Hyperhomocysteinemia: detection, risk assessment, and treatment

OBJECTIVE: The aim of this study was to evaluate both the importance of the screening strategy and the familial aggregation characteristics of families with hypercholesterolemic children. PATIENTS AND METHODS: Ninety-one families (369 subjects) with one hypercholesterolemic child were studied. In addition to clinical and general biochemical evaluation, lipids including apo A-I and B-100 were examined. LDL was quantified under ultracentrifugation. RESULTS: Among the 91 children studied, 10 (10.99%) suffered heterozygous hypercholesterolemia, while 81 (89.01%) suffered polygenic hypercholesterolemia. Following a diet, polygenic children exhibited normal lipid parameters. In heterozygous children a decrease of 19% for total cholesterol, 19.9% for LDL-cholesterol and 16.3% for apo B were observed. When starting the study, 77.5% of the family members thought that they had normal serum lipid values. At the end of the study it was confirmed that only 28% were really normolipemic, indicating that 49.4% of the individual did not know that they were suffering dyslipemia. The study also showed that fathers exhibited the highest incidence of hypercholesterolemia (80.2%) followed by brothers (65.6%) and mothers (61.5%). Therefore, 69.4% of the individuals studied exhibited dyslipemia. CONCLUSIONS: The screening strategy allows one to diagnose a high percentage (almost 50%) of individuals suffering hypercholesterolemia in families with a child previously diagnosed of this pathology. Moreover, in these families there is a high degree of familiar aggregation of dyslipemia.     

Chances of cure are not compromised with sphincter-saving procedures for cancer of the lower third of the rectum

BACKGROUND: The goal of this study was to compare patterns of recurrence and long-term outcome after sphincter-saving procedures (SSPs) and abdominoperineal resection (APR) in patients with tumors located in the lower third of the rectum. METHODS: We reviewed the charts of 1001 patients operated on for primary rectal adenocarcinoma between 1980 and 1991. All patients with tumors located between 5 and 7 cm from the anal verge and treated with curative intent were included. RESULTS: Of the 261 patients who met our criteria, 162 had undergone SSP and 99 had undergone APR. The local recurrence rates for SSP and APR were 8% and 11%, respectively (p = 0.41), and the distant metastases rates were 23% and 28%, respectively (p = 0.35). Recurrence and distant metastases rates for SSP and APR, respectively, did not differ by TNM classification: state I, 10% versus 9% (p = 0.9); stage II, 25% versus 43% (p = 0.13); and stage III, 56% versus 57% (p = 0.92). Five-year disease-free survival rates for SSP and APR patients were 70.5% and 62.3%, respectively (p = 0.2). CONCLUSIONS: Tumors in the lower third of the rectum can be treated with sphincter-saving procedures without compromising the chance of cure.     

The role of urodynamics in the evaluation of voiding dysfunction in men after cerebrovascular accident

PURPOSE: The etiology of voiding dysfunction was determined in men after a cerebrovascular accident who were at risk for obstructive uropathy to evaluate whether the cause of voiding dysfunction could be predicted by the type (obstructive or irritative) or onset of symptoms. MATERIALS AND METHODS: We evaluated 38 men with complaints of voiding dysfunction following a cerebrovascular accident. All patients were of the age when bladder outlet obstruction secondary to benign prostatic hyperplasia would otherwise be prevalent. After a comprehensive history and physical examination, all patients underwent multichannel urodynamic studies at a medium fill rate (20 to 50 ml. per minute). Findings were classified by the Abrams-Griffiths nomogram as obstruction, no obstruction or equivocal. RESULTS: Mean patient age was 70 years (range 54 to 87). Patients were grouped according to the presenting voiding complaints (purely irritative in 42%, purely obstructive in 34% or mixed in 24%). In 34 patients (89%) the onset of symptoms paralleled the occurrence of the cerebrovascular accident. Detrusor hyperreflexia was noted in 82% of the patients. There was no statistically significant difference in the occurrence of detrusor hyperreflexia among the 3 symptom groups (Fisher's exact test). Pressure-flow analysis clearly showed obstruction in 24 patients (63%), no obstruction in 9 (24%) and equivocal results in 5 (13%) according to the nomogram. There was no statistically significant difference in the incidence of obstruction among the 3 symptom groups (Fisher's exact test). CONCLUSIONS: Presenting symptoms did not predict the urodynamic findings of bladder outlet obstruction or detrusor hyperreflexia. The significant incidence of onset of symptoms after stroke suggests that the cerebrovascular accident induced voiding dysfunction in the face of preexisting bladder outlet obstruction may exacerbate the symptoms of the latter condition or vice versa.     

