Determining the optimal mix of exercise activities using mathematical programming

A 56K protein co-purified with bovine milk fat globule membrane (MFGM) proteins bound to Wisteria floribunda agglutinin (WFA) like most MFGM glycoproteins. Treatment with N-glycanase or beta-N-acetylhexosaminidase abolished the lectin binding to the protein. Amino acid sequence and immunoblot analyses revealed that the 56K protein is an IgG heavy chain. Lectin column chromatography of the oligosaccharides released by hydrazinolysis from the purified IgG heavy chains revealed that 0.08% of the total N-linked sugar chains bind to a WFA-agarose column, suggesting that they contain the beta-N-acetylgalactosaminylated structure.     

Effect of anesthesia and surgery on energy expenditure determined by indirect calorimetry in dogs with malignant and nonmalignant conditions

OBJECTIVE: To determine energy expenditure (EE) of apparently resting, client-owned dogs with malignant or nonmalignant diseases that were recovering from anesthesia and surgery, and compare those values with values from clinically normal, apparently resting, client owned dogs. ANIMALS: 40 apparently resting, client-owned dogs that had been given general anesthesia for various elective and nonelective surgical procedures, and 30 apparently resting, clinically normal client-owned dogs used as controls. PROCEDURE: EE was determined, using an open-flow indirect calorimetry system. Each dog was evaluated before and after surgery (0, 1, 2, and 3 days after surgery, then at suture removal > 14 days later) and compared with apparently resting, clinically normal, client-owned dogs (n = 30). Parameters evaluated were rate of oxygen consumption (Vo2/kg of body weight: ml/min/kg; Vo2/kg0.75: ml/min/kg0.75), EE (EE/kg: kcal/kg/d; EE/kg0.75: kcal/kg0.75/d), and respiratory quotient. RESULTS: Surgery and anesthesia did not significantly alter any of these parameters at any time assessed in any group. The pretreatment Vo2 and EE were significantly lower in the dogs with cancer, compared with dogs of other groups. CONCLUSIONS: These data suggest that the EE of a restricted group of dogs that undergo anesthesia and surgery for malignant and nonmalignant conditions does not increase from baseline values or when compared with values in clinically normal, client-owned dogs. CLINICAL RELEVANCE: This information may be of value when planning nutritional treatment for dogs recovering from anesthesia and surgery.     

Immediate management of posterior urethral disruptions due to pelvic fracture: therapeutic alternatives

PURPOSE: We retrospectively reviewed the results of 3 types of initial management of pelvic fracture urethral disruption in children. MATERIALS AND METHODS: From 1980 to 1994, 35 boys 2 to 15 years old (mean age 8.1) with prostatomembranous urethral disruption were treated, including 17 who also had associated injuries. Immediate treatment included suprapubic cystostomy and delayed urethroplasty in 19 patients (group 1), urethral catheter alignment without traction and concomitant suprapubic cystostomy in 10 (group 2), and primary retropubic anastomotic urethroplasty in 6 (group 3). RESULTS: In all patients in groups 1 and 2 severe urethral obliteration developed. Four group 3 patients (66%) had a stricture at the site of anastomotic repair. After delayed urethroplasty 16 group 1 (84%) and all 10 group 2 patients were continent. However, only 3 group 3 patients (50%) achieved continence. Retrospectively associated bladder neck injury occurred in 5 of the 6 incontinent boys. Erections were observed before and after treatment in all but 3 children. Unstable pelvic ring fractures (type IV) comprised 28% of all pelvic fractures with a high rate of associated injuries. CONCLUSIONS: As described, urethral alignment was not beneficial for avoiding urethral obliteration. Therefore we recommend suprapublic cystostomy as the only form of initial treatment in these cases. Urinary incontinence seems more likely related to associated bladder neck rupture and the severity of pelvic fracture rather than to initial treatment or delayed urethral repair. Consequently, when associated bladder neck injury is present, we advocate immediate surgical repair.     

Inhalatory anesthetic (halothane) associated changes in the immune response in mice

The extent of surgery, the patient's age, health status and other factors may contribute to alteration of the immune system during anesthesia and surgery. In addition, inhalatory anesthetics may cause acute and chronic toxicity because of the production of intermediate and end metabolic compounds. The present work was undertaken to evaluate, both in vivo and in vitro, if repeated doses of halothane were able to affect the immune response in a murine model developed at our laboratory. Weekly doses of halothane were administered to mice subjected to no surgery and three days after the last anesthetic-exposure, several immunologic parameters were assessed. Results on the in vivo response to sheep red blood cells showed that halothane treatment increased the amount of specific antibody secreting B-cells, without affecting the delayed type hypersensitivity reaction to the same antigen. In vitro studies on spleen cell composition showed that halothane re-exposure diminished the number of CD4+, CD8+ and B-cells. Such changes were not translated into alterations on the mitogen-driven lymphoproliferation, as well as macrophage phagocytic and lytic functions. Our results indicate that halothane re-exposure is able to modulate the immune response affecting both the number of antibody secreting cells involved in a specific in vivo response, and the splenic lymphoid cell composition. Since such halothane-induced immune alterations might bias the results of a wide range of physiological research, even those involving other systems, a careful selection of the anesthetic agent and methods by which the compound is administered is advisable.     

