Occlusion of large atrial septal defects with a centering buttoned device: early clinical experience

A feasibility clinical study was conducted for the transcatheter occlusion of large ostium secundum atrial septal defects with the centering buttoned device. The centering buttoned device is a modification of the regular buttoned device in which a centering counter-occluder is sutured at the central 40% portion of the occluder. During centering it is stretched, forming a parachute-shaped structure and pulling the occluder over the center of the defect. During buttoning, the counter-occluder forms a double figure eight, opposing the right atrial side of the atrial septum. Occlusion was performed in 12 patients aged 6 to 56 years. All had been rejected for transcatheter occlusion by the regular buttoned device, because of either their defect size or the lack of adequate septal rim. The defect size varied between 23 and 31 mm, and the device size varied between 45 and 60 mm. Nine had immediate effective occlusions of their defects and three residual shunts. One patient with unbuttoning had hemolysis at 2 weeks and underwent surgery. Early results of the transcatheter occlusion of large atrial septal defects are promising, and larger clinical trials are justified.     

Compulsory notification of cysticercosis in Ribeir?o Preto-SP, Brazil

Cysticercosis is a severe public health problem in several regions of Asia, Africa and Latin America. Epidemiologic studies based on the frequency of cases observed in specialized neurology, neurosurgery and computed tomography services, at autopsy and in seroepidemiologic studies do not permit the determination of the true prevalence of the disease in the population. The objective of the present study was to investigate the prevalence of cysticercosis by compulsory notification. The coefficient of prevalence was 54 cases/100,000 inhabitants in the municipality of Ribeir?o Preto. The results also indicated that cysticercosis is not under control in our region since 21% of cases presented the active form of the disease. Compulsory notification proved to be a valuable resource for the epidemiologic study of cysticercosis, also permitting the mapping of more affected areas for a better direction of prevention strategies.     

Nitrone spin-traps block calcium channels and induce pulmonary artery relaxation independent of free radicals

Free radicals react with nitrones to form stable nitroxides which can be identified by ESR spectroscopy. Unfortunately, little is known regarding the pharmacological properties of these compounds. In this study, three commonly used nitrones, 5,5-dimethylpyrroline-N-oxide (DMPO), alpha-phenyl-tert-butylnitrone (PBN), and alpha-(4-pyridyl 1-oxide)-N-tert-butylnitrone (POBN), were found to induce relaxation of preconstricted isolated rat pulmonary artery rings. Additional experiments with PBN indicated that vasorelaxation could not be attributed to production of endothelial derived factors, prostaglandins, or free radicals. Patch-clamp techniques revealed reversible calcium channel blockade with PBN at a concentration below that needed to detect free radicals. Calcium channel blockade probably accounts for the vasorelaxation observed in the isolated ring preparations described here, and should be considered when using nitrone spin-traps both in in vivo and clinical studies.     

Effects of high oxygen concentrations on microbial biosensor signals. Hyperoxygenation by means of perfluorodecalin

Amperometric biosensors register oxygen depletion in response to analyte catabolism, and thus are limited by the availability of dissolved oxygen. Microbial sensors containing immobilized cells of Gluconobacter oxydans were hyperoxygenated to 400% of control levels and the effects on sensor responses to glucose were determined. Oxygenated perfluorodecalin (a completely fluorinated organic substance) was as effective in hyperoxygenation as direct sparging with O2, increasing sensor base medium oxygen concentrations from 9.3 to 37 mg/l. Hyperoxygenation enhanced maximal biosensor response amplitudes, particularly at high cell loading densities. Maximal response rates were also improved, although less dramatically. Results suggest that hyperoxygenation may be a new general approach for modulating biosensor responses.     

Radar detection of low-altitude targets in a maritime environment

Results from a unique analytical and experimental effort to assess low-altitude, short-range, radar detection capabilities in an evaporation ducting environment are presented. Within the horizon, the duct may shift the location of the last interference null several kilometers in range, which may cause nondetection at ranges where detection is expected and detection at ranges where detection is not expected. In addition, the evaporation duct may reduce the signal strength at ranges near the last interference peak so that detection of low-altitude, small-size, targets may not be possible until the target is much closer. At ranges near and beyond the horizon, radar signal strength depends both on the surface layer and on the mixed layer. To accurately model propagation in this region, knowledge of both surface layer and upper air meteorology Is required. An empirical model to merge the surface layer with the mixed layer has been developed. Comparisons of measured to calculated detection range indicate that the assumption of a standard atmosphere minimizes the variance of the difference between the detection ranges whereas ranges calculated using the measured surface meteorological conditions and a modified surface layer model minimizes the median of the difference     

