A novel k-space trajectory measurement technique

OBJECTIVE: To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. METHODS: A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. RESULTS: Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. CONCLUSION: Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.     

Synergistic decrease of clonal proliferation, induction of differentiation, and apoptosis of acute promyelocytic leukemia cells after combined treatment with novel 20-epi vitamin D3 analogs and 9-cis retinoic acid

Patients with acute promyelocytic leukemia (APL) usually relapse after all-trans retinoic acid (RA) treatment because this therapy fails to eradicate the malignant clone. Our data showed that KH 1060 and other 20-epi vitamin D3 analogs alone were potent inhibitors of clonal growth of NB4 cells, an APL cell line (ED50, approximately 5 x 10(-11) M). The combination of KH 1060 and 9-cis-RA synergistically and irreversibly enhanced this effect. Neither KH 1060 nor 9-cis-RA (10(-6) M, 3 d) were strong inducers of differentiation of NB4 cells. However, 98% of the cells underwent differentiation to a mature phenotype with features of both granulocytes and monocytes after exposure to a combination of both compounds. Apoptosis only increased after incubation of NB4 cells with 9-cis-RA alone (28%) or with a combination of 9-cis-RA plus KH1060 (32%). Immunohistochemistry showed that the bcl-2 protein decreased from nearly 100% of the wild-type NB4 cells to 2% after incubation with a combination of KH 1060 and 9-cis-RA, and the bax protein increased from 50% of wild-type NB4 cells to 92% after culture with both analogs (5 x 10(-7) M, 3 d). Western blot analysis paralleled these results. Studies of APL cells from one untreated individual paralleled our results with NB4 cells. Taken together, the data demonstrated that nearly all of the NB4 cells can be irreversibly induced to differentiate terminally when exposed to the combination of KH 1060 and 9-cis-RA.     

Human wound contraction: collagen organization, fibroblasts, and myofibroblasts

The closure of ungrafted sacrococcygeal pilonidal sinus excisional wounds was studied in 15 patients. Wound punch biopsies were taken on a regular basis, and histologic sections were made. To document changes, computer-assisted morphometric image analysis was employed. Initial average wound depth was 37.8 +/- 4.6 mm, and complete closure (0 wound depth) was reached by 68 days. Wound contraction contributed 88 percent to wound closure, whereas the deposition of scar only contributed 12 percent. Maximum cells density within granulation tissue was reached by day 18. Myofibroblasts, identified by alpha-smooth muscle actin immunostaining, first appeared on day 11. Unlike those observed in laboratory animals, myofibroblasts were a minor cell population of granulation tissue, never exceeding 10 percent of the cells. The pattern of collagen fiber organization was documented by polarized light microscopy of Sirius red-stained sections. Early granulation tissue collagen fibers demonstrated a fine greenish birefringence, whereas more mature granulation tissue collagen fibers were thicker, displaying orange-yellowish birefringence. Myofibroblasts were associated exclusively with thicker collagen fibers, whereas fibroblasts were associated with both fine and thick collagen fibers. It is proposed that human wound contraction involves a volume change whereby normal dermal and adipose tissues are pulled into the defect by forces generated within fibroblasts.     

Immunological identification of candidate proteins involved in regulating active shape changes of outer hair cells

By employing immunological methods, it has been demonstrated that myosin, myosin light chain (MLC) and myosin light chain kinase (MLCK) proteins in outer hair cells (OHC) are immunologically different from isoforms in platelets, smooth muscle and heart muscle, and are probably more related to isoforms found in red blood cells (RBC). Moreover, proteins related to band 3 protein (b3p) and protein 4.1 (p 4.1), ankyrin as well as fodrin and spectrin, but not glycophorin, have been identified in isolated OHCs. Both OHCs and RBC differ from other motile non-muscle cells in their lack of smooth muscle isoforms of actin, their common high levels of spectrin-, ankyrin- and band 3-like proteins, as well as the expression of the 80 kDa protein 4.1 isoform. The data support the notion that motility of OHC may be based upon regulation of the b3p/p 4.1/ankyrin complex, and thus may be reminiscent to the active shape changes in RBC.     

