Postoperative spondylodiscitis as the cause of failed-back syndrome--clinical aspects, diagnosis, therapy

OBJECTIVES: The choice of cell line for in vitro biological tests which assess the cytotoxicity of dental materials remains controversial, yet this issue is important because these tests are widely used to rate the biocompatibility of new and existing materials, and many different cell lines are commonly used. The purpose of the current study was to quantify the responses of four cell lines (Balb/c 3T3, L929, ROS 17/2.8 and WI-38) to 14 metal ions which are released from dental materials, and relate these responses to the metabolic activity and population doubling times of these cells. METHODS: Succinic dehydrogenase (SDH) activity was used to monitor metabolic activity and cytotoxic response. RESULTS: The cell lines responded differently to most metal ions. In general, the Balb/c 3T3 line was the most sensitive, and the WI-38 line was the least sensitive. However, there were many exceptions depending on the metal ion. The passage number of the cells also affected the cytotoxic response. It was concluded that the cytotoxicity of materials which release metal ions will be significantly different depending on which cell line is selected and its passage number. SIGNIFICANCE: Based on the findings that cell lines ranked the toxicities of the metal ions similarly, it seems reasonable to use these types of in vitro tests to rank the cytotoxicities of materials. However, if these types of tests are used to predict in vivo cytotoxicity, care should be taken to choose conditions and cells which are relevant.     

Ischemic proctosigmoiditis

Rectal ischemia is rare because of excellent collateral supply. Although rectosigmoid ischemia is usually accompanied by more proximal colonic involvement, it may occur alone. METHODS: A retrospective review of all patients diagnosed as having colonic ischemia at the Mayo Clinic from 1976 to 1991 was performed. Clinical, endoscopic, radiological, and pathological data were obtained from patient charts. Patients with involvement of the rectosigmoid colon extending to no more than 30 cm above the dentate line on endoscopy were included in the study. A single radiologist reviewed CT scans and aortograms, and a single pathologist reviewed tissue specimens. RESULTS: Ten of 328 patients with ischemic colitis had isolated ischemic proctosigmoiditis. Six patients had acute ischemia (i.e., symptom duration of less than 4 wk), and four had chronic ischemia (symptoms for 4 wk or longer). Ischemic proctosigmoiditis affects elderly patients with atherosclerosis. An identifiable precipitating factor, such as a major illness or hemodynamic disturbance, was identified in four of six patients with acute ischemic proctosigmoiditis and in one of four patients with chronic ischemic proctosigmoiditis. CT revealed rectal wall thickening and/or perirectal stranding. Angiography may demonstrate atheromatous disease of the aortoiliac vessels. Acute and "chronic" presentations had similar histopathological changes. CONCLUSIONS: Ischemic proctosigmoiditis is rare. In contrast to generalized colonic ischemia, patients with acute rectal ischemia often have clearly identifiable precipitating factors. Conservative management is appropriate for uncomplicated acute ischemic proctosigmoiditis. Patients with chronic ischemic proctosigmoiditis. Patients with chronic ischemic proctosigmoiditis may develop bowel perforation necessitating a proctectomy or colonic diversion. Recognition of this entity and differentiation from idiopathic inflammatory bowel disease is important to determine appropriate therapy.     

The efficacy of oral appliances in the treatment of persistent sleep apnea after uvulopalatopharyngoplasty

Twenty-four patients who failed uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA) had an adjustable oral (Herbst) appliance made to treat the persistent apnea. Six patients discontinued the device prior to sleep evaluation. Eighteen patients had polysomnographic evaluations at baseline, post-UPPP, and with the Herbst appliance in place. The apnea-hypopnea index baseline (AHI) and arterial oxygen saturation (SaO2) nadir were 42.3+/-6.1 and 83.6+/-1.8%, respectively. There was no significant change in either parameter with surgery. With the oral appliance, the AHI fell to 15.3+/-4.4 (p < or = 0.01) and the SaO2 nadir increased to 87.9+/-1.2% (p < or = 0.05). Ten of the patients had control of the OSA with the Herbst appliance with a fall in the AHI to < 10. There were, in addition, two partial responders as defined by an AHI of <20 and a >50% fall in AHI compared with baseline and post-UPPP values. All but one of the responders and partial responders had complete resolution of subjective symptoms of daytime sleepiness with the appliance. An adjustable oral appliance appears to be an effective mode of therapy to control OSA after an unsuccessful UPPP.     

建立精密的直流浮动电流源

尽管有源滤波器的理论家和设计者都对GIC（通用阻抗变换器）非常熟悉，但一般模拟人员对它并不了解。一个单端口有源电路一般包括低成本运放、电阻和电容，GIC将容抗转换为感抗，因而可以替代滤波器中以RLC传输函数描述的电感。另外，GIC输入阻抗方程的灵活性允许进行虚拟阻抗的设计，这在实际元器件中是不存在的，例如依赖频率的电阻。GIC是30年前推出的，已广泛应用于交流电路和有源滤波电路。     

Nails and claws in primate evolution

The issue of whether nails or claws were present on the digits of the last common ancestor of living primates is central to the understanding of the ecological context in which the order originated. Two lines of evidence are available, the shape (claw, nail, toilet-claw) and the histological structure (one or two horny strata). Here we review the existing data regarding the shape and histological structure of cheirideal appendages in primates and present new information from a wide range of living primates. We demonstrate the presence of a typical toilet-claw in Daubentonia madagascariensis and discuss its consequences, since the alleged lack of such structures in this species has long obscured the issue. The general view that primate nails, with the exception of those in New World primates, consist of only one layer is disproved by the presence of two distinct strata in the nails of the feet of three out of seven catarrhine species examined, as well as in Lemur catta. The combined new and old data indicate that the last common ancestor of the extant primates had lost the typical mammalian claws of its ancestors and developed nails on all pedal digits except digit II, which bore a toilet-claw. All nails as well as the toilet-claw originally consisted of two layers. We present a new hypothesis regarding the adaptational significance of these changes.     

The changing nature of office work: effects on repetitive strain injuries

This historical perspective underscores that there is rarely a simple connection between the demands of a particular technology and the risk of occupational disease.     

Application of dried blood spot specimens for serologic subtyping of human immunodeficiency virus type 1 in Thailand

Dried blood spot (DBS) specimens were assessed as an alternative to plasma for human immunodeficiency virus type 1 (HIV-1) serotyping by V3 loop peptide enzyme immunoassay. Nested PCR capable of distinguishing HIV-1 subtypes B and E was used as the reference standard. Ninety-two percent of DBS samples were typeable as either HIV-1 subtype B or E. Serotype results with DBS and plasma were identical for 254 of 257 specimens. A simple DBS collection method provides a convenient alternative for conducting HIV-1 serotype surveillance while retaining sensitivity and specificity.