Surgical revision of the problematic transmetatarsal amputation

Recurrent ulcerations may develop following transmetatarsal amputation in patients with diabetes mellitus. In many cases, these ulcerations require surgical intervention to achieve healing, especially in situations where conservative care has not been effective. These procedures range from the local resection of bone to skin grafting and flap techniques to successfully heal the wound. The ultimate goal of any surgical intervention is to prevent a more proximal amputation.     

Gender differences in psychiatric comorbidity among cocaine-using opiate addicts

Psychiatric comorbidity was examined for a sample of 212 methadone patients dually addicted to opiates and cocaine, focusing on gender differences. Diagnoses were determined by the SCID for DSM-III-R. Men displayed more lifetime (but not current) substance use disorders, while women displayed more lifetime and current non-substance use disorders. There were several significant interactions among psychiatric disorders and gender. Women were more likely than men to present with concurrent mood and anxiety disorders. Women with ASPD were unlikely to have alcohol use disorder, but likely to have opioid use disorder. Men with anxiety were likely to be diagnosed with ASPD. Treatment implications of the findings are discussed.     

Isolation and partial characterization of a fatty-acid-binding protein from Ascaris suum reproductive tissue

A 12-kDa fatty-acid-binding protein was purified to homogeneity from Ascaris suum reproductive tissue as confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. N-terminal amino-acid-sequence analysis of the protein revealed its identity with the ABA-1 allergen protein isolated from A. suum pseudocoelomic fluid. Fatty-acid binding by the protein from A. suum reproductive tissue was investigated using the Lipidex 1000 assay, which revealed the presence of a single class of fatty-acid-binding sites with an apparent dissociation constant for palmitate of about 0.8 microM.     

The heat shock response inhibits RANTES gene expression in cultured human lung epithelium

The chemokine RANTES is thought to be involved in the pathophysiology of inflammation-associated acute lung injury. Although much is known regarding signals that induce RANTES gene expression, relatively few data exist regarding signals that inhibit RANTES gene expression. The heat shock response, a highly conserved cellular defense mechanism, has been demonstrated to inhibit a variety of lung proinflammatory responses. We tested the hypothesis that induction of the heat shock response inhibits RANTES gene expression. Treatment of A549 cells with TNF-alpha induced RANTES gene expression in a concentration-dependent manner. Induction of the heat shock response inhibited subsequent TNF-alpha-mediated RANTES mRNA expression and secretion of immunoreactive RANTES. Transient transfection assays involving a RANTES promoter-luciferase reporter plasmid demonstrated that the heat shock response inhibited TNF-alpha-mediated activation of the RANTES promoter. Inhibition of NF-kappaB nuclear translocation with isohelenin inhibited TNF-alpha-mediated RANTES mRNA expression, indicating that RANTES gene expression is NF-kappaB dependent in A549 cells. Induction of the heat shock response inhibited degradation of the NF-kappaB inhibitory protein, I-kappaBalpha but did not significantly inhibit phosphorylation of I-kappaBalpha. We conclude that the heat shock response inhibits RANTES gene expression by a mechanism involving inhibition of NF-kappaB nuclear translocation and subsequent inhibition of RANTES promoter activation. The mechanism by which the heat shock response inhibits NF-kappaB nuclear translocation involves stabilization of I-kappaBalpha, without significantly affecting phosphorylation of I-kappaBalpha.     

Humanized M195 monoclonal antibody conjugated to recombinant gelonin: an anti-CD33 immunotoxin with antileukemic activity

The recently characterized immunotoxin HuM195-gelonin consists of a humanized anti-CD33 monoclonal antibody conjugated to the single-chain plant toxin gelonin. Binding of the immunotoxin to hematopoietic cells that express the CD33 differentiation antigen has been demonstrated and results in cytotoxicity due to ribosomal inactivation by gelonin. Blast cells from most patients with acute myelogenous leukemia express CD33, whereas normal stem cells necessary for maintenance of hematopoiesis do not. We asked whether an immunoconjugate using recombinant gelonin rather than plant gelonin is toxic to acute myelogenous leukemia (AML) cell lines and primary AML blasts obtained from patients and exposed to the immunotoxin in vitro. The CD33pos cell lines HL60, OCI/AML2, and OCI/ AML5 showed decreased proliferation when exposed to immunotoxin for 24-72 h. The CD33neg cell line OCI/AML3 was relatively resistant to HuM195, and all cell lines were resistant to equimolar concentrations of unconjugated antibody and gelonin. Primary blast cultures from seven patients with AML had CD33 detectable on 75.7-99.8% of cells by flow cytometry, and all showed dose-dependent decreases in clonogenic cell survival during 24-h incubation with the immunotoxin. Cells selected for low CD33 expression by cell sorting or by prolonged incubation with immunotoxin could reexpress CD33 at baseline levels and remained sensitive to immunotoxin. We conclude that humanized M195 conjugated to recombinant gelonin has antileukemic activity and should be considered for clinical testing in Phase I trials.     

Vinyl Ether–Iron Complexes as Vinyl Cation Equivalents. Preparation and Use of an α-Acrylic Ester Cation Equivalent

The organoiron complex 4 is readily prepared from α-bromopyruvic ester diethyl acetal, and has been shown to serve as an effective α-acrylic ester cation equivalent, in the synthesis of α-methylene-γ-lactones. Cyclohexanone lithium enolate is transformed to either the cis or trans fused lactones 12c , t, and ethyl acetoacetate lithium enolate can be converted to the lactone 21 t. The use of methyl 3-oxohexadecanoate as starting material provides a stereospecific synthesis of protolichesterinic acid methyl ester.     

Fundamental understanding and implementation of Al-enhanced PECVD SiNx hydrogenation in silicon ribbons

A low-cost, manufacturable defect gettering and passivation treatment, involving simultaneous anneal of a PECVD SiN_x film and a screen-printed Al layer, is found to improve the lifetime in Si ribbon materials from 1–10 μs to over 20 μs. Our results indicate that the optimum anneal temperature for SiN_x-induced hydrogenation is 700°C for EFG and increases to 825°C when Al is present on the back of the sample. This not only improves the degree of hydrogenation, but also forms an effective back surface field. We propose a three-step physical model, based on our results, in which defect passivation is governed by the release of hydrogen from the SiN_x film due to annealing, the generation of vacancies during Al–Si alloying, and the retention of hydrogen at defect sites due to rapid cooling. Controlled rapid cooling was implemented after the hydrogenation anneal to improve the retention of hydrogen at defect sites by incorporating an RTP contact firing scheme. RTP contact firing improved the performance of ribbon solar cells by 1.3–1.5% absolute when compared to slow, belt furnace contact firing. This enhancement was due to improved back surface recombination velocity, fill factor, and bulk lifetime. Enhanced hydrogenation and rapid heating and cooling resulted in screen-printed Si ribbon cell efficiencies approaching 15%.