Determination of the short-range order structure of Au-25 At. Pct Fe using wide-angle diffuse synchrotron X-Ray scattering

The short-range order (SRO) structure of a Au-25 at. pct Fe single crystal was studied using wide-angle diffuse synchrotron X-radiation scattering at room temperature. Two heat treatments were investigated: a 400 °C aging treatment for 2 days and a 440 °C treatment for 5 days, both preceded by solution treatment in the single-phase field and water-quenched to room temperature. Evolution of the SRO structure with aging was determined by fitting the two sets of Cowley-Warren (C-W) SRO parameters to a pair of 140,608-atom models. The microstructures, although quite disordered, showed a trend with aging for an increasing volume fraction of an Fe-enriched and an Fe-depleted environment. The Fe-enriched environment displayed a preference for Fe segregation to the {110} and {100} face-centered cubic (fcc) matrix planes. A major portion of the Fe-depleted environment was found to contain elements (and variations of these elements) of the Dl_a ordered superstructure. The SRO contained in the Fe-depleted environment may be best described in terms of the standing concentration wave packet (SCWP) model. This study provides, for the first time, a quantitative real-space view of the atomic arrangements, which make up both environments in the SRO structure of Au-25 at. pct Fe. Formerly Graduate Research Assistant, University of Illinois, Urbana, IL.     

Esmolol potentiates reduction of minimum alveolar isoflurane concentration by alfentanil

The beta subunit of human chorionic gonadotropin is potentially encoded by six genes, which can be categorized into two types based on a sequence change at codon 117: GCC for the type I and GAC for the type II genes. We previously showed that, whereas type I genes were exclusively expressed in normal breast tissues, expression of type II genes was associated with malignant transformation (Bellet, D., et al. Cancer Res., 57: 516-523, 1997). We designed a simple and robust test (the CG117 assay) that measures the percentage of type II over both types of chorionic gonadotropin beta mRNAs. Normal breast tissues consistently had a negative CG117 index, whereas cancer breast tissues showed indexes ranging from 0 to 100%. The prognostic significance of the CG117 index was investigated in a series of 99 unilateral invasive primary breast cancer patients with known long-term outcome (median follow-up, 9 years). The CG117 index was positive in 48 (48.5%) of the 99 tumor mRNA samples. The index was not significantly associated with standard prognostic parameters, including clinical and macroscopic tumor size, histopathological grade, and lymph node status or steroid receptor status. Patients with a positive CG117 index in primary tumor mRNA had significantly shorter metastasis-free survival (P = 0.014) and overall survival (P = 0.038) after surgery, compared to patients with a negative index. The prognostic significance of the CG117 index persisted in Cox multivariate regression analysis, both for metastasis-free survival (P = 0.008) and overall survival (P = 0.016), together with lymph node status (P = 0.027 and P = 0.009, respectively). These findings indicate that the CG117 index may contribute to the identification of high-risk breast cancer patients.     

Helicobacter pylori and gastric lymphoma]

BACKGROUND: Continent urinary diversion may be necessary in a range of urological abnormalities. In circumstances where the standard techniques are not possible, alternative innovative techniques may be used. METHODS: In a female patient with bladder exstrophy, a continent diversion was recommended. The appendix was not available, the ureters were not suitable and a continent stoma was fashioned from an isolated segment of colon. RESULTS: The stoma proved to be continent, although it was somewhat stenotic. However, clean intermittent catheterization maintained its patency. CONCLUSIONS: A continent catheterizable stoma may be constructed from a segment of colon. The technique may be considered when other well recognized methods are not feasible.     

Application of composite resin for single-appointment anterior and posterior diastema closure

Due to aesthetic and periodontal factors, patients often seek treatment to close diastemata. This condition may be eliminated by either direct or indirect techniques. Indirect techniques generally require multiple visits to facilitate the placement of laminate, crown, or bridge restorations, and involve significant financial expense. Direct techniques can be economical and successful, although they present unique challenges in the achievement of satisfactory proximal contacts and contours. This article describes three clinical techniques that may be employed to treat anterior and posterior diastemata in a single appointment.