Traumatic myocardial infarction caused by lead shot

The authors report the case of a 32 year old woman who was shot with a shotgun. Acute inferior wall infarction was detected fortuitously on electrocardiography and coronary angiography showed occlusion of the right coronary artery with lead shot. The single coronary lesion, absence, of other cardiac complications (haemopericardium, cardiac perforation, ...) and the favourable outcome with conservative medical treatment has not been previously reported to the authors' knowledge.     

A randomized trial of cisplatin, etoposide and bleomycin (PEB) versus carboplatin, etoposide and bleomycin (CEB) for patients with 'good-risk' metastatic non-seminomatous germ cell tumors

BACKGROUND: Cisplatin-based combination chemotherapy will cure 70% to 80% of patients with metastatic non-seminomatous germ cell tumors but is associated with the possibility of severe neuro-, oto- and nephro-toxicities. Carboplatin, a cisplatin analogue, is an active drug in testicular cancer with a more favourable spectrum of side effects. In a randomized trial, the German Testicular Cancer Study Group compared a combination regimen of carboplatin, etoposide and bleomycin (CEB) to standard cisplatin, etoposide and bleomycin (PEB) chemotherapy for patients with 'minimal-' and moderate-disease' non-seminomatous germ cell tumors, according to the Indiana University classification. PATIENTS AND METHODS: PEB was given for three cycles at standard doses (given days 1-5), and the CEB regimen consisted of carboplatin (target AUC of 5 mg/ml x min) on day 1, etoposide 120 mg/m2 on days 1 to 3 and bleomycin 30 mg on days 1, 8 and 15. Four cycles of CEB were given, with the omission of bleomycin in the fourth cycle. Thus, the cumulative doses of etoposide and bleomycin applied in the two treatment arms were comparable. Fifty-four patients were entered on the trial, 29 were treated with PEB and 25 with CEB chemotherapy. Patients were stratified according to disease extent (minimal versus moderate) and the degree of tumor marker elevation. Thirty-two patients (59%) belonged to the group with minimal disease and low markers. RESULTS: No significant difference in response to chemotherapy was seen between the two arms, with CR rates of 81% for the PEB arm and 76% for CEB treatment. However, more patients treated with CEB (32% versus 13%) have relapsed after therapy, and 4 patients (16%) have died of disease progression after CEP in contrast to 1 (3%) after PEB therapy. The first interim analysis of negative events (relapse, vital tumor at secondary resection, death from disease and therapy-associated death) showed a significantly higher rate after CEB than after PEB therapy, and the trial was terminated early. After a median follow-up of 33 months for all patients, the calculation of negative events is still significantly in favour of PEB-treated patient, particularly since three late relapses > 2 years have been observed in the CEB arm (P = 0.03). CONCLUSION: This randomized trial demonstrates that even with the use of adequate doses of etoposide and full-dose bleomycin, carboplatin cannot altogether replace cisplatin in patients with testicular cancer. Treatment with the PEB regimen remains the standard approach in patients with 'good-risk' non-seminomatous germ cell tumors.     

Empowering a society of future users of information technology: a longitudinal study of an application in early education

This paper presents a six-year study of the use of computers in a Greek primary school, based on the premise that, in contrast to current technocentric views regarding the use of information technology in the Greek educational system, computers can be used as tools for self-enhancement. The aim of the school project was to infuse a child-centred pedagogy, through the learning of Logo programming, into the whole of the school's society, i.e. all children and all teachers. Within this context, we have identified and explored how children may learn programming through a process of forming ‘naive’ or locally applicable theorems concerning key programming ideas such as the use of primitives, structuring a problem by means of writing procedures, and constructing and working with generalised notional objects by means of defining procedures with variable inputs. We discuss the emerging interrelated educational and technological aspects concerning this kind of learning, and then set these against the challenge to exploit the developing technology further in order to design expressive media of increasing flexibility and power, and to focus on specific learning domains.     