A systematic review of the literature on patient priorities for general practice care. Part 1: Description of the research domain

To make health care more responsive to patient needs, insight into patient priorities is needed. A systematic literature review, using electronic and manual searches, was made of studies on patient priorities with regard to primary health care. Data-extraction was performed by two researchers, followed by systematic analyses of study features. 57 studies were included. The aspects of care and methods used showed a wide variation. Aspects most often included were "informativeness", "humaneness" and "competence/accuracy". Based on an analysis of 19 studies, the following aspects were seen by patients as most important in more than 50% of the studies that included them: "humaneness", "competence/accuracy", "patients' involvement in decisions", "time for care", "other aspects of availability/accessibility", "informativeness", "exploring patients' needs", "other aspects of relation and communication" and "availability of special services".     

Animal experimental studies on the thrombolytic effect of streptokinase

The purpose of this investigation was to explore the feasibility of enhancing the electrochemical stability of dental amalgam restorations by a process of "selective interfacial amalgamation." If dental amalgam restorations can be selectively alloyed at the tooth-amalgam interface, to a minor thickness as compared with the dimensions of the bulk amalgam, so as to present a more electrochemically stable phase than psi2 to the oral environment, corrosion will be reduced and desirable qualities of existing amalgams can be utilized. It was found that selective interfacial amalgamation was indeed possible and that it could be readily accomplished using a silver suspension as a cavity liner. By then placing a conventional silver-tin amalgam according to ordinary dental techniques, mercury expressed during hand condensing reacted with the silver in the liner resulting in the formation of an integral amalgam restoration with the more noble psi1 phase adjacent to tooth structure. In vitro corrosion tests of samples so prepared exhibited corrosion resistance far superior to unlined control samples.     

Specific changes of the uterine cervix due to contraceptives]

A group of 344 cervices, produced by conisation within a period of 5 1/2 years, were examined for specific effects of contraceptives. In half of all women, who used oral contraceptives, specific lesions such as "siebartige polypoide Hyperplasie" (cribriform polypoid hyperplasia) were found. The findings and their etiology and importance are discussed.     

Effect of composition on the matrix transformation of the Co-Re-Cr-Ta-C alloys

Neutron diffraction measurement was performed in-situ at high temperatures on Co-Re-Ta-C alloys with and without Cr addition. This included alloys containing different C content with the C/Ta ratio varying between 0.5 and 1.0. The Co-Re-solid solution matrix of the experimental alloys is polymorphic (like in pure cobalt) and transformed from low temperature hexagonal ? phase to high temperature cubic γ phase on heating. This transformation is reversible and show hysteresis. The main alloying addition, Re, stabilizes the ? Co-phase and increases the transformation temperature to above 1273 K. The onset of the \(\varepsilon \rightleftharpoons \gamma\) transformation during heating and cooling was found to differ depending on the alloy composition. In alloys without Cr addition the transformation was not completed on cooling and the high temperature γ phase was partly retained at room temperature in metastable state with the amount depending on the cooling rate from high temperature. The diffraction and microstructural results showed that Cr is ? stabilizer (similar as Re) but the role of Ta is not clear. The C/Ta ratio has no direct effect on the matrix phase transformation. Nevertheless, it influences indirectly by determining the amount of Ta which is freely available in the matrix.     

Azoperoxide. VI. Selektive Spaltungen von β-Azo-acylperoxiden

Azoperoxides. VI. Selective Decomposition of β-Azoacylperoxides The selective decomposition of the O O-Groups in the azoperoxides 1 and 2 is possible by reaction with dimethylaniline at 35°C. Rate constants were measured and the decomposition products were analyzed. Intermediates are azoalkyl radicals. The radical yield of the amine induced decomposition of 2 in ethylbenzene is 8.2% at 35°C. UV irradiation of the azoperoxides 1 and 2 at 20°C in ethylbenzene results in a quantitative and selective decomposition of the azo groups. Intermediates are C-radicals with intact peroxide groups. The reaction of 1 and 2 with triethylstannane yields reduction products of the O O-groups and the NN-groups, respectively.