Vaginal colonization with Group B beta-hemolytic streptococcus as a risk factor for post-cesarean section febrile morbidity

Vaginal colonization of mothers with Group B beta-hemolytic streptococcus (GBS) has been recognized as a risk factor for neonatal morbidity. The relationship of GBS colonization to risks for the mother who undergoes cesarean section has not been defined. In this study, we found that, among patients who underwent cesarean section, the 19% of them who were colonized with GBS had a higher incidence of standard fever (66.6% vs. 30.5%), clinical diagnosis of endomyometritis (61.1% vs. 12.5%), and use of antibiotics (61.1% vs. 26.3%) in relationship to a significantly increased frequency of premature rupture of the membranes (50.0% vs. 14.8%). Reasons for the association between vaginal colonization and increased morbidity are discussed.     

Dissolution of a radiolucent stone in the common bile duct by sodium cholate infusions through the T-tube (author's transl)

A case of a retained gallstone in the common bile duct after cholecystectomy (in a 38-year old man) is reported in which infusions with saline and spasmolytics failed to flush out the retained stone into the duodenum. An infusion with sodium cholate over nine days through the T-tube was successful in dissolution of the radiolucent stone.     

Minor and major lip reconstruction

Lip reconstruction has made significant advances over the past two decades with refinement of some old techniques and the introduction of new innovative methods. Small and medium defects can be repaired in a variety of ways with similar results. Local lip switch flaps are far superior to any distant tissue. Total lip loss is probably best handled with nasolabial flaps. Extensive resections including the lip, premaxilla, mandible, and skin of the chin and upper neck remain a challenge with all modern techniques, including myocutaneous flaps and free flaps, having little advantage over the standard visor forehead flap.     

Significance of adrenal hormones in brain energy metabolism

Intensity of glycolysis was studied under conditions of immobilization stress and adrenalectomy as well as with administration of adrenaline and hydrocortisone. The processes of aerobic glycolysis, activity of enzymes of the tricarboxylic acid cycle and mitochondria respiratory chain, content of total, free and protein-bound glycogen, glucose-I-phosphate, glucose-6-phosphate, pyruvate, alpha-ketoglutarate, cytrate and macroergs in the brain are shown to depend on the level of adrenal hormones producing a multilateral effect on a series of energy metabolism links.     

Sodium nitroprusside and intracranial pressure

The effects of sodium nitroprusside on intracranial pressure were studied in 10 patients, candidates for surgical treatment, prior to anaesthesia. Blood pressure was lowered to at least 50% of its initial value. In all cases, at the beginning of nitroprusside infusion, both the mean and the pulse intracranial pressures increased (mean increase: 83.2% of the initial value). At a certain moment, however, while the blood pressure continued to fall, the mean intracranial pressure did not increase any more; on the contrary, it decreased. On the other hand, in many cases, the pulse intracranial pressure continued to increase. No neurological or EEG changes were observed. The possible changes of cerebral circulation and CSF dynamics underlying the phenomena observed are discussed.     

Wedgelike glycodendrimers as inhibitors of binding of mammalian galectins to glycoproteins, lactose maxiclusters, and cell surface glycoconjugates

Galectins are mammalian carbohydrate-binding proteins that are involved in cell-cell and cell-matrix adhesion, cell migration, and growth regulation with relevance to inflammation and tumor spread. These important functions account for the interest to design suitable low molecular weight inhibitors that match the distinct modes of presentation of the carbohydrate recognition domains of the different galectin subfamilies. Using 3,5-di-(2-aminoethoxy)benzoic acid as the branching unit, wedgelike glycodendrimers with two, four, and eight lactose moieties (G1-G3) were synthesized. They were tested in solid-phase competition assays with lactose maxiclusters and various N-glycan branching profiles (miniclusters) as the matrix and also in cell assays. Prototype galectins-1 and -7, chimera-type galectin-3, a plant (AB)(2) toxin, and a lactose-binding immunoglobulin G fraction from human serum were the carbohydrate-binding targets. Potent inhibition and remarkable cluster effects were seen for the homodimeric galectin-1, especially in combination with biantennary N-glycans as the matrix. Remarkably, for the tetravalent G2 glycodendrimer, the inhibitory potency of each lactose unit reached a maximum value of 1667 relative to free lactose. In haemagglutination experiments as a model for cell adhesion, galectin-3 was markedly sensitive to increased sugar valency and a relative potency per lactose of 150 was reached. The spatial orientation of the carbohydrate recognition domains of the endogenous lectins and the branching pattern of the carbohydrates of the glycoprotein matrices used are both important factors in the design and synthesis of glycodendrimers with galectin-selective properties.     

Robust planning of airport platform buses

Most airports have two types of gates: gates with an air bridge to the terminal and remote stands. For flights at a remote stand, passengers are transported to and from the aircraft by platform buses. In this paper we investigate the problem of planning platform buses as it appears at Amsterdam Airport Schiphol. We focus on robust planning, i.e. we want to avoid that the bus planning is affected by flight delays and in this way invokes delays in other flights and ground-handling processes. We present a column generation algorithm for planning of platform buses that maximizes robustness. We also present a discrete-event simulation model to compare our algorithm to a first-come-first-served heuristic as is used in current practice. Our computational results with real-life data indicate that our algorithm significantly reduces the number of replanning steps and special recovery measures during the day of operation.