Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: report of 11 cases

Pyloromyotomy remains the standard of care for the treatment of infantile hypertrophic pyloric stenosis. Open pyloromyotomy is effective and is the gold-standard technique. The authors report on the techniques of laparoscopic pyloromyotomy. The clinical courses of the first 11 infants treated with laparoscopic pyloromyotomy we with the courses of 14 infants treated recently with open pyloromyotomy. The average surgical time for the laparoscopic group was 25.4 minutes. The average time (postoperatively) until full feedings was 19.0 hours. In the open pyloromyotomy group the average surgical time was 26.1 minutes, and the time until full feedings was 23.2 hours. These results are not significantly different. When compared with open pyloromyotomy, the laparoscopic approach appears to be equally safe and effective, with superior cosmetic results. The authors believe that laparoscopic pyloromyotomy is an excellent alternative procedure for the management of hypertrophic pyloric stenosis.     

The application of participatory control to facilitate patient well-being: An experimental study of nursing impact on geriatric patients.

Evaluated a program to teach 20 nurses skills to increase their 20 patients' sense of participatory control (the process by which people increase control through reciprocal interactions with their environment). Seven nurse-pairs were in the skills training (intervention) group, 6 in an attention-control group, and 7 in a no treatment control group. Training program topics included sensitivity training, goal-setting, clarity of communication, problem-solving, and interpretation of behavior. According to the Ward Atmosphere Scale, patients in the skills training group showed increases in Autonomy and Spontaneity and decreases in Staff Control. Patient scores on a self-concept scale showed an increase in positive self-concept. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Microswitches with sputtered Au, AuPd,Au-on-AuPt, and AuPtCu alloy electric contacts

This paper is the first to report on a new analytic model for predicting microcontact resistance and the design, fabrication, and testing of microelectromechanical systems (MEMS) metal contact switches with sputtered bimetallic (i.e., gold (Au)-on-Au-platinum (Pt), (Au-on-Au-(6.3at%)Pt)), binary alloy (i.e., Au-palladium (Pd), (Au-(3.7at%)Pd)), and ternary alloy (i.e., Au-Pt-copper (Cu), (Au-(5.0at%)Pt-(0.5at%)Cu)) electric contacts. The microswitches with bimetallic and binary alloy contacts resulted in contact resistance values between 1-2/spl Omega/. Preliminary reliability testing indicates a 3/spl times/ increase in switching lifetime when compared to microswitches with sputtered Au electric contacts. The ternary alloy exhibited approximately a 6/spl times/ increase in switch lifetime with contact resistance values ranging from approximately 0.2-1.8/spl Omega/.     

Lisfranc's fracture-dislocation. A literature review and case presentations of tarsometatarsal joint injuries

Lisfranc's fracture-dislocations are relatively infrequent injuries that may result in major debilitation. A review of the literature is presented with focus on the proper evaluation, diagnosis, and management of these injuries. Three cases are presented that illustrate the more common mechanisms of injury.     

Structural design of the femoral neck in primates

This study investigates the structural design of the femoral neck with respect to phylogeny, locomotor behavior, and body size in a large comparative sample of primates. Since a bone's strength is determined by the amount and arrangement of its constituent material, the amount and distribution of bone in the femoral neck are the focus of the present study. Two types of data were collected. First, the total distribution of bone across the femoral neck (perpendicular to the femoral neck axis) was examined using image analysis techniques. The distribution of both cortical and trabecular bone are included in this analysis. Secondly, the external dimensions of the femoral neck and the thickness of the superior and inferior cortices, measured from radiographs, were used to calculate femoral neck cross-sectional properties (cortical area and second moment of area). These data were input into a simplified cantilevered beam model that incorporates femoral neck-shaft angle and femoral neck length and is used to predict stress under one unit body mass of loading on the femoral head. The patterns of bone distribution in the femoral neck between taxa are broadly similar for the analysis that includes both trabecular and cortical bone and that which includes only cortical bone. In all cases, there tends to be more bone on the inferior aspect of the femoral neck compared to the superior aspect. However, the non-human hominoids and New World monkeys (e.g., Ateles and Alouatta) have a more even distribution of bone across the femoral neck and have thicker superior cortices relative to inferior cortices compared to the rest of the comparative sample, including humans. It is proposed that the more equal distributional pattern in the non-human hominoids and atelines reflects less stereotypical, more generalized loading orientations. Differences between species in overall strength of the femoral neck are a function of both body size and locomotor mode.     

The IPCS Collaborative Study on Neurobehavioral Screening Methods: V. Results of chemical testing. Steering Group

The goal of the International Programme on Chemical Safety (IPCS) Collaborative Study on Neurobehavioral Screening Methods was to determine the intra- and inter-laboratory reliability of a functional observational battery (FOB) and an automated assessment of motor activity in eight laboratories worldwide. The control data were crucial to the outcome of the studies in terms of sensitivity and reliability of the test measures, which in turn impact on the between-laboratory comparisons of chemical effects. In addition, analyses of control data can aid in determining endpoints that may require modification to improve their sensitivity and reliability. The control data from the eight laboratories were examined in terms of the following parameters: 1) control variability within studies for each laboratory; 2) within-laboratory replicability of control values across studies; 3) within-laboratory stability of control values over the course of testing for a given study; and 4) between-laboratory comparisons of parameters (1), (2), and (3). The analyses indicated considerable differences across endpoints, wherein some measures showed high variability and little replicability, while others were extremely reproducible. Generally, there were similar ranges of variability and replicability of control data across laboratories, although in some cases one or two laboratories were markedly different from the others. The physiological (weight, body temperature) and neuromuscular (grip strength, landing foot splay) endpoints exhibited the least variability, whereas the subjective assessments of reactivity varied the most. These data indicate a reasonable degree of comparability in the data generated in the participating laboratories.     

Mutagenesis of a buried polar interaction in an SH3 domain: sequence conservation provides the best prediction of stability effects

The SH3 domain from the Fyn tyrosine kinase possesses a buried hydrogen bond between the side chains of a glutamate (Glu24) and a serine (Ser41) residue. Multiple amino acid substitutions were made at these positions to determine the role of this interaction in the stability and conformational specificity of the domain and to assess the relationship between the thermodynamic stability of mutants and sequence conservation seen in the SH3 domain family. Analysis of single and double alanine mutations indicated that the Glu24-Ser41 interaction contributes 0.50 kcal/mol to the stability of the domain. However, disruption of the Glu24-Ser41 interaction did not impair peptide binding function, suggesting that the interaction is not critical for conformational specificity. The stability of the domain was not increased by the replacement of these residues with different combinations of hydrophobic residues or with potential salt bridge forming residues. Despite their similar structural roles in the Fyn SH3 domain, the Ser41 position was considerably more tolerant to substitution than was the Glu24 position. An alignment of >350 different SH3 domains has been completed in our laboratory. A statistically significant correlation was found between the conservation data for the Glu24 and Ser41 positions and the thermodynamic stabilities of the mutants constructed at these positions. Surprisingly, our analysis of sequence alignment data provided a more accurate prediction of the stability of mutants than did examination of the three-dimensional structure of the domain.     

Prevention of nonmelanoma skin cancer. Standard and investigative approaches

Today, in many fields of medicine, the focus is on prevention. This discussion highlights the salient features of sunscreens, protective clothing, and education, as they relate to the hazards and potential sequelae of sun exposure and tanning parlors. It also includes information on the status of clinical and laboratory investigation in the development of agents to prevent skin cancer in high-risk individuals.