Correlation between int-2 oncogene amplification and increased tumor size in breast cancer]

Gloves should provide two-way protection from the transmission of microorganisms between worker and patient. Until recently, glove manufacturers paid little attention to barrier properties. Because the operating room is a high-risk area, surgical nurses must be especially careful about gloving practices.     

Treatment of proctalgia fugax with salbutamol inhalation

OBJECTIVES: Although no generally effective treatment for proctalgia fugax is known, inhalation of salbutamol has been reported to shorten pain attacks in isolated cases. METHODS: We conducted a randomized, double-blind, placebo-controlled, crossover trial of inhaled salbutamol in 18 patients with proctalgia fugax. The clinical effect was evaluated by recording the duration of severe pain and discomfort during acute attacks. In addition, anorectal motility recordings were analyzed for possible changes in anal resting tone, sphincter relaxation during rectal distension and in rectal compliance prior to and following administration of the two test substances. RESULTS: Sixteen patients completed all investigations. Compared to placebo, salbutamol inhalation shortened the duration of severe pain (p = 0.019). The effect was most marked in patients having prolonged attacks. In the asymptomatic state, neither salbutamol nor placebo led to a significant change in anal resting pressure, anal relaxation during rectal distension, or rectal compliance. Salbutamol also did not alter the threshold for rectal sensation. CONCLUSIONS: Salbutamol inhalation shortens attacks of severe pain in patients with proctalgia fugax. The mechanism of this effect remains unexplained.     

The complex forensic medical study of the bony remains from a burial long ago]

A cross-sectional study was conducted in a randomly selected village of Rangpur district from June '94 to May '95. Serum from 1000 human subjects irrespective of age and sex were screened for hepatitis B surface antigen (HBsAg). Among the respondents 661 were male and 339 female. The overall seroprevalence of HBsAg was 6.4%. It was 6.66% in male and 5.89% in female. Age, sex, religion, income, occupation, education and marital status did not show any relationship with HBsAg status. Among 64 sero-positive cases, 16 (25%) had no history of exposure to known risk factors and 48 (75%) had one or more exposure to known risk factors (p < 0.05). This study did not depict the national scenario. Well designed studies with more sensitive serological methods are recommended to get the epidemiological information of hepatitis B virus (HBV) infection in our community.     

Changes in the calpains and calpastatin during postmortem storage of bovine muscle

Changes in activity and protein status of micro-calpain, m-calpain, and calpastatin in bovine semimembranosus muscle during the first 7d of postmortem storage were monitored by using assays of proteolytic activity, SDS-polyacrylamide gel electrophoresis, and Western blot analysis. Extractable m-calpain activity changed slightly during the first 7d after death (decreased to 63% of at-death activity after 7d), whereas extractable calpastatin activity decreased substantially (to 60% of at-death activity after 1d and to 30% of at-death activity after 7d of postmortem storage) during this period. Extractable micro-calpain activity also decreased rapidly (to 20% of at-death activity at 1d and to less than 4% of its at-death activity at 7d after death) during postmortem storage. Western blot analysis showed that the 80-kDa subunit of m-calpain remained undegraded during the first 7d after death but that the 125- to 130-kDa calpastatin polypeptide was gone entirely at 7d after death. Hence, the calpastatin activity remaining at 7d originates from calpastatin polypeptides that are 42 kDa or smaller. The 80-kDa micro-calpain subunit was almost entirely in the 76-kDa autolyzed form at 7d after death; this form is proteolytically active in in vitro systems, and it is unclear why the postmortem, autolyzed micro-calpain is not active. Over 50% of total muscle micro-calpain is tightly bound to myofibrils 7d after death; this micro-calpain is also nearly inactive proteolytically. Unless postmortem muscle contains some factor that enables micro-calpain in this muscle to be proteolytically active, it is not clear whether micro-calpain could be responsible for any appreciable postmortem myofibrillar proteolysis.     

Effect of growth and development on cephalometric shapes in orthodontic patients: a Fourier analysis

The age- and gender-related shape variations of the craniofacial skeleton in skeletal Class I children were quantified using a Fourier analysis on the pre-treatment lateral head films of 122 orthodontic patients (age range 7-15 years), who were subdivided into six groups for sex and age (2-year intervals). Seven landmarks representative of the maxillo-mandibular sagittal and vertical relationship were identified and digitized. The contiguous landmarks were connected by segments, the form was normalized with respect to its orientation and size, and a Fourier analysis of the contour was performed. Mean values of the cosine and sine coefficients of the first six harmonics in the sex and age classes were computed. The size-standardized outlines of the oldest boys were narrower and longer than the outlines of the youngest boys (differences at gonion, menton, sella and nasion). Shape differences between mean plots in girls were negligible. In the youngest patients, girls had a larger size-independent shape in the mandibular region; their shape was narrower (anterior-posterior direction) and longer (vertical direction) than male shape. In the oldest patients, boys had a larger size-independent shape at gonion, and a narrower shape at articulare and pogonion than girls. Size increased from the youngest to the oldest boys; size differences were not conspicuous in girls. Within an age class, male size was always larger than female. Fourier analysis allowed a global evaluation of the cephalometric forms, with separate quantifications of the age- and gender-related differences in size and shape.     