Advancing controlled release packaging through smart blending

Researchers from Rutgers University and Clemson University have collaborated to develop a concept of using smart blending to generate functional packaging films for the controlled release of active compounds such as antimicrobials, antioxidants and flavour compounds to extend the shelf‐life of food. In this paper, literature results are reviewed to justify the significance of controlled release packaging (CRP) and the research gaps for further development are identified. A major research gap is the lack of packaging materials that can provide the release of active compounds at rates suitable for a wide range of food packaging applications. Smart blending is a promising technology for bridging this research gap. To fully realize the potentials of smart blending, a systematic approach for developing CRP using smart blending is also presented. Copyright © 2005 John Wiley & Sons, Ltd.     

Interpolation with function space representation of membership functions

This paper generalizes a previous Cartesian approach for interpolating fuzzy rules comprised of membership functions with finite number of characteristic points. Instead of representing membership functions as points in Cartesian spaces, they now become elements in the space of square, integrable function. Interpolation is thus conducted between the antecedent and consequent function spaces. The generalized representation allows an extended class of membership functions satisfying two monotonicity conditions to be accommodated in the interpolation process. They include the popular bell-shaped membership functions, which were not possible before with the Cartesian representation. The work also extends the similarity triangle-based interpolation technique from the previous Cartesian representation to the new representation. Ensuing issues on computational complexity and nonunique conclusion are discussed. Other concepts such as spanning set and extensibility functions are also presented under the generalized framework. Examples to illustrate the extended approach and to compare with the Cartesian approach are given.     

Model for drying during fluidized-bed combustion of wet low-rank coals

An unsteady state heat conduction model with a convective boundary condition is proposed for the drying of low-rank, high-porosity coals, such as lignites, during fluidized-bed combustion. The drying front is assumed to be the receding surface of a wet core. The solution technique for this moving boundary problem is based on the heat balance integral approach with immobilization of the moving boundary by a change in space variable. The governing cubic equation describing the drying curve in dimensionless form may be solved easily by the Newton—Raphson method. The model predictions are compared with experimental data for Mississippi lignite with excellent agreement. A correlation for estimation of total drying time is proposed. The temperature profiles obtained may be used for the study of the coupled drying and devolatilization in fluidized-bed combustors. The profiles could also be of importance in the study of formation of fissures/cracks in lignites subjected to intense heating conditions encountered during fluidized-bed combustion.     

The necessity of conducting to the end the activities of vector control in the onchocerciasis control program in west Africa: recall of the stakes and proposal of a minimum budget for the period 1998-2002

After a brief presentation of the Onchocerciasis Control Programme in West Africa (OCP), the authors realize the health and socioeconomic consequences that could follow a cessation of larvicide treatment before 2002 in the south-eastern and western extensions of the Programme. Taking into account that OCP activities are theoretically supported until 1997, but aware of financial constraints that will probably increase from now to 2002, this paper proposes an a minima estimation of the residual vector control activities for a "phasing out" spread out for five years (1998-2002). These estimations essentially concern the larvicide coverage, the insecticides used, the entomological surveillance, the logistical support and their financial aspects. As far as 48 U.S. $ million amount for 5 years are concerned, the budget allocated for vector control activities should not exceed the third of the global amount allocated to OCP for the actual fourth financial phase of the Programme (1992-1997).