Relations of left ventricular mass to fat-free and adipose body mass: the strong heart study. The Strong Heart Study Investigators

STUDY DESIGN: The effects of nucleus pulposus and various treatments to block tumor necrosis factor alpha activity were evaluated in an experimental set-up using immunohistochemistry and nerve conduction velocity recordings. OBJECTIVES: To assess the presence of tumor necrosis factor alpha in pig nucleus pulposus cells, and to see if block of tumor necrosis factor alpha also blocks the nucleus-pulposus-induced reduction of nerve root conduction velocity. SUMMARY AND BACKGROUND DATA: A meta-analysis of observed effects induced by nucleus pulposus revealed that these effects might relate to one specific cytokine-tumor necrosis factor alpha. METHODS: Series-1: Cultured nucleus pulposus cells were stained immunohistologically with a monoclonal antibody for tumor necrosis factor alpha. Series-2: Nucleus pulposus was harvested from lumbar discs and applied to the sacrococcygeal cauda equina in 13 pigs autologously. Four pigs received 100 mg of doxycycline intravenously; five pigs had a blocking monoclonal antibody to tumor necrosis factor alpha applied locally in the nucleus pulposus, and four pigs remained nontreated, forming a control group. Three days after the application, the nerve root conduction velocity was determined over the application zone by local electrical stimulation. RESULTS: Series-1: Tumor necrosis factor alpha was found to be present in the nucleus pulposus cells. Series-2: The selective antibody to tumor necrosis factor alpha limited the reduction of nerve conduction velocity, although in comparison with the control group this was not statistically significant. However, treatment with doxycycline significantly blocked the nucleus-pulposus-induced reduction of conduction velocity. CONCLUSION: For the first time, a specific substance, tumor necrosis factor alpha, has been linked to the nucleus-pulposus-induced effects of nerve roots after local application. Although the effects of this substance may be synergistic with those of other similar substances, the data of the current study may be of significant importance for the continued understanding of nucleus pulposus' biologic activity, and of possible potential use for future strategies in managing sciatica.     

Pediatric pyeloplasty: outcome analysis based on patient age and surgical technique

OBJECTIVES: To analyze our experience with open pyeloplasty, with specific emphasis on procedural outcome on the basis of patient age, surgical technique, complication rate, and complication management. METHODS: All patients from 1974 to 1994 who underwent pyeloplasty at our institution were included in our review. Charts were analyzed for age at presentation, presenting signs and symptoms, type of surgical reconstruction, complications and treatment, and final outcome. RESULTS: From 1974 to 1994, 234 pyeloplasties were performed in 227 patients (108 less than 1 year old, 119 more than 1 year old). The percentage of children less than 1 year old increased throughout: 24% for 1975 to 1980, 37% for 1981 to 1990, and 69% for 1991 to 1994. Presenting signs and symptoms varied according to the age of the child at pyeloplasty. For children less than 1 year old, these were prenatal ultrasound in 86 (79%), urinary tract infection (UTI) in 9 (8%), and abdominal mass in 5 (4.6%). For children more than 1 year old, these were pain in 57 (48%), UTI in 29 (24%), hematuria in 12 (10%), and prenatal ultrasound in 3 (2.5%). Reconstruction was a dismembered pyeloplasty in all cases. The majority of patients in both age groups underwent a nonintubated repair (less than 1 year old, 99 of 114; more than 1 year old, 102 of 120). Postoperative results were evaluated by ultrasound or intravenous urography, with improvement or stable results in 95% of children less than 1 year old and in 96% of children more than 1 year old. Complications included UTI in 18 patients (7.7%), recurrent obstruction in 5 (2.1%), and persistent leak in 4 (1.7%). The complication rate was not related to age. CONCLUSIONS: The nonintubated, dismembered pyeloplasty is an excellent technique for all age groups and has a low complication rate.     

Identification of specific relaxin-binding cells in the human female

Relaxin is secreted during pregnancy, but it has no verified effects in humans. The objective of the present study was to identify the cells containing specific relaxin-binding sites in the uterine cervix, vagina, uterus, mammary glands, mammary nipples, and term placenta in the human. The uterine cervix, vagina, and uterus were obtained from hysterectomy specimens. Mammary glands and nipples were obtained after modified radical mastectomy. Placenta was obtained after normal delivery. Tissue samples were cut into slices (0.5-3 cm3), frozen in liquid nitrogen, and cryosectioned (8 microm). Cells that bind relaxin were identified by sequential application of biotinylated porcine relaxin probe, antibiotin immunoglobulin G conjugated to 1 nm colloidal gold, and silver enhancement for signal amplification. Relaxin bound with specificity to epithelial cells, smooth muscle cells, and blood vessels in the cervix, vagina, uterus, and mammary nipples; to epithelial cells and blood vessels in the mammary glands; and to skin of the mammary nipples. In addition, relaxin bound to individual cell types within the term placenta (amnion epithelium, syncytiotrophoblasts, blood vessels), and to sebaceous glands within the nipples. We conclude that the specific relaxin-binding cells probably contain relaxin receptors. Identification of putative relaxin receptors may provide insight into physiological and/or therapeutic roles of relaxin in the human.     