Results after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with familial adenomatous polyposis and coexisting colorectal cancer

Although the operation of choice for patients with familial adenomatous polyposis (FAP) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA), its place in the management of patients with FAP and cancer has not been defined. The authors have reviewed their experience with these patients to determine the safety of IPAA and its efficacy as a cancer operation. The records of 55 patients with FAP who had undergone IPAA were examined. Follow-up studies included an annual questionnaire and physical examination. Eight patients had FAP with coexisting colorectal cancer. Median age at diagnosis was 25 (range 13-46) years, and at operation 33 (range 22-36) years. Of the eight patients (four men), four had colonic cancer and four had rectal cancer. Synchronous colorectal carcinoma was found in two patients. Staging according to the tumor node metastasis classification showed that five patients had stage 1 tumour, two had stage 2 and one had stage 3. Tumours were well, moderately or poorly differentiated in one, five and two patients respectively. During a median follow-up of 56 (range 14-98) months, metastasis developed in the liver of one patient 66 months after surgery. Two patients suffered complications: one had small bowel obstruction and the other mucosal prolapse. Tubular adenomas were found in the pouch of two patients and in the anal transitional zone of one. Pouch function is good to excellent in all surviving patients. Restorative proctocolectomy for patients with FAP and coexisting colorectal cancer can be undertaken with a favourable prognosis and function. It is compatible with curative intent.     

Systems analysis of activities of the intensive care and resuscitation department at a multidisciplinary hospital. II. Intensity of work and quality indicators

The second part of the research is devoted to problems of the personnel labor load, to maintenance of reanimation asepsis, to analysis of the complications of intensive care, the causes and outcomes of these complications. A total system approach allows, as the authors believe, an objective assessment of the prerequisites of complications in expert evaluations.     

The role of the eicosanoids in the development of a postischemic shock reaction

The role of eicosanoids as one of the main shock mediators was demonstrated in experiments anesthetized dogs with modeled postischemic shock using premedication with indometacin and/or quercetin. Preliminary administration of the eicosanoid biosynthesis inhibitors has prevented reperfusion hemodynamics disturbances during 3 hours after the beginning of an extremity reperfusion. The presented results confirm vascular endothelium injury in the investigated areas, which caused disbalance in the necessity-flow balance in working organs. Therefore, a damage in the endotheliocytes function is the first and, probably, a leading factor in development of the postischemic disturbances of circulation.     

Effectiveness of controlled and spontaneous modes in nasal two-level positive pressure ventilation in awake and asleep normal subjects

STUDY OBJECTIVES: The purpose of the present study was to compare in awake and asleep healthy subjects, under nasal intermittent positive pressure ventilation (nIPPV) with a two-level intermittent positive pressure device (two-level nIPPV), the efficacy of the controlled and spontaneous modes, and of different ventilator settings in increasing effective minute ventilation (VE). PARTICIPANTS: Eight healthy subjects were studied. SETTING: In the controlled mode, inspiratory positive airway pressure (IPAP) was kept at 15 cm H2O, expiratory positive airway pressure (EPAP) at 4 cm H2O, and the inspiratory/expiratory (I/E) time ratio at 1. The respirator frequencies were 17 and 25/min. In the spontaneous mode experiment, IPAP was started at 10 cm H2O and progressively increased to 15 and 20 cm H2O; EPAP was kept at 4 cm H2O. MEASUREMENTS AND RESULTS: We measured breath by breath the effective tidal volume (VT with respiratory inductive plethysmography), actual respiratory frequency (f), and effective VE. Using the controlled mode, effective VE was significantly higher on nIPPV than during spontaneous unassisted breathing, except in stage 2 nonrapid eye movement sleep at 17/min of frequency; increases in f from 17 to 25/min led to a significant decrease in VT reaching the lungs, during wakefulness and sleep; effective VE was higher at 25 than at 17/min of frequency only during sleep; periodic breathing was scarce and apneas were never observed. Using the spontaneous mode, with respect to awake spontaneous unassisted breathing, two-level nIPPV at 10 and 15 cm H2O of IPAP did not result in any significant increase in effective VE either in wakefulness or in sleep; only IPAP levels of 20 cm H2O resulted in a significant increase in effective VE; during sleep, effective VE was significantly lower than during wakefulness; respiratory rhythm instability (ie, periodic breathing and central apneas) were exceedingly common, and in some subjects extremely frequent, leading to surprisingly large falls in arterial oxygen saturation. CONCLUSIONS: It appears that two-level nIPPV should be used in the controlled mode rather than in the spontaneous mode, since it seems easier to increase effective VE with a lower IPAP at a high frequency than at a high pressure using the spontaneous mode. We suggest that the initial respirator settings in the controlled mode should be an f around 20/min, an I/E ratio of 1, 15 cm H2O of IPAP, and EPAP as low as possible.