Medical challenges of internal conflicts

The most prevalent menace since the end of the cold war is the occurrence of civil wars and local and regional conflicts. The term "low intensity conflict" describes the new threat environment and covers a multitude of phenomena, such as civil wars, guerrilla warfare, terrorism and counterinsurgency operations occurring between routine, peaceful inter- or intrastate competition, and a sustained conventional conflict. There is a great challenge to alert the physicians in general, and the surgical community of the world in particular, to the new threat environment and the medical challenges involved in treating casualties of low intensity conflicts. Specifically, a new international body of surgeons might be required to coordinate the recruitment, training, and creditation for surgeons with special expertise in the management of victims of such conflicts and to facilitate research and general knowledge of the medical challenges of modern conflicts.     

The resting and activation issue of hypofrontality: a single photon emission computed tomography study in neuroleptic-naive and neuroleptic-free schizophrenic female patients

BACKGROUND: Functional neuroimaging findings of "hypofrontality" in schizophrenic patients is still controversial, due to the heterogeneity of methods and patient samples. This study tries to prevent some of these concerns by studying neuroleptic-naive (NN) and neuroleptic-free (NF) young female patients both in resting conditions and during a frontal cognitive activation task. METHODS: Regional cerebral blood flow (rCBF) was studied at rest and during the Wisconsin Card Sorting Test (WCST) in 25 young acute unmedicated schizophrenic female patients (14 NN and 11 NF) and 15 female controls, using single photon emission computed tomography. RESULTS: The schizophrenic and control groups did not differ in rCBF during the baseline condition, but the schizophrenic group failed to activate the frontal lobe during the WCST condition. In addition, the left anterior temporal rCBF at rest correlated with the Scale for the Assessment of Positive Symptoms total score. CONCLUSIONS: The results suggest that hypofrontality in young acute unmedicated schizophrenic patients is a result of an inability to activate frontal regions during cognition, rather than a baseline decrease in frontal activity. Furthermore, positive symptoms seem to be associated with left temporal cortex activity.     

Combining make to order and make to stock

In inventory control and production planning one is tempted to use one of two strategies: produce all demand to stock or produce all demand to order. The disadvantages are well-known. In the make everything to order case (MTO) the response times may become quite long if the load is high, in the make everything to stock case (MTS) one gets an enormous inventory if the number of different products is large.In this paper we study two simple models which combine MTO and MTS, and investigate the effect of combining MTO and MTS on the production lead times.     

Design rules for an integratable low-power amplifier/filter combination

In this paper design rules for a circuit topology in which there is an inseparable combination of an amplifier and a filter characteristic, are presented. By intentionally using the capacitance of an already present input sensor for the filtering, the total required integrated capacitance is much less than that in circuits, which have a separately designed amplifier and filter function. Consequently, it is possible to have the advantage of a better integratability. Moreover, less complexity in the design is achieved. The presented circuit shows a current-to-voltage conversion and an inherently controllable second-order low-pass filter characteristic. A discrete realization has been designed to test the circuit. This circuit operates down to a 1 V supply voltage and the transfer shows a 1.8 M currentto-voltage conversion with a bandwidth of 6 kHz. Measurement results of this circuit show that a 63 dB dynamic range can be achieved with a total required integrated capacitance of only 31 pF.     

Deviant auditory stimuli activate human left and right auditory cortex differently

Infrequent "deviant' auditory stimuli embedded in a homogeneous sequence of "standard' sounds evoke a neuromagnetic mismatch field (MMF), which is assumed to reflect automatic change detection in the brain. We investigated whether MMFs would reveal hemispheric differences in cortical auditory processing. Seven healthy adults were studied with a whole-scalp neuromagnetometer. The sound sequence, delivered to one ear at time, contained three infrequent deviants (differing from standards in duration, frequency, or interstimulus interval) intermixed with standard tones. MMFs peaked 9-34 msec earlier in the right than in the left hemisphere, irrespective of the stimulated ear. Whereas deviants activated only one MMF source in the left hemisphere, two temporally overlapping but spatially separate sources, one in the temporal lobe and another in the inferior parietal cortex, were necessary to explain the right-hemisphere MMFs. We suggest that the bilateral MMF components originating in the supratemporal cortex are feature specific whereas the right-hemisphere parietal component reflects more global auditory change detection. The results imply hemispheric differences in sound processing and suggest stronger involvement of the right than the left hemisphere in change detection.     

The axisymmetric crack problem in a non-homogeneous interfacial region between homogeneous half-spaces

In this paper, the axisymmetric crack problem in a non-homogeneous interfacial region between two homogeneous half-spaces is considered. It is assumed that the shear modulus varies continuously between that of the two half-spaces; and the shear modulus for the interface region is approximated by = ₀ e^mz. By using Hankel transform technique the problem is reduced to a pair of singular integral equations. The solutions of the problem are obtained for different material combinations and loading conditions; and modes I and II stress intensity factors, and the direction of a probable crack growth are calculated.     

