Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Regional industrial recycling network in energy supply,the case of Joensuu city, Finland

Jouni Korhonen
Industrial recycling networks offer an example of the practical application of some of the industrial ecology (IE) principles. In the industrial ecosystem and eco-industrial park approaches the material cycles and energy cascades in a natural ecosystem serve as the metaphoric vision for a local/regional industrial system in which waste material and waste (residual) energy are utilized through cooperation between the actors in the system. In this paper, a local/regional recycling network scenario is presented with the energy supply system of the city of Joensuu in Finland. The conditions of success include the co-production of heat and electricity (heat and power, CHP), waste energy utilization for industrial steam and renewable flow use as fuel. Some difficulties in the industrial ecosystem-type development of the system are discussed. Methodological suggestions for industrial ecosystem and eco-industrial park case studies are considered and the experience from this Finnish case is discussed in terms of wider application of IE in local/regional economic energy systems. For future research on the theme, it is suggested that regional industrial ecology may benefit from regional economics theory and, vice versa, regional economics theory may find a new area of application in regional industrial ecology. Copyright © 2002 John Wiley & Sons, Ltd. and ERP Environment. [source]

I PREVENT Bacterial Resistance.

An Update on the Use of Antibiotics in Dermatologic Surgery
BACKGROUND AND OBJECTIVES Prophylaxis may be given to prevent a surgical wound infection, infective endocarditis (IE), or infection of a prosthetic joint, but its use before cutaneous surgery is controversial. Our aim was to review the current literature and provide a mnemonic to assist providers in appropriately prescribing prophylactic antibiotics. METHODS AND MATERIALS We reviewed the current literature, including the new guidelines provided by the American Heart Association (AHA). RESULTS The new AHA guidelines recommend prophylaxis for patients with high risk of an adverse outcome from IE instead of high risk of developing IE. The American Academy of Orthopedic Surgeons and the American Dental Association also provide guidelines. Given the paucity of conclusive studies, prophylaxis against a surgical wound infection is based more on clinical judgment. CONCLUSION The mnemonic we propose, "I PREVENT," represents: Immunosuppressed patients; patients with a Prosthetic valve; some patients with a joint Replacement; a history of infective Endocarditis; a Valvulopathy in cardiac transplant recipients; Endocrine disorders such as uncontrolled diabetes mellitus; Neonatal disorders including unrepaired cyanotic heart disorders (CHDs), repaired CHD with prosthetic material, or repaired CHD with residual defects; and the Tetrad of antibiotics: amoxicillin, cephalexin, clindamycin, and ciprofloxacin. [source]

Staphylococcus aureus Infective Endocarditis Mimicking a Hydatid Cyst

Jeroen Walpot M.D.
We report an atypical echocardiographic presentation of Staphylococcus aureus infective endocarditis (IE) of the mitral valve in an octogenarian female. Echocardiography revealed perforation of the anterior mitral valve leaflet (AMVL), with a large cystic mass seemingly attached to the AMVL and surrounded by a thin membranous structure. These images were strongly reminiscent of a hydatid cyst. The significant comorbidity of the patient did not justify an urgent surgical approach, and the patient subsequently expired of cardiogenic and septic shock. Autopsy revealed a large vegetation attached to the interatrial septum in the immediate proximity of the AMVL, without signs of the membranous structure and without pathological evidence for septic embolism. This atypical presentation of IE prompted us to discuss a brief review of intracardiac cystic masses. (Echocardiography 2010;27:E80-E82) [source]

Surgery for Ruptured Sinus of Valsalva Aneurysm into Right Ventricular Outflow Tract: Role of Intraoperative 2D and Real Time 3D Transesophageal Echocardiography

Shrinivas Gadhinglajkar M.D.
A major limitation of the 2D echocardiography during surgery for a complex cardiac lesion is its inability to provide an accurate spatial orientation of the structure. The real time 3D transesophageal echocardiography (RT-3D-TEE) technology available in Philips IE 33 ultrasound machine is relatively new to an operation suite. We evaluated its intraoperative utility in a patient, who was operated for repair of a ruptured sinus of Valsalva aneurysm (RSOVA) and closure of a supracristal ventricular septal defect. The VSD and RSOVA were visualized through different virtual windows in a more promising way on intraoperative RT-3D-TEE than on the 2D echocardiography. The acquired images could be virtually cropped and displayed in anatomical views to the operating surgeon for a clear orientation to the anatomy of the lesion. RT-3D-TEE is a potential intraoperative monitoring tool in surgeries for complex cardiac lesions. (Echocardiography 2010;27:E65-E69) [source]

Extremely Rapid Formation of Mitral Valve Ring Abscess in Infective Endocarditis

Balaram Shrestha M.D., Ph.D.
A patient with infective endocarditis (IE) due to methicillin-resistant staphylococcus aureus (MRSA) was found to have conversion of the hypoechoic region of the posterior mitral valve ring apparatus into a clearly delineated echolucent space by repeating transthoracic echocardiography at an interval of 1 week. Color Doppler showed features of blood entry into this space. Abscess formation in IE due to MRSA may be quick and repeated echocardiography may help detect the complications of IE. Semiurgent mitral valve plasty was performed for the associated prolapse of the posterior mitral leaflet using a hand-made, rolled, twisted autologous pericardial ring. [source]

