Radical abdominopelvic lymphadenectomy: historic perspective and current role in the surgical management of rectal cancer

Radical abdominopelvic lymphadenectomy for rectal cancer is based on the tenet that removal of all potentially involved lymphatic tissue will yield a lower rate of locoregional failure and improve survival. At centers with extensive experience with the procedure, the operating time is only modestly prolonged compared with conventional resection. Blood loss and postoperative hospitalization are not significantly increased. Urinary dysfunction and impotence associated with radical abdominopelvic lymphadenectomy (as high as 80 percent and 76 percent, respectively, in recent series) have been major deterrents to its more routine application. Preservation of the hypogastric plexus and even selective preservation of a unilateral S4 nerve root have been shown to reduce the occurrence of genitourinary complications. Improved five-year survival of 68 percent and local recurrence rates of 5 to 20 percent for TNM Stage III cancers have been achieved with radical abdominopelvic lymphadenectomy. These results compare favorably with recent trials of adjuvant chemoradiation after conventional resection in stage-matched patients. The rationale, evolution, and application of radical abdominopelvic lymphadenectomy to the surgical management of rectal cancer are critically examined. The potential benefits of radical abdominopelvic lymphadenectomy, which have been demonstrated in nonrandomized trials, should be evaluated in a prospective and properly randomized study to clearly establish or refute its efficacy.     

Capacitive transducer for relative position error galvo mirrors

A transducer was designed to sense small angular displacements of servo-controlled galvo mirrors in rotary optical storage devices. The transducer is differential in nature, and operates on the principle of linear electrical capacitance variation with area overlap of uniquely shaped capacitor plates. These capacitive plates lie in planes normal to the axis of rotation, and consist of many electrically connected wedge-shaped projections aligned radially to the center of rotation. A prototype was fabricated and tested. For optical storage devices, experimentally determined characteristic curves show sufficient linearity and repeatability for relative position error (RPE) feedback applications, at plate spacings of 0.15 mm or less. A design change, for further extending the linear range of the characteristic curve of the transducer beyond RPE feedback requirements, is described. A circuit design to produce voltage variations proportional to differential capacitance changes in the transducer is discussed, and peak-to-peak signal-to-noise ratio is conservatively approximated at 2×10⁴ with 10 kHz bandwidth     

Juice-extracted grass pellets and sodium bicarbonate for cows fed timothy silage of two chop lengths

Eighteen multiparous Holstein cows in midlactation were used in a switchback design trial to evaluate the effect of chop length (3 or 30 mm) of timothy grass silage, containing less than 30% ADF and treated with formic acid, on DMI and cow performance. Within chop length, addition of NaHCO3 (2% of DMI) or the replacement of 30% of silage DM with juice-extracted grass pellets was also evaluated. Cows were fed a TMR composed of 90% silage and 10% concentrate. Silage preservation characteristics were not different between chop lengths. The DMI and apparent digestibility were similar among treatments. Yields of 4% FCM (24.9 vs. 22.7 kg/d), fat (1.03 vs. .93 kg/d), and protein (.83 vs .77 kg/d) were higher with the short chopped silage. Milk protein, milk NPN content, and serum urea were higher for cows fed long chopped silage. Yields of milk and milk constituents were not affected by the addition of juice-extracted grass pellets or NaHCO3. Fat percentage and fatty acid composition of milk remained unchanged by treatments. Reduction of particle size, from 30 to 3 mm, of timothy grass, treated with formic acid at harvest and using compaction at ensiling in bag silos, did not affect silage conservation characteristics but did improve milk, fat, and protein yields when cows were fed high silage diets.     

Lung transplantation in cystic fibrosis

PURPOSE: To assess the non-cutaneous involvement in primary B-cell non-Hodgkin's lymphoma (NHL) of the skin. PATIENTS AND METHODS: Data from 45 patients with B-cell NHL of the skin were retrospectively analysed. The patients were diagnosed on histologic and immunocytochemical grounds between June 1977 and July 1993, and 14 cases were selected for their exclusively cutaneous initial involvement. Initial treatment, response to therapy, disease-free survival characteristics of relapse and therapeutic sequence were evaluated in every case. RESULTS: Cutaneous involvement presented as nodules or patches, on a single location, in 12 cases, or disseminated, in 2 others. No prognostic factor could be identified, and complete remission was attained in all cases. Cutaneous relapse was seen in 7 patients after 4 to 108 months since diagnosis. Extracutaneous dissemination was not seen in any case, and 13 patients are alive and disease-free. A 90 year-old woman died of toxic complications. CONCLUSIONS: The clinical facts reported here confirm the not too aggressive behaviour of certain B-cell cutaneous NHL, probably related with their origin on the skin itself.     

