Tutor-student interaction in the operating theatre

This paper examines the view that productive teaching in the operating theatre requires a recognition of the unique set of factors which may influence the process of communication. For tutor-student interaction to occur in a productive manner, the tutor's behaviour will need to be modified to suit the demands of the other tasks in which both tutor and student are involved. The particular value of recognizing the role of nonverbal behaviours during interaction is discussed, with the use of specific examples related to the positioning of the tutor and student, and their use of facial expression, the eyes and voice.     

Muscle fiber composition and blood ammonia levels after intense exercise in humans

The relationship between fiber type composition and the increase in blood ammonia was examined following a maximal O2 consumption (VO2max) test. Muscle biopsies were taken from the middle portion of the vastus lateralis for determination of fiber type percentages. Two subject groups were selected on the basis of a high (HST) or low (LST) percentage of slow-twitch fibers and compared for blood ammonia and lactate levels after exercise at work loads of approximately 85 and 110% of VO2max. An inverse relationship was found between the percentage of slow-twitch fibers and the increase in blood ammonia. Blood ammonia increased after exercise at both 85 and 110% of VO2max. However, the increase was twofold greater for the LST group following the 110% work effort. The increases in blood ammonia and lactate were positively correlated for both groups following exercise. The results suggest that the proportion of slow-twitch fibers plays an important role in determining the magnitude of the increase in blood ammonia after intense exercise.     

Ultrastructural changes in the mycelia of Actinomyces hygroscopicus var. var. enhygrus--a proteolytic enzyme producer--during submerged fermentation

Ultrastructural changes were found to occur in the mycelium of Actinomyces hygroscopicus, strain 33x, which produced an exocellular proteolytic enzyme during submerged fermentation, in both laboratory and semiindustrial conditions (in 100-1 fermenters). In the course of the enzyme accumulation, numerous vacuoles appeared in the hyphae, some hyphae became wider, and the cell walls were more loose. The greatest structural changes were found in the intracytoplasmic membrane systems. The ultrastructural changes of the mycelium are not presumably connected with the accumulation of the enzyme, but are the result of the differentiation of cellular structures during aging of the cells and their transition to the stage of autolysis.     

Differences in tissue fatty acids and cholesterol of swine from different genetic backgrounds

A review of 1,000 consecutive coronary angiograms, most of them performed for evaluation of angina pectoris, yielded 9 examples of congenital anomalies of the coronary arteries. In 2 cases the angina may have been due to malposition of the left coronary artery or one of its branches. There were 2 cases of aberrant origin of the circumflex artery from the right coronary artery, 2 cases of aberrant left anterior descending artery, 3 cases in which all three major coronary branches arose from the right aortic sinus, and 2 cases of coronary artery fistulas. Malposition of the coronary artery should be considered as a possible cause of angina.     

Heavy metal contamination in the Taimyr Peninsula,Siberian Arctic

The Taimyr Peninsula is directly north of the world's largest heavy metal smelting complex (Norilsk, Russia). Despite this proximity, there has been little research to examine the extent of contamination of the Taimyr Peninsula. We analyzed heavy metal concentrations in lichen (Cetraria cucullata), moss (Hylocomium splendens), soils, lake sediment, freshwater fish (Salvelinus alpinus, Lota lota and Coregonus spp.) and collared lemming (Dicrostonyx torquatus) from 13 sites between 30 and 300 km from Norilsk. Element concentrations were low in both C. cucullata and H. splendens, although concentrations of Al, Fe, Cu, Ni and Pb were significantly higher than those in Arctic Alaska, probably due to natural differences in the geochemical environments. Inorganic surface soils had significantly higher concentrations of Cd, Zn, Pb and Mg than inorganic soils at depth, although a lake sediment core from the eastern Taimyr Peninsula indicated no recent enrichment by atmospherically transported elements. Tissue concentrations of heavy metals in fish and lemming were not elevated relative to other Arctic sites. Our results show that the impact of the Norilsk smelting complex is primarily localized rather than regional, and does not extend northward beyond 100 km.     

Porous-coated total hip replacement

Fifteen years of clinical experience with porous-coated prostheses demonstrated the durability of this type of fixation. This experience was documented by clinical follow-up study of the 393 cases treated by the senior author before 1985. Only six of these femoral components have been revised: three for loosening, two for stem breakage, and one for infection. Thus, the revision rate for the porous-coated stems was 1.5%. Porous-coated acetabular components were used in 227 of the arthroplasties. Five of these porous-coated cups have been revised: four for malposition leading to dislocation and one for late loosening secondary to osteolysis. Thus, the revision rate for these porous-coated acetabular components was 2.2%. Twenty bipolar and 146 cemented acetabular components were used in the remaining 166 cases treated before 1985. Eleven (7.5%) of the cemented acetabular components were revised. Revisions of the porous-coated components were rare in the first ten postoperative years. The clinical data were supplemented with analysis of postmortem specimens from 15 patients. Mechanical testing of the femoral specimens showed the relative micromotion at the porous surface to be exceptionally small (less than 40 microns). Seven of these postmortem retrievals involved cases with unilateral arthroplasties. In these cases, the contralateral normal femur also was removed, and a prosthesis identical to that in the in vivo implanted side was inserted to simulate the immediate postoperative condition. Dual-energy X-ray absorptiometry (DEXA) of the seven paired femora demonstrated that bone remodeling can be expected to produce a 5%-52% loss of periprosthetic bone mineral content, with the greatest loss occurring in the more osteoporotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of adhesion molecules in human leukocyte attachment to porcine vascular endothelium: implications for xenotransplantation

Many obstacles still prevent successful xenotransplantation of porcine donor organs. When hyperacute rejection is averted, transplanted pig organs are subject to acute vascular and cellular rejection. In autologous systems, leukocyte recruitment into inflamed tissues involves selectins, integrins, and Ig family members. To determine whether these mechanisms allow human leukocytes to effectively enter porcine grafts, the pathways by which human leukocytes adhere to TNF-alpha-stimulated porcine aortic endothelium were examined under static and physiologic flow conditions. L-selectin and E-selectin had overlapping functions in neutrophil capture and rolling, whereas Ab blockade of E-selectin and the beta2 integrins inhibited firm arrest of rolling neutrophils. Combined blockade of selectins and beta2 integrins resulted in negligible human neutrophil attachment to pig endothelium. Lymphocyte attachment to porcine endothelium was primarily L-selectin mediated, whereas beta2 integrin and VCAM-1/very late Ag-4 (VLA-4) interactions promoted static adhesion. Concurrent beta2 integrin, VLA-4, VCAM-1, and L-selectin blockade completely inhibited lymphocyte attachment. Thus, interactions between leukocyte-endothelial cell adhesion receptor pairs remained remarkably intact across the human-porcine species barrier. Moreover, disrupting the adhesion cascade may impair the ability of human leukocytes to infiltrate a transplanted porcine organ during rejection.