Active Vegetations Can Be Differentiated from Chronic Vegetations by Visual Inspection of Standardized Two-Dimensional Echocardiograms

The ability to differentiate active from chronic valvular vegetations (VEGs) by digital image processing and by visual observation was evaluated in 18 patients with a clinical diagnosis of infective endocarditis (IE). Two-dimensional echocardiographic (2-DE) examinations were performed on all patients at diagnosis and after a mean period of 52 days. Two comparable images (active and chronic) from the same patient and in the same phase of the cardiac cycle were digitized, magnified, and displayed on a high resolution monitor. The mean pixel intensity (MPI) was 72 ± 14 in the active stage and 143 ± 23 in the chronic stage (P < 0.0001). The VEG size was 0.64 ± 0.15 cm2 in the active stage and decreased to 0.46 ± 0.17 cm2 in the chronic stage (P < 0.001). Two experienced echocar-diographers, who were blinded to the age of the VEGs, identified each echocardiographic image as active or chronic based on visual observation of density of the VEGs. The VEGs were correctly identified as active or chronic in 17 out of the 18 patients. In summary, although digital image processing of 2-DE may be useful, the density of VEGs assessed by visual inspection will help differentiate between active and chronic VEGs of IE. The standardization procedure at the time of the initial study and use of identical gain settings in subsequent studies are key factors in making this distinction. [source]

Effect of isometric exercise and body scanning on cigarette cravings and withdrawal symptoms

ADDICTION, Issue 7 2009
Michael Ussher
ABSTRACT Aims To examine the acute effects of a guided relaxation routine (body scan) and isometric exercise on desire to smoke and tobacco withdrawal symptoms. Design Experimental comparison of three conditions. Participants Forty-eight individuals reporting smoking ,10 cigarettes daily. Intervention Random assignment to one of three interventions delivered via a 10-minute audio: isometric exercise (IE, n = 14), body scanning (BS, n = 18) or a reading about natural history (control group, n = 16). Interventions were delivered twice on the same day: in the laboratory, then in their ,normal' environment. Measurements Desire to smoke (primary outcome) and withdrawal symptoms were rated at pre-intervention and up to 30 minutes post-intervention. Findings Controlling for baseline scores, post-intervention desire to smoke and withdrawal symptoms were significantly lower for IE and BS groups, compared with the controls, in both environments. There were no significant differences for IE versus BS. For desire to smoke, controlling for baseline values, ratings in the laboratory were significantly lower for IE and BS versus the control up to 30 minutes post-intervention. In the normal environment, these ratings were significantly lower only up to 5 minutes post-intervention. Conclusions Brief IE and BS interventions are effective for reducing desire to smoke and withdrawal symptoms in temporarily abstaining smokers. These interventions were found to be more effective in the laboratory than in the smoker's normal environment, but this may be an artefact of there not being a sufficient ,wash-out' period between interventions. These techniques may be beneficial for managing desire to smoke and tobacco withdrawal. [source]

Numerical modelling of regional faults in land subsidence prediction above gas/oil reservoirs

Massimiliano Ferronato
Abstract The stress variation induced by gas/oil production may activate pre-existing regional faults. This may enhance the expected land subsidence due to the generation of mechanically weak points close to the producing field. A class of elasto-plastic interface elements (IE), specifically designed to address the mechanical behaviour of faults over a regional scale, is integrated into a finite element (FE) geomechanical model and used to investigate the role exerted by active faults in anthropogenic land subsidence. The importance of regional faults depends on a variety of factors including depth of the depleted reservoir, fault number, orientation and size, geomechanical properties of porous medium, pore pressure drawdown induced by fluid production, etc. With the aid of some representative examples, a useful indication is provided as to where and how fault activation may influence both magnitude and extent of the land subsidence bowl above producing gas/oil reservoirs, pointing to a generally limited impact on the ground surface. The simulation of a real faulted gas reservoir in a complex 3-D setting shows that the proposed IE can be simply and efficiently incorporated into a FE geomechanical model, thus improving the quality of the stress and displacement prediction. Copyright © 2007 John Wiley & Sons, Ltd. [source]

