Thoracoscopic T2-sympathetic block by clipping--a better and reversible operation for treatment of hyperhidrosis palmaris: experience with 326 cases

Although thoracoscopic sympathectomy or sympathicotomy is the best treatment for hyperhidrosis palmaris, a new approach of clipping only without transection of T2-sympathetic trunk is just as effective. Aside from the guaranteed cure of hyperhidrosis, this new method has fewer complications and has the advantage of recovery of the sympathetic tone in the hands if the procedure is reversed by the removal of the clips. Between March 18 and September 30 of 1996, 326 patients (190 female and 136 male with a mean age of 20.5 years) underwent thoracoscopic T2-sympathetic block by clipping to treat hyperhidrosis. Good results and few complications were noted during follow up six months to one year postoperatively. Five of the 326 patients, all female, had the operation reversed because of intolerable compensatory sweating. Three recovered from the compensatory sweating within two months and had less palmar sweating than before their sympathetic block; the fourth achieved relief of compensatory sweating after nine months, and the fifth reported no improvement.     

A neostriatal habit learning system in humans

Amnesic patients and nondemented patients with Parkinson's disease were given a probabilistic classification task in which they learned which of two outcomes would occur on each trial, given the particular combination of cues that appeared. Amnesic patients exhibited normal learning of the task but had severely impaired declarative memory for the training episode. In contrast, patients with Parkinson's disease failed to learn the probabilistic classification task, despite having intact memory for the training episode. This double dissociation shows that the limbic-diencephalic regions damaged in amnesia and the neostriatum damaged in Parkinson's disease support separate and parallel learning systems. In humans, the neostriatum (caudate nucleus and putamen) is essential for the gradual, incremental learning of associations that is characteristic of habit learning. The neostriatum is important not just for motor behavior and motor learning but also for acquiring nonmotor dispositions and tendencies that depend on new associations.     

Association of MSX1 and TGFB3 with nonsyndromic clefting in humans

Nonsyndromic cleft lip with or without cleft palate (CL/P) and nonsyndromic cleft palate only (CPO) are common congenital anomalies with significant medical, psychological, social, and economic ramifications. Both CL/P and CPO are examples of complex genetic traits. There exists sufficient evidence to hypothesize that disease loci for CL/P and CPO can be identified by a candidate-gene linkage-disequilibrium (LD) strategy. Candidate genes for clefting, including TGFA, BCL3, DLX2, MSX1, and TGFB3, were screened for LD with either CL/P or CPO in a predominantly Caucasian population, with both case-control- and nuclear-family-based approaches. Previously reported LD for TGFA with both CL/P and CPO could not be confirmed, except in CL/P patients with a positive family history. Also, in contrast to previous studies, no LD was found between BCL3 and either CL/P or CPO. Significant LD was found between CL/P and both MSX1 and TGFB3 and between CPO and MSX1, suggesting that these genes are involved in the pathogenesis of clefting. In addition, a mutation search in the genes DLX2, MSX1, and TGFB3 was performed in 69 CPO patients and in a subset of the CL/P patients. No common mutations were found in the coding regions of these genes; however, several rare variants of MSX1 and TGFB3 were found that may alter the latters' normal function. These results form the basis for future research, including (a) mutation searches in the MSX1 and TGFB3 genes in Caucasian CL/P patients and (b) extension of the search for MSX1 mutations in CPO patients to the noncoding regions.     

The regulation of drugs and medicines in horse racing in the United States. The Association of Racing Commissioners International Uniform Classification of Foreign Substances Guidelines

It is proposed that both polar and radical reactions should be considered when discussing radical ion reactivity. The fact that only the polar reactivity has dominated previous discussions is pointed out. It is argued that if the configuration mixing model is applicable for the estimation of radical cation-nucleophile (or cation-nucleophile) combination reaction barriers, the theory should also explain the reactivity of the proton toward anionic nucleophiles. The model severely overestimates reaction barriers for the latter reactions. The discussion is centered around the following hypothesis: In the absence of severe steric effects, the reactivity of radical ions, especially evident in the reactions with radicals (for example very few radical cations react with dioxygen at measurable rates), is dominated by the degree of coupling between charge and radical centers. Evidence from the literature supporting the hypothesis is presented for a number of different classes of radical ion reactions. Further work to test the validity of the hypothesis is proposed for many of the reaction types. Triarylmethyl radicals and carbenium ions are suggested as models to which the radical and polar reactivities of 9,10-diarylanthracene radical cations may be compared. It is concluded that the radical cation/carbenium ion comparison (for the reaction with acetate ion) would show similar reactivities while the radical cation/free radical comparison (for the reaction with dioxygen) would fail, since no reaction at all would be observed with the radical cation while the free radical reacts rapidly.     

On Barenblatt's problem

The problem of flow in media with double porosity (e.g. fissured rocks) is considered by utilizing the author's concept of “multiporosity” and employing the apparatus of continuum theory of mixtures. Relevant results obtained by Barenblatt et al. within the Russian literature are shown to be contained in the present theory.     

A primate model for enteral nutrition by tube

To establish an animal model for the controlled study of enteral nutrition by tube, five adult chair-adapted primates (Macaca fasicularis) had gastrostomy and jejunostomy tubes placed for the delivery of a modified protein isolate diet. Following 7 days of postoperative depletion with a hypocaloric infusion of dextrose (20 kcal, 0 g N/kg/day), the animals were repleted for 10 days with tube feedings (124 kcal, 0.73 g N/kg/day). There was no operative mortality or morbidity and each animal demonstrated conversion to anabolism by significant weight gain, positive nitrogen balance, and net protein synthesis as determined by [15N]glycine protein turnover rates. Significant correlation was found between caloric intake and nitrogen balance at the level of nitrogen provided in this diet (r = 0.88, p less than 0.05). This model was found to be well suited for the surgical and nutritional techniques required for the long-term study of enteral nutrition by tube.     

Inverted-annular film boiling heat transfer from vertical surfaces

A theoretical model is developed which allows a consistent treatment of the wall heat flux in an inverted-annular film boiling regime. The model is based on an analytical solution of the energy conservation equations in the vapor and liquid regions downstream of the quench front. A constant vapor film thickness is assumed, which depends on the fluid equilibrium quality at the quench front. Good agreement is obtained in comparing the model with quasi-steady state experimental results.