Sequence requirements of the Epstein-Barr virus latent origin of DNA replication

The Epstein-Barr virus (EBV) latent origin of DNA replication (oriP) is composed of two elements that contain binding sites for the sole viral gene product required for latent cycle replication, EBNA-1. One of these elements, region I, functions as an EBNA-1-dependent enhancer for RNA polymerase II-transcribed genes, may play a role in plasmid segregation, and is required for origin function in B cells latently infected with EBV. The second element, region II, contains or is very near the site of initiation of DNA replication. A genetic approach was taken to determine the contribution of the EBNA-1 binding sites in oriP to origin function. Although region I is required for the transient replication of plasmids bearing region II in EBV-infected B cells, a plasmid lacking region I but containing region II, was observed to replicate transiently in both D98/Raji and HeLa cells expressing EBNA-1. Thus, binding of EBNA-1 to region I is not absolutely required for the molecular events that lead to initiation of DNA replication at region II. Site-directed mutagenesis of the four EBNA-1-binding sites in region II, individually and in various combinations, demonstrated that only two EBNA-1-binding sites are required for region II function. The results obtained with these mutants, together with the analysis of the replicative ability of plasmids containing insertions between EBNA-1-binding sites, suggested that the spatial relationship of the two sites is critical. Mutants that contain only two EBNA-1-binding sites separated by 26 to 31 bp in region II were not maintained as plasmids over many cell generations and were greatly reduced in their ability to replicate transiently in D98/Raji cells. The EBNA-1-induced bending or untwisting of the DNA in EBNA-1-binding sites 1 and 4 in region II did not, however, demonstrate this spatial constraint. It may be concluded from these results that specific protein-protein interactions between EBNA-1 and/or between EBNA-1 and a cellular protein(s) are required for origin function.     

A technique for developing a master cast with previously made dies

This article describes a technique for preparing final working casts to be used in the laboratory phase of restorative treatment. The goal is to produce accurate working casts that have stable dies which are easily removed from the base and reliably replaced. Most casts with removable dies are made from a single master impression. However, individual dies are sometimes made previously from individual tooth (preparation) impressions. In such cases, transfer copings are required to relate the dies and produce the final working cast. Hollow plastic casting sprues are used as temporary dowels in this technique until a transfer coping pickup impression has been made. After the dies are seated and secured in the transfer coping pickup impression, the plastic casting sprues are replaced with conventional brass dowel pins. This technique ensures well-placed dowel pins that will facilitate easy and accurate withdrawal and replacement of the dies.     

Job demands and worker health: Three-dimensional reexamination of the relationship between person€nvironment fit and strain.

The most influential study of the person–environment (P–E) fit approach to stress was conducted by J. R. French et al (1982). Unfortunately, this study operationalized fit using various transformations of difference scores, thereby introducing numerous substantive and methodological problems. In the present study, the authors reanalyze data from French et al, using a procedure described by J. R. Edwards (in press) that avoids problems with difference scores and captures the underlying 3-dimensional relationship between environment, person, and strain. Results resolve ambiguities in the French et al findings and identify relationships between environment, person, and strain that, although consistent with P–E fit theory, cannot be adequately represented by fit measures such as those used by French et al. Implications for P–E fit research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity

A prospective assessment of late changes in breast appearance in 559 patients after tumour excision and radiotherapy for early breast cancer noted a strong association with breast size. Only 3/48 (6%) patients with small breasts developed moderate or severe late changes compared with 94/423 (22%) with medium sized breasts and 34/88 (39%) patients with large breasts (p < 0.001). One possibility is that greater radiation changes are related to greater dose inhomogeneity in women with large breasts. To explore this hypothesis, radiation dose distributions were assessed in a separate group of 37 women in whom three-level transverse computer tomographic images of the breast in the treatment position were available. A significant correlation was found between breast size and dose inhomogeneity which may account for the marked changes in breast appearance reported in women with large breasts.