Fractional composition of partly hydrolysed polyvinyl acetate and its compatibility with hydroxypropyl methylcellulose in aqueous solutions

Fractionation of partly hydrolysed polyvinyl acetate (PVA) was performed by warming of its aqueous solutions. The following properties of the obtained fractions were determined: viscosity, molecular weight and molecular weight distribution, surface tension, and absorbance in the IR range. The blockiness of the polymer molecules, characterized by their behaviour towards iodine-containing systems such as I₂,-H₃BO₃ and I₂,-KI, was estimated. Fractionation of the aqueous solutions of PVA by warming is based mainly on the different internal molecular structure of the separated products, i.e. on the length of the vinyl acetate blocks in the PVA molecules and, to a lesser extent, on the degree of hydrolysis and the degree of polymerization. The more blocklike are the PVA molecules, the less compatible are the polymers in the PVA-hydroxypropyl methylcellulose (HPMC)-water system. At phase separation in this sytem the PVA molecules which are not compatible with HPMC are, in the first place, those of the highest blockiness.     

A unified formulation for Chebyshev and Legendre superdirective endfire array design

Contents A unified formulation for superdirective end-fire arrays by using Chebyshev and Legendre Polynomials and their maximum directivities as well as the corresponding efficiency index and theQ factor are found. Several examples show the simplicity of the formulation.

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Eine einheitliche Formulierung zum Design von Supergain-Längsstrahlern mit Tschebyscheff- und Legendre-Polynomen

Übersicht Es wird eine einheitliche Formulierung für Supergain-Längsstrahler mit Tschebyscheff- und Legendre-Polynomen vorgestellt. Die Strahlergruppen werden für unterschiedliche Kombinationen dieser Polynome angegeben, ebenso ihre optimalen Richtgewinne wie auch der dazugehörige Strahlungs- Wirkungsgrad in der Hauptrichtung und der GütefaktorQ. Einige Beispiele belegen die Einfachheit der Formulierung.

     

Localization of G-proteins in macrophages and E. coli during phagocytosis

Heterotrimeric GTP-binding proteins (G-proteins) have been shown to play an important role in cellular signalling. However, G-protein involvement in the intracellular spreading of bacterial pathogens is still poorly understood. In this study, antibodies, that recognize G-protein alpha-subunits (anti-G alpha), were used to investigate the localization of G-proteins in the macrophage-like cell line P388D1 and E. coli, also in their L-forms, during phagocytosis. In E. coli, anti-G alpha-binding sites were detected preferably in the cell wall and septa of the whole bacterial forms as well as in the cytoplasm of L-forms. Western blotting of bacterial lysates demonstrated protein bands with positive immunoreaction to antibodies against Gs alpha, Gi alpha, and Gcommon alpha with a higher affinity to the antibody against Gs alpha. Immunoreaction with the anti-Gs alpha-antibody was markedly higher in pathogenic strains of E. coli. Because of the conserved structure in all GTP-binding proteins which seem to derive from a single primordial protein involved in signal transduction mechanisms, it is reasonable to assume that some anti-Ga-positive proteins in E. coli might be related to G-proteins of higher organisms. A putative candidate for bacterial G-proteins seems to be a 36 kDa protein. Enhancement in G-protein immunostaining in the cytoplasm of macrophages around the internalized bacteria testifies to the involvement of G-proteins in mediation of endocytosis responses of phagocytes.     

Noninvasive real-time multipoint temperature control for ultrasoundphased array treatments

A method for noninvasively estimating spatiotemporal temperature changes in samples using diagnostic ultrasound, and using these as inputs to a multipoint ultrasound phased array temperature controller, is presented in this paper. This method is based on a linear relationship between the apparent tissue echo pattern displacements and temperature, as seen along A-lines acquired with diagnostic ultrasound when the sample is heated by external heating fields. The proportionality constant between echo displacement and temperature is determined by the local change in speed of sound due to temperature and the linear coefficient of thermal expansion of the material. Accurate estimation of the displacements and proportionality constant yields accurate calibrated high-resolution (1 mm spatial, sub-°C) noninvasive sample temperature estimates. These are used as inputs to a multipoint temperature controller, capable of controlling ultrasound phased array treatments in real-time. Phantom and in vitro results show that the noninvasively estimated temperature values can effectively be used to control ultrasound hyperthermia treatments, almost replacing invasive thermocouple measurements. The mathematical background and assumptions of the noninvasive temperature estimator and the controller are presented in this paper, together with experimental results showing estimator and controller performance and limitations. To the best of our knowledge, this paper presents the first demonstration of real-time treatment control based entirely on noninvasive temperature estimates