A unified method for calculating the center of pressure during wheelchair propulsion

The measurement of the center of pressure (COP) has been and continues to be a successful tool for gait analysis. The definition of a similar COP for wheelchair propulsion. however, is not straightforward. Previously, a COP definition similar to that used in force plate analysis had been proposed. Unfortunately, this solution has the disadvantage of requiring a separate COP definition for each plane of analysis. A definition of the generalized center of pressure (GCOP) which is consistent in all planes of analysis is derived here. This definition is based on the placement of a force-moment system, equivalent to the force-moment system at the hub, on a line in space where the moment vector (wrench moment) is parallel to the force vector. The parallel force-moment system is then intersected with three planes defined by anatomical landmarks on the hand. Data were collected using eight subjects at propulsion speeds of 1.34 m/s and 2.24 m/s (1.34 m/s only for subject 1, 0.894 m/s and 1.79 m/s for subject 8). Each subject propelled a wheelchair instrumented with a SMARTwheel. A PEAK 5 video system was used to determine the position of anatomical markers attached to each subject's upper extremity. The GCOP in the transverse plane of the wrist formed clusters for all subject's except subject 2 at 1.34 m/s. The clustering of the GCOP indicates that the line of action for the force applied by the hand is approximately perpendicular to the transverse plane through the wrist. When comparing the magnitude of the moment vector part of the wrench with the moment of the force vector of the wrench about the hub, the wrench moment is approximately an order of magnitude smaller. This indicates that the role of the wrist for wheelchair propulsion is primarily to stabilize the force applied by the arm and shoulder.     

Control of fibroblast populated collagen lattice contraction by antibody targeted photolysis of fibroblasts

BACKGROUND AND OBJECTIVE: Hypertrophic scarring and rigid scar contracture are disorders of wound healing for which there is presently no effective therapy. The dermal fibroblast plays a major role in scar fibrillogenesis and contracture. The objective of this study was to establish a selective and effective method to destroy fibroblasts. STUDY DESIGN/MATERIALS AND METHODS: An antifibroblast conjugate was synthesized by covalent attachment of the antifibroblast antibody PR2D3 to the photosensitizer Sn-chlorin e6. Fibroblasts were cultured in fibroblast-populated collagen lattices (FPCLs), incubated with the conjugate and exposed to light. The effect of the treatment on cell viability and the rate of contraction of the FPCL were assessed. RESULTS: The toxicity of antifibroblast conjugates increased with increasing conjugate concentration, light dose, and number of photosensitizers per antibody molecule, until nearly complete killing was achieved. The rate of lattice contraction after irradiation linearly correlated with the remaining viable fraction of fibroblasts. These conjugates were not cytotoxic to keratinocytes cultured on collagen lattices, and nonspecific conjugates could not cause significant fibroblast killing. Spatial selectivity was demonstrated using a light mask. CONCLUSIONS: Antibody-targeted photolysis is an effective and selective technique for controlling FPCL contraction in vitro and may have potential in vivo applications to modulate extracellular matrix remodeling by connective tissue cells.     

Aims, processes and problems of antenatal education as identified by three groups of childbirth teachers

OBJECTIVE: To establish whether variations exist in the philosophy and approach of three groups of childbirth teachers working in different organisations in the UK. PARTICIPANTS: Two midwifery Parentcraft Sisters working in the UK maternity services, three National Childbirth Trust Antenatal Teachers and two Active Birth Teachers working in the voluntary sector, and two Midwife Teachers. METHOD: Semi-structured interviews were tape-recorded, transcribed and analysed using a grounded theory approach to identify common categories. FINDINGS: All three groups of teachers identified similar aims for antenatal education, with the need to build clients' confidence in their ability to give birth and care for their babies as the most important. However, the process by which the various teachers attempted to realise their aims appeared to be very different. IMPLICATIONS FOR PRACTICE: In order to ensure the prioritization of antenatal education with purchasers and providers, childbirth teachers need to define more clearly the criteria by which it can be audited.     

First degree atrioventricular block caused by a calcified tumor of the atrioventricular septum

First degree atrioventricular block occurred in a 69-year-old patient with a calcified atrioventricular septum tumour. The patient suffered several episodes of syncope and the only abnormality found in the routine clinical work-up was a remarkable first degree atrioventricular block. The echocardiogram, computed tomography (CT) and the magnetic resonance imaging (MRI) procedure showed a calcified tumour in the posterior part of the left ventricle, between the left atrium and left ventricle, just beneath the aortic root spreading to the interventricular septum. It was suggested that the first degree atrioventricular block was caused by the tumour. The symptoms were relieved by implantation of permanent cardiac pacemaker.