the rear surface of the crystal. The sensors can be any two-dimensional array of solid state readout devices (e.g., silicon photomultipliers (SiPM) or avalanche photodiodes (APD)). SiPMs are a new type of solid-state photodetector with Geiger mode operation that can provide signal gain similar to a photomltipiler tube (PMT). Utilizing a multi-step simulation process, we determined the intrinsic spatial resolution characteristics for a variety of detector configurations. The SES design was evaluated via simulation for three different two-dimensional array sizes: 8×8 with 5.8×5.8 mm(2) pads; 12×12 with 3.8×3.8mm(2) pads; and 16×16 with 2.8×2.8 mm(2) pads. To reduce the number of signal channels row-column summing readout was used for the 12×12 and 16×16 channel array devices. The crystal was modeled as a 15 mm monolithic slab of a lutetium-based scintillator with the large area surface varying from 48.8×48.8 mm(2) up to 49.6×49.6 mm(2) depending upon the dimensions of the two-dimensional photo-sensor array. The intrinsic spatial resolution for the 8×8 array is 0.88 mm FWHM in X and Y, and 1.83 mm FWHM in Z (i.e., DOI). Comparing the results versus using a conventional design with the photo-sensors on the backside of the crystal, an average improvement of ~24% in X and Y and 20% in Z is achieved. The X, Y intrinsic spatial resolution improved to 0.67 mm and 0.64 mm FWHM for the 12×12 and 16×16 arrays using row-column readout. Using the 12×12 and 16×16 arrays also led to a slight improvement in the DOI positioning accuracy.