Percutaneous effects of iodine inhibit the development of experimental silicosis

Experiments on white rats proved that the silicotic pulmonary changes slowed with the tails periodically immersed into iodine solution. Those pulmonary changes were due to inhalation of quartzite dust and especially due to intratracheal administration of standardized quartz dust DQ12. Influenced by inhalation of dust containing quartz, the rats demonstrated characteristic alterations in cytologic features of bronchial and alveolar lavage water. The "iodine baths" also declined those alterations, that may prove higher resistance of pulmonary macrophages to cytotoxic effects of quartz. This hypothesis finds a support in experiments with culture of rat peritoneal macrophages. If incubated in a medium with low iodine concentrations and subsequently washed off, the macrophages demonstrate lower incidence of cytotoxic effects due to the next incubation with particles of DQ12. The macrophage's higher resistance against cytotoxic agents is believed to result directly in antisilicotic effect of iodine, so "iodine baths" could be recommended for pathogenetic therapy and medical prophylaxis of silicosis.     

Endoscopic sclerotherapy is useful in Dieulafoy''s disease

1.5% Capsaicin (Cap) or Vehicle was respectively used to treat the right or left sciatic nerve in 20 Sprague-Dawley rats. On the seventh day, the 20 rats were at random divided into electroacupuncture (EA) group and non-EA group, the spinal cord corresponding to the afferent segments of sciatic nerve was taken out for observing the changes of acetylcholinesterase (AChE) activity and [3H]-quinuelidinylbenzylate (QNB) binding sites in the spinal dorsal horn (SDH). The results were as follows: (1) EA "Huantiao" could enhance AChE activity in the SDH and decrease [3H]-QNB binding sites; (2) Cap treating sciatice nerve could weaken AChE activity in the SDH and merease [3H]-QNB binding sites; (3) Cap treatment could inhibit or partially inhibit the actions of EA as above. The results indicated that ACh participated in the primary afferent of acupuncture information and might exist in Cap-sensitive neurons.     

Meal patterns in obese and normal weight men: the ''Gustaf'' study

OBJECTIVE: To compare the reported meal patterns between obese and normal weight men. DESIGN: A dietary survey, by means of 12 repeated telephone-administered 24-hour dietary recalls, was conducted in obese and normal weight men. The study period was three months with all seven days of the week included. The contribution of intake types to the reported daily energy intake (EI) was studied as well as the circadian distribution of EI and the reported number of intakes. SUBJECTS: 86 obese men (BMI 37.7 +/- 4.4 kg/m2, mean +/- SD) from the waiting list of the outpatient clinic completed the study altogether with 61 normal weight men (BMI 23.0 +/- 1.9 kg/m2), randomly selected from the Stockholm County Census Bureau. All men were 20-60 years old. RESULTS: Results were analyzed for Group A = all men who completed the study and for Group B = the men who exceeded the CUT-OFF 1 limit for energy intake (reasonably true report as defined by Goldberg). The obvious under-reporters amounted to 73% of the obese and to 28% of the normal weight men. The meal patterns were similar for the obese and the normal weight men. The greatest contributors to EI in both groups were cooked meals, sandwich meals, snacks and breakfast-like meals. The circadian eating pattern was mainly the same in both obese and normal weight men. The reported number of intakes was 5.3 (median) per day in all obese men vs 5.6 in all the controls (P = 0.02), and in Group B 5.3 s 5.9 (P = 0.16) intakes. No specific "obese eating style' could be detected in this study.     

Chemotherapy with the "8 in 1" protocol for malignant brain tumors in children: a population-based study in Finland

We evaluated the outcome of 68 children with malignant brain tumors treated with the "8 in 1" chemotherapy protocol in Finland from 1986 to 1993, comparing 5-year survival rates with those for a historical control group (from 1975 to 1985). For all malignant brain tumors, overall survival was 43% (vs 28% in the control group; P <0.05), and progression-free survival (PFS) was 43% (vs 23%; P <0.05). For medulloblastoma and primitive neuroectodermal tumor, survival was 63% (vs 35%; P <0.05), and the corresponding PFS was 59% (vs 35%; P = 0.15). For high-grade glioma, both the survival rate and the PFS were 27% (vs 17%; P = NS). Thus the outcome was significantly better for our "8 in 1" -treated patients than for the historical controls, especially among the children with primitive neuroectodermal tumor and medulloblastoma. In contrast, those with high-grade gliomas and brain stem tumors seem to have received little benefit; different, more effective treatments are needed for these patients.