Pre-incision infiltration with lidocaine reduces pain and opioid consumption after reduction mammoplasty

BACKGROUND: The main purpose of the reconstruction of the cranium is the protection of the brain. Besides we have to consider important functional and aesthetic necessities in order to achieve satisfactory results. METHODS: Thirty-six clinical cases, operated from November 1991 to June 1996, in which the reconstruction of the cranial vault is carried out by a polymethylmethacrylate acrylic resin are analysed. The causes and locations of the most common bone defects and the main indications for reconstruction are examined. While the repair of the osseous gaps caused by neoplasms is immediate, in the traumatic occurrences, in order to reduce the probability of infectious complications, an average time of 11 months elapsed from the first operation. The surgical technique, with slightest alterations, is the same in all the presented cases, preparing the acrylic resin straight on the operating table. The resin, moulded and adapted to the defect until its complete hardening, presents, thanks to its properties, manifold advantages (and few real disadvantages). RESULTS: The results, in terms of complications, are very satisfactory, with an infectious rate of 2.7%. Besides, in one third of the patients, a considerable clinical improvement after the repair has been observed. CONCLUSIONS: According to personal experience, it is possible to affirm that polymethylmethacrylate, with its remarkable plasticity and stability in time, can always guarantee a satisfactory functional and aesthetic result.     

Use of pentastarch solution in the treatment of patients with hemorrhagic hypovolemia: randomized phase II study in the emergency room

The weeping fig, Ficus benjamina (Fb), is a relatively common indoor allergen. Many cases of perennial allergic rhinoconjunctivitis and allergic asthma caused by Fb hypersensitivity are not detected. These patients typically have proven sensitization to housedust mites and do not improve after avoidance of exposure (encasing) and specific immunotherapy. The number of Fb sensitizations is increasing in Germany, which can partly be explained by the cross-reactivity between Hevea brasiliensis (Hb) latex and Fb and the rapidly increasing number of mostly occupational latex allergies. But Fb itself is a potential sensitizer which is widely spread as ornamental plant in homes and offices. As relevant indoor allergen Fb ranks third after housedust mites and pets but before molds among our allergy patients. For diagnosis, prick-tests with Fb-latex seem to be more sensitive than in vitro-methods (RAST, CAPRAST). Fb plants should not be kept in the homes of atopic individuals or persons with latex (Hb) allergy.     

Accumulation of chylomicron remnants in homozygous subjects with familial hypercholesterolaemia

Despite the obvious differences between the USA and UK health care systems, they share the characteristics of being motivated and managed in relation to cost and process rather than quality (the improved health status of patients). Whilst governments and insurers across the world use the rhetoric of quality, they, as epitomized by the behaviours of UK and USA decision makers, fail to define, measure and implement quality outcome policies. These behaviours are examined and some of their causes are explored briefly. Competition, as designed and used in public (e.g. UK National Health Service) and private (e.g. USA managed care) markets is shown to fail both to identify quality outcome targets and to provide evidence-based and efficient mechanisms to motivate decision makers to be orientated towards continuous quality outcome improvement in health care. A central policy challenge is, consequently, not just the measurement of quality outcomes but also their management into practice.     

Challenges to successful seismic retrofit implementation: a socio-behavioural perspective

Seismic retrofit implementation has been a major challenge in many earthquake-prone cities. This paper examines why building owners are reluctant to adopt measures to reduce earthquake losses despite advancement in seismic design methods and the enactment of intervening legislative frameworks. A case study approach revealed the socio-behavioural barriers affecting seismic retrofit implementation. Significant barriers identified included the perception of earthquake risks, a lack of trust in seismic strengthening techniques and a lack of support for pro-social mitigation behaviours from public authorities. The findings suggest that a reappraisal of the policy implementation approach used by government agencies is required, and that greater attention should be given to seismic designs recommended by professionals and approved by regulatory authorities in order to earn building owners' trust regarding the efficacy of earthquake risk-reduction measures.

