Referral of patients with pain from pancreatic cancer for neurolytic celiac plexus block

OBJECTIVE: To assess whether patients with pancreatic cancer-associated pain living near a pain control center were more likely to undergo neurolytic celiac plexus block (NCPB) than those living at a distance and to determine the rationale of physicians at our institution for referring patients for NCPB. DESIGN: We retrospectively reviewed the frequency of use of NCPB in patients with pancreatic cancer and conducted an anonymous physician survey of referral patterns for NCPB for such patients. MATERIAL AND METHODS: A prospective database of medical diagnoses and a clinical database at our institution were used to identify patients with pancreatic cancer within three geographic regions who were assessed during the inclusive years 1980 through 1989: group I ("local") = all patient with pancreatic cancer in Olmsted County, Minnesota; group II ("surrounding") and group III ("distant") = patients referred for pancreatic cancer evaluation who lived within 100 miles of our institution (excluding Olmsted County) or more than 100 miles from our institution, respectively. Medical records were retrospectively reviewed to assess the use of NCPB at any time during the course of pancreatic cancer. For the physician survey component, all medical oncologists, gastroenterologists, and general surgeons at our institution who might be responsible for the care of patients with pancreatic cancer were sent a questionnaire about their referral patterns for NCPB among patients with pancreatic cancer. RESULTS: Overall, approximately 15% of the 292 patients with pancreatic cancer studied underwent NCPB. Distance from our pain control center was not found to be associated with frequency of use of NCPB. Of the 78 physicians surveyed, 59 (76%) responded, and 35 of the responders (59%) had encountered at least 1 patient with pancreatic cancer during the preceding 12 months. In that subset of physicians, perceived barriers for referral for NCPB were limited appointment availability and need for repeating the procedure. CONCLUSION: On the basis of this study, referral patterns for NCPB in patients with pancreatic cancer do not seem to be associated with the geographic distance of a patient's residence from a pain control center. Improving appointment availability for NCPB might increase the number of patients offered this technique for control of pain.     

"Candidatus phytoplasma australiense," a new phytoplasma taxon associated with Australian grapevine yellows

A phytoplasma was detected in naturally diseased 'Chardonnay' grapevines exhibiting symptoms of Australian grapevine yellows disease. The use of PCR designed to amplify phytoplasma DNA resulted in detection of phytoplasma DNA in all of the diseased plants examined; no phytoplasma DNA was detected in healthy seedling grapevines. The collective restriction fragment length polymorphism (RFLP) patterns of amplified 16S ribosomal DNA differed from the patterns described previously for other phytoplamas. On the basis of the RFLP patterns, Australian grapevine yellows phytoplasma was classified as a representative of a new subgroup, designated subgroup 16SrI-J, in phytoplasma 16S rRNA group 16SrI (aster yellows and related phytoplasmas). A phylogenetic analysis in which parsimony of 16S rRNA gene sequences from this and other group 16SrI phytoplasmas was used identified the Australian grapevine yellows phytoplasma as a member of a distinct subclade (subclade xii) in the phytoplasma clade of the class Mollicutes. A phylogenetic tree constructed on the basis of 16S rRNA gene sequences was consistent with the hypothesis that there was divergent evolution of Australian grapevine yellows phytoplasma and its closet known relative, European stolbur phytoplasma (subgroup 16SrI-G), from a common ancestor. The unique properties of the DNA from the Australian grapevine yellows phytoplasma clearly establish that it represents a new taxon, "Candidatus Phytoplasma australiense."     

Variable regions V13 and V3 of Saccharomyces cerevisiae contain structural features essential for normal biogenesis and stability of 5.8S and 25S rRNA

The homologous ribosomal RNA species of all organisms can be folded into a common "core" secondary structure. In addition, eukaryotic rRNAs contain a large number of segments, located at fixed positions, that are highly variable in size and sequence from one organism to another. We have investigated the role of the two largest of these variable regions in Saccharomyces cerevisiae 25S rRNA, V13, and V3, by mutational analysis in a yeast strain that can be rendered completely dependent on the synthesis of mutant (pre-)rRNA. We found that approximately half of variable region V13 can be deleted without any phenotypic effect. The remaining portion, however, contains multiple structural features whose disturbance causes serious growth defects or lethality. Accumulation of 25S rRNA is strongly reduced by these mutations, at least in part because they inhibit processing of ITS2. Removal of even a relatively small portion of V3 also strongly reduces the cellular growth rate and larger deletions are lethal. Interestingly, some of the deletions in V3 cause accumulation of 27S(A) pre-rRNA and, moreover, appear to interfere with the close coupling between the processing cleavages at sites A3 and B1(S). These results demonstrate that both variable regions play an important role in 60S subunit formation.     

Forward Light Cuts: A Scalable Approach to Real‐Time Global Illumination

We present Forward Light Cuts, a novel approach to real‐time global illumination using forward rendering techniques. We focus on unshadowed diffuse interactions for the first indirect light bounce in the context of large models such as the complex scenes usually encountered in CAD application scenarios. Our approach efficiently generates and uses a multiscale radiance cache by exploiting the geometry‐specific stages of the graphics pipeline, namely the tessellator unit and the geometry shader To do so, we assimilate virtual point lights to the scene's triangles and design a stochastic decimation process chained with a partitioning strategy that accounts for both close‐by strong light reflections, and distant regions from which numerous virtual point lights collectively contribute strongly to the end pixel. Our probabilistic solution is supported by a mathematical analysis and a number of experiments covering a wide range of application scenarios. As a result, our algorithm requires no precomputation of any kind, is compatible with dynamic view points, lighting condition, geometry and materials, and scales to tens of millions of polygons on current graphics hardware.     