Removal of 4‐chlorophenol from contaminated water using coconut shell waste pretreated with chemical agents

BACKGROUND: At concentrations higher than 1 mg L^?1, 4‐chlorophenol (4‐CP) is very toxic to living organisms, and if ingested beyond the permitted concentration it causes health disorders such as cancer and mutation. This laboratory study investigates treatment of contaminated water laden with 4‐CP using coconut shell charcoal (CSC) waste. Batch studies were conducted to study the effects of dose, pH, and equilibrium time on 4‐CP removal. To improve 4‐CP removal, surface modification of the adsorbent with TiO₂, HNO₃, and/or NaOH was undertaken. RESULTS: At an initial 4‐CP concentration of 25 mg L^?1 under optimized conditions (dose 13.5 g L^?1, pH 2.0; agitation speed 150 rpm and 50 min equilibrium time), the NaOH‐treated CSC demonstrated a greater removal of 4‐CP (71%) than those oxidized with HNO₃ (40%) and/or coated with TiO₂ (52%). The adsorption capacity of the NaOH‐treated CSC (54.65 mg g^?1) was higher than those treated with HNO₃ (23.13 mg g^?1) or coated with TiO₂ (48.42 mg g^?1). CONCLUSION: Although treatment results using the NaOH‐treated CSC alone were promising, the treated effluents were still unable to meet the required limit of less than 1 mg L^?1. Therefore, subsequent treatments are still required to complement the removal of 4‐CP from the wastewater. Copyright © 2010 Society of Chemical Industry     

Obstetric postanesthesia care unit stays: reevaluation of discharge criteria after regional anesthesia

BACKGROUND: Obstetric patients may have long postanesthesia care unit (OB-PACU) stays after surgery because of residual regional block or other conditions. This study evaluated whether modified discharge criteria might allow for earlier discharge without compromising patient safety. METHODS: Data were prospectively collected for 6 months for all patients (N=358) who underwent cesarean section or tubal ligation and recovered in the OB-PACU. Regional anesthesia was used in 94% of patients. The duration of anesthesia and PACU stays, the presence and treatment of events in the PACU, and the regression of neural blockade were recorded. Discharge from the OB-PACU required a 60-min minimum stay, stable vital signs, adequate analgesia, and ability to flex the knees. After completion of prospective data collection, events that kept patients in the PACU after 60 min were reevaluated as to whether patients needed to stay in the PACU for medical reasons. "Needed to stay" events included bleeding, cardiorespiratory problems, sedation, dizziness, and pain. "Safe to leave" conditions included pruritus, nausea, and residual neural blockade. The cumulative duration of OB-PACU stays not clearly justifiable for medical reasons was calculated. RESULTS: Residual block and spinal opioid side effects accounted for the majority of "unnecessary" stays. Annually, 429 h of PACU time could have been saved using the revised criteria. Complications did not develop subsequently in any patient deemed "safe to leave." CONCLUSIONS: In many obstetric patients, the duration of PACU stays could safely be shortened by continuing observation in a lower-acuity setting. This may result in greater flexibility and more efficient use of nursing personnel.     

Heat resistance of Salmonella weltevreden in low-moisture environments

The heat resistance of Salmonella weltevreden inoculated into flour and heated in hot air was determined for (a) an initial water activity (aw) range of 0.20 to 0.60 prior to heating, (b) a range of storage relative humidities of 6.0 to 35.5% prior to heating, and (c) temperatures of 57 to 77 degrees C. The death curves obtained were biphasic, demonstrating an initial rapid decline in the numbers of survivors (1.0- to 1.5-log reductions) during the first 5 to 10 min of heating for all the temperature-water activity combinations tested. Following this initial rapid decline in the number of cells, a linear survivor curve was obtained where inactivation occurred at a slower rate. The initial decline in survivors coincided with a rapid decrease in the water activity of all the samples tested. Irrespective of the initial water activity level in the samples prior to heating, the aw decreased to < 0.2 during the first 5 to 10 min of heating. The D values obtained for these experimental parameters ranged from a D60-62 of 875 min at an initial aw of 0.4 to a D63-65 of 29 min at an initial aw of 0.5. The results demonstrated that, for any temperature, as the initial water activity of the sample prior to heating decreased, the heat resistance of the cells increased. The z values obtained from these data ranged from 15.2 to 53.9 degrees C. The relative humidity during storage prior to heating did not appear to have a significant effect on the heat resistance of S. weltevreden in flour. These results demonstrate that the amount of available water in foods that are considered to be "dry" (i.e., with a water activity less than 0.60) will significantly influence the effectiveness of the heat processing of foods and, in addition to the temperature, the aw prior to heating is a critical controlling factor during these processes.