La mise aux normes parasismiques des constructions existantes est un défi majeur dans de nombreuses villes sujettes aux tremblements de terre. Le présent article examine pourquoi les propriétaires d'immeubles sont peu disposés à adopter des mesures permettant de réduire les sinistres dus aux tremblements de terre en dépit des progrès réalisés dans les méthodes de conception parasismique et malgré la promulgation de cadres législatifs d'intervention. Une approche par étude de cas a mis en évidence les barrières sociocomportementales affectant la mise en ?uvre des normes parasismiques dans les immeubles existants. Ont été identifiés parmi ces obstacles importants la perception des risques de tremblements de terre, un manque de confiance dans les techniques de renforcement parasismique et un manque de soutien de la part des autorités publiques en faveur de comportements pro-sociaux permettant d'adoucir ces politiques. Les résultats obtenus suggèrent qu'il est nécessaire d'opérer une réévaluation de l'approche utilisée par les organismes publics pour mettre en ?uvre ces politiques, et qu'il devrait être porté une plus grande attention aux conceptions parasismiques recommandées par les professionnels et homologuées par les organismes de réglementation de façon à gagner la confiance des propriétaires d'immeubles, s'agissant de l'efficacité des mesures de réduction des risques liés aux tremblements de terre.

Mots clés: propriétaires d'immeubles, prise de décision, immeubles sujets aux tremblements de terre, politique publique, perception des risques, mise aux normes parasismiques, comportement des parties prenantes     

The role of the surface amorphous layer of articular cartilage in joint lubrication

Articular cartilage is a complex soft tissue that performs multiple functions in the joint. In particular, the amorphous layer that covers the surface of articular cartilage is thought to play some role in lubrication. This study aimed to characterize the surface amorphous layer (SAL) using a variety of techniques, including environmental scanning electron microscopy, transmission electron microscopy, white light interferometry, and biochemical analysis of its composition. Friction tests were conducted to investigate the role of the SAL in lubrication. A protocol to remove successfully the SAL without damaging the underlying cartilage was developed and the material removed from healthy cartilage was found to contain approximately equal quantities of glycosaminoglycan (GAG), protein, and lipid. Cartilage-on-cartilage friction tests were conducted on fresh, healthy cartilage with and without the SAL, under both dynamic and static operating conditions. Removal of the SAL was not found to change the friction coefficient. However, subsequent staining of specimens indicated that the SAL had replenished during the test following loading. The replenished SAL was characterized and found to contain lipids and sulphated GAGs with undetectable protein. This study revealed experimental evidence of surface layer replenishment in articular cartilage. It was postulated that the surface layer regeneration mechanism was purely mechanical and associated with movement of GAGs and lipids through the cartilage matrix during deformation, since the experimental set-up did not contain any means of biochemical activation.     

Characterization of type I 5 alpha-reductase activity in DU145 human prostatic adenocarcinoma cells

Each amino acid is represented by a vector of numerical measurements for the attributes of volume, area, hydrophilicity, polarity, hydrogen bonding, shape, and charge. Inter-residue distances are then calculated according to common metrics, and we introduce a new clustering objective function derived from information-theoretic considerations. The arguments of the function are the inter-object distances of the things to be clustered: in this case the amino acids. By means of approximating the solution of an integer programming problem, then, the residues are partitioned into clusters. The clusters obtained are compared with groups obtained in substitution/mutation studies and found to be similar. Thus, probably the strongest and most objective evidence to date is supplied for believing that physico-chemical properties account for the viability of substitutions and that the important similarities/differences are explained by a relatively small and simple set of properties.     

Transient free convection near the lower stagnation point of a cylindrical surface subjected to a sudden change in surface temperature

This paper presents the development of the free convection boundary-layer flow of a viscous and incompressible fluid near the lower stagnation point of a cylindrical body which is subjected to a sudden change in surface temperature. Analytical solutions for both small (unsteady) and large (steady) values of time have been obtained for the boundary-layer equations. These equations are then integrated numerically.     

不溶性硫黄在轮胎胶料配合中的应用

不溶性硫黄在轮胎胶料配合中的应用ＩｎｇｈａｍＦＡＡ等著谭向东摘译涂学忠校橡胶配方中所用的普通硫黄是稳定的斜方晶体，在加工和硫化温度下的橡胶烃中具有中等溶解度。硫黄的溶解度水平随着混炼及加工温度的升高而提高。图１所示为硫黄在几种不同聚合物中的溶解度与温...