Comparison of intensive versus moderate chemotherapy of lymphocytic lymphomas: a progress report

In an Easter Cooperative Oncology Group trial, Cytoxan-prednisone (CP) Induction was compared to BCNU-prednisone (BP) in 273 patients with lymphocytic lymphoma. Response rates were comparable, with 21% achieving complete response and 40%, partial response. Patients with a nodular pattern responded better. Maintenance phase comparing cyclic intensive therapy (BCVP) with intermittent chlorambucil revealed the superiority of BCVP as demonstrated by improvement of the quality of response and somewhat longer remissions. The value of the Rappaport classification in the evaluation of lymphoma chemotherapy results is discussed. It is suggested tha NHL be separated into "favorable" and "unfavorable" groups, based on the presence or absence of nodularity and treatment schedules devised accordingly.     

Fluorometric determination of pyruvate and alpha-ketoglutarate in cerebrospinal fluid and plasma of infants and children. A simple test that screen for metabolic disorders

Levels of pyruvate and alpha-ketoglutarate in the cerebrospinal fluid (CSF) of 26 children, aged 4 months to 5 1/2 years, with febrile seizures and of 19 children, aged 4 months to 14 years, with the diagnosis of epilepsy were not different from values seen in 119 "normal" children 8 days to 14 years of age. The CSF samples from 24 adults, 24 to 81 years of age, suspected of having a herniated disk were also examined. In the pediatric age group, the data showed a highly significant downward trend of CSF and plasma alpha-ketoglutarate values with age; pyruvate values did not change. A correlation of the values of the two keto acids in the blood and CSF of 42 other children without apparent neurologic disease was also made. Findings in a child with thiamine deficiency suggest that CSF alpha-ketoglutarate may be a more sensitive indicator of deficiency than plasma alpha-ketoglutarate or pyruvate. Measurements of these keto acids in plasma and CSF may be diagnostically useful in a variety of metabolic disorders. Findings in 155 children from birth (20 minutes) to 17 years of age without neurologic disease are submitted as a standard of reference.     

The expansion and extraction of rice bran

Expansion of rice bran as a pretreatment for solvent extraction was studied. It was found that the expanded bran showed no rise in free fatty acid (FFA) even when stored at room temp, in open containers, for a period of three months, and a slight rise after one year storage; and that the bran was agglomerated into large particles which eliminated the “fines” and channeling problems characteristic of rice bran; and that the retention time for good extraction was on the order of 45 min; and that the percolation rate for a four ft depth of expanded bran was on the order of 35 gpm/ft².     

Highly Porous Vitrified Bonded Abrasives by the Selective Extraction of Butyl Carbamate from Green Grinding Wheels with Supercritical CO2

Highly porous vitrified bonded grinding wheels were produced by selective extraction of butyl carbamate pore inducer using supercritical (sc) CO₂. Butyl carbamate was found to be an excellent pore inducer, as the extraction was fast and the desired pore structure was obtained. The investigation revealed that the extraction was controlled by the solubility of butyl carbamate in scCO₂ and the flow direction had a large effect on extraction times. The solubility of butyl carbamate determined from cloud point measurements was found to be high at moderate conditions. Grinding tests demonstrated that scCO₂ pore-induced wheels performed slightly better then conventionally produced wheels at the conditions investigated. The power required for grinding, wheel wear, and part quality were comparable with those of conventionally produced wheels at low metal removal rates. However, the extracted wheels outperformed the conventional wheel at high metal removal rates, indicating the scCO₂ processing produces a slightly superior product than that made by conventional means. Liquefaction of the pore inducer during extraction had a minor effect on the final properties of the wheel.     

Effects of phospholipids on lipid oxidation of a salmon oil model system

Total lipid (TL), neutral lipid (NL), and phospholipid (PL) fractions were extracted from bluefish (Pomatomus saltatrix) white and dark muscle with skin. The effects of each fraction on the oxidative stability of a refined salmon oil model system was measured by monitoring changes in the 2-thiobarbituric acid assay and decreases in the ratio of docosahexaenoic acid (DHA) to palmitic acid (C22:6/C16:0) following incubation at 55°C or 180°C. Phospholipid fractions at 2.5% and 5.0% (wt/wt) of oil improved the oxidative stability of oils incubated at both temperatures compared to controls, TL- and NL-supplemented oils at similar concentrations. Phospholipid fractions exhibiting antioxidant properties contained an average of 34% DHA as compared to only 15% in the NL and TL fractions.     

Cavitation Damage During Flexural Creep of SiAlON–YAG Ceramics

Cavitation damage in flexure bars crept at 1170°C was studied by a density measurement technique. The cavity density within the flexure beams could be approximated by a linear function of position from the tensile surface. A threshold stress for cavitation damage is suggested from the results of this study. Below the threshold tensile stress, cavitation ceases, whereas above the threshold, cavitation damage is in the form of wedge-shaped cracks at grain-boundary triple junctions. Cavitation is not observed in compression for the conditions used in this study. From a stress analysis of the flexure bars, a cavitation threshold of 55 MPa is estimated for this material.