Detachment of the continent ileostomy poucn from the anterior abdominal wall: report of two unusual cases

The cases of two patients with continent ileostomies are presented. These illustrate the problems encountered with detachment of the pouch from the abdominal wall resulting in angulation of the efferent loop of the pouch in relation to the nipple valve and difficulty intubating the pouch. Both patients required operative correction of the separation. Several suggestions are made in order to prevent or decrease the incidence of the complications. Removal of a peritoneal strip around the efferent loop of the pouch appears to facilitate adequate fixation of the pouch to the anterior abdominal wall.     

Papillary tumours of the minor salivary glands

The clinical and histological features of oncocytic adenomatous hyperplasia, papillary adenoma, and papillary adenocarcinoma of the oral cavity are described, and the literature is reviewed. Histological features which may be of value in distinguishing between benign and malignant variants are described, and in view of the slow growth rate of most of these tumours, the importance of long-term follow-up is stressed.     

Fracture of uncured linear flexible-chain polymers of narrow molecular mass distribution in triaxial stress (behaviour of elastomers as adhesives)

Possibly the simplest method of studying polymers under conditions of triaxial stress is the investigation of the behaviour of thin films of adhesive between two rigid surfaces. The adhesives used were uncured linear flexible chain polymers-polybutadienes. These polymers were of narrow molecular mass distribution (MMD). The use of high molecular polymers of narrow MMD allows the evaluation of the behaviour of elastomers as adhesive joints to be simplified. It has been shown recently that, depending on the rate of deformation, the behaviour of polymers of this kind may be similar to that of viscoelastic liquids or systems in the high-elastic state, which behave as quasi-cured systems, The transition from the fluid to the high-elastic state is a pure relaxation process. It would be expected that the behaviour of the adhesive would vary substantially, depending on its physical state. The fracture behaviour of the adhesive and the rupture of its contact with the solid surface must be dependent on this factor. Cohesive, cohesive-adhesive and adhesive fractures may be observed in such cases. Cohesive fracture is typical for regimes of polymer deformation upon transition from the fluid to the high-elastic state. The further the transition of the polymer to the high-elastic state, the more sharply pronounced is the adhesive fracture of the polymer in triaxial stress. The present work is concerned with the investigation of the temperature-time dependence of the parameters characterizing the fracture of the adhesive and its contact with the solid surface. The results of experiments carried out under conditions of triaxial stress are compared with the data obtained for the same polybutadienes by experiments involving simple shear and uniaxial extension.     

Anomalous double blood supply to the lung

We report an unusual case in which an apparently normal upper lobe of the right lung was supplied by major systemic arterial and pulmonary arterial vessels. The anomalous artery arose from the descending aorta. Following interruption of this vessel, the machinery-like murmur previously present disappeared.     

Erosional and depositional features produced by a convulsive event,San Carlos,Colombia, September 21, 1990

The upper catchment, of the San Carlos River, located on the eastern slope of the Colombian Central Cordillera, was affected by a rainstorm which had no historic equivalent in the area, caused 20 deaths and important destruction and therefore might be called convulsive in the sense of Clifton (1988). Steep upper slopes suffered more than one hundred shallow mudflows. In the catchment channel deepening and widening cut through older torrential and slope deposits and weathered granodiorite, A large amount of material was eroded including blocks up to 8 m in diameter. Resultings deposits show the well-known differentiation: blocks accumulated in the upper part, coarse and settled in the intermediate course and clay was carried to the Punchinà Reservois about 20 km downstream. A volcanic ash layer which covers the older torrential deposits shows mineral assemblages which may enable its correlation with other ashes found eastward with an age estimated in about 10.500 years BP.     

The lives of female physicians

Survey data from 113 female physicians, 634 male physicians, and 41 female dentists were compared. Instruments designed to assess work satisfaction, work stress, marital satisfaction, family competence, and psychiatric symptoms and treatment were used, thereby exploring important life domains concurrently. The results suggest that female physicians are much more like both male physicians and female dentists than anticipated. Generally, female physicians describe high levels of work satisfaction, moderate levels of work stress, average-to-high levels of marital satisfaction, and relatively low levels of psychiatric distress. Their lower levels of practice income remain something of an enigma as gender remains the most powerful predictor of income and is not replaced in statistical analyses by specialty, hours worked, or other significant variables. Finally, female physicians who find higher levels of satisfaction in work also report higher levels of marital satisfaction and fewer psychiatric symptoms. For these women, a highly satisfying medical career does not apparently need to be experienced at the cost of marital or personal distress.     

Effect of protein content on low temperature inactivation of the extracellular proteinase from Pseudomonas fluorescens 22F

The formation of cholic acid and chenodeoxycholic acid through cleavage of the side chains of CoA esters of 3alpha,7alpha,12alpha-trihydroxy-5beta-choles tan-26-oic acid and 3alpha,7alpha-dihydroxy-5beta-cholestan-26-oic acid is believed to occur in peroxisomes. Recently, we found a new peroxisomal enzyme, D-3-hydroxyacyl-CoA dehydratase/D-3-hydroxyacyl-CoA dehydrogenase bifunctional protein, and suggested that this bifunctional protein is responsible for the conversion of 3alpha,7alpha,12alpha-trihydroxy-5beta-cholest-2 4-en-26-oyl-CoA and 3alpha,7alpha-dihydroxy-5beta-cholest-24-en-26-oyl-CoA to their 24-oxo-forms. In the present study, the products of this bifunctional protein reaction were analyzed by gas chromatography-mass spectrometry, and the formation of 24-oxo-27-nor-cholestanes was confirmed. Previously, we found a new thiolase in Caenorhabditis elegans, P-44, and suggested that P-44 and sterol carrier protein x, a peroxisomal protein, constitute a second group of 3-oxoacyl-CoA thiolases. The production of cholic acid and chenodeoxycholic acid from the precursors on incubation with the bifunctional protein and sterol carrier protein x or P-44 was confirmed by gas chromatography.     

Liver disease and compensatory growth: unexpected lessons from genetically altered mice

Over the last decade, several animal models have been established that permit exploration of liver biology and disease. Although these models have been developed using diverse strategies, including transgene targeting, homozygous gene disruption and administration of hepatotoxic chemicals, each approach creates an animal with hepatocyte damage, resulting in an hepatic microenvironment that supports proliferation of healthy hepatocytes. These models have been used to demonstrate: (1) the remarkable ability of adult hepatocytes to clonally proliferate in response to liver growth signals, (2) the effectiveness of transplanted donor hepatocytes in repopulating damaged liver parenchyma, and (3) the feasibility of reconstituting liver with xenogeneic hepatocytes. This paper reviews the development and use of these models, and outlines their potential future application to the study of hepatic stem cells, therapy of liver disease and hepatic toxicology.     

Novel algorithms for the network lifetime problem in wireless settings

One of the major concerns in wireless ad-hoc networks design is energy efficiency. Wireless devices are typically equipped with a limited energy supply sufficient only for a limited amount of time which is reversely proportional to the transmission power of the device. The network lifetime is defined as the time the first device runs out of its initial energy charge. In this paper we study the maximum network lifetime problem for broadcast and data gathering in wireless settings. We provide polynomial time approximation algorithms, with guaranteed performance bounds while considering omnidirectional and unidirectional transmissions. We also consider an extended variant of the maximum lifetime problem, which simultaneously satisfies additional constraints, such as bounded hop-diameter and degree of the routing tree, and minimizing the total energy used in a single transmission. Finally, we evaluate the performance of some of our algorithms through simulations.