,Lues maligna" bei insulinpflichtigem Diabetes mellitus

"Lues maligna" in a female patient with diabetes
Zusammenfassung Bei einer 40-jährige Patientin mit insulinpflichtigem Diabetes mellitus traten innerhalb weniger Wochen vor allem am Stamm multiple bis 2,5,cm große, lividrote Knoten und Plaques auf, die rasch ulzerierten. Einige Monate zuvor habe beim Partner ein kleines Ulkus am Penis bestanden. Die HIV-negative Patientin hatte eine hochtitrig positive Syphilisserologie (TPPA-Titer >,1 : 20.480, VDRL-Titer 1 : 128). Die nüchtern Blutglukosewerte lagen über 275,mg/dl. Nach Ausschluss einer Neurolues stellten wir die Diagnose einer ,Lues maligna" bei schlecht eingestelltem Diabetes mellitus. Unter einer Therapie mit 3,Injektionen Benzylpenicillin-Benzathin (2,4,Mio.,IE) i. m. in wöchentlichen Abständen und Einstellung des Diabetes heilten die Hautveränderungen komplett ab. Im Verlauf war der VDRL-Titer negativ. Die ,Lues maligna" tritt seit einigen Jahren wieder gehäuft auf und wird vor allem bei HIV-positiven Männern beobachtet. Das Auftreten dieser Erkrankung bei durch Diabetes mellitus bedingter Immunsuppression ist ausgesprochen selten. Summary A 40-year-old female patient with diabetes mellitus presented with multiple erythematous ulcerated nodules and plaques predominantly on the trunk. A few months ago her partner had a small ulcer on the penis. She was HIV negative but showed markedly elevated syphilis serology titers (TPPA titer >,1 : 20.480, VDRL titer 1 : 128). The serum glucose levels exceeded 275,mg/dl. After exclusion of neurological involvement, we made the diagnosis of ,lues maligna" arising in the setting of diabetes mellitus. The patient was treated with 2.4 million units benzathine penicillin intramuscularly weekly for three weeks. Simultaneously, diabetes therapy was improved with insulin injections. The syphilitic lesions cleared rapidly. In the follow-up VDRL titer was negative. ,Lues maligna" is an unusual ulcerative variant of secondary syphilis which has been observed more frequently in HIV-infected patients in the last years. The occurrence of this aggressive variant in the clinical setting of diabetes mellitus is extremely rare. [source]

Application of a Depth Sensing Indentation Hardness Test to Evaluate the Mechanical Properties of Food Materials

N. ÖZkan
ABSTRACT: A depth sensing indentation hardness test with an associated analysis is described as a convenient and simple technique for characterizing mechanical properties of food materials, such as hardness (H), elastic modulus (E), and an elasticity index (IE), which represents the ratio of elastic to total deformation. Storage modulus (G,) and loss tangent (tan§) of the selected model food material, a whey protein concentrate (WPC) gel, have also been determined using an oscillatory dynamic testing. Fractal dimension (D) and strain rate (or frequency) exponent (n) of the WPC gels were determined using both the indentation and dynamic test results. A good correlation between the results from the indentation and the dynamic tests was established. The effects of protein concentration, deformation rate, and chemical treatment on the mechanical properties of the WPC gels were clearly illustrated using the indentation test. [source]

Dissociative photoionization of isoprene: experiments and calculations

Xianyun Liu
Abstract Vacuum ultraviolet (VUV) dissociative photoionization of isoprene in the energy region 8.5,18 eV was investigated with photoionization mass spectroscopy (PIMS) using synchrotron radiation (SR). The ionization energy (IE) of isoprene as well as the appearance energies (AEs) of its fragment ions C5H7+, C5H5+, C4H5+, C3H6+, C3H5+, C3H4+, C3H3+ and C2H3+ were determined with photoionization efficiency (PIE) curves. The dissociation energies of some possible dissociation channels to produce those fragment ions were also determined experimentally. The total energies of C5H8 and its main fragments were calculated using the Gaussian 03 program and the Gaussian-2 method. The IE of C5H8, the AEs for its fragment ions, and the dissociation energies to produce them were predicted using the high-accuracy energy model. According to our results, the experimental dissociation energies were in reasonable agreement with the calculated values of the proposed photodissociation channels of C5H8. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Multivariate modeling of encapsulation and release of an ionizable drug from polymer microspheres

Hagar I. Labouta
Abstract In the formulation of polymer microspheres (MSs) loaded with verapamil hydrochloride (VRP), a low molecular weight ionizable drug, by W/O/W emulsification, the pH of the external aqueous phase proved to be a primary determinant of both IE and drug release behavior. Increasing the pH of the external aqueous phase enhanced IE (,100% at pH 8.4). This was associated with a considerable increase in initial release rate at pH 1.2. Two multivariate methods, factorial analysis (FA) and artificial neural network (ANN), were used to investigate the impact of the combined effect of the external phase pH and other parameters (polymer concentration and initial drug load) on MS characteristics; IE, initial drug release, MS size and yield. FA indicated that the external aqueous phase pH affected all responses, with a particularly strong correlation with IE in addition to a combined synergistic effect with polymer concentration on MS size. ANN showed better internal and external predictive ability of responses compared to FA. The ANN model developed in the study can be successfully used for multivariate modeling of the encapsulation and release of VRP and similar drug salts from hydrophobic polymer MSs prepared by multiple emulsification in addition to other MS characteristics. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 98:4603,4615, 2009 [source]

Epilepsy in Border Collies: Clinical Manifestation, Outcome, and Mode of Inheritance

V. Hülsmeyer
Background: There is a lack of data on idiopathic epilepsy (IE) in Border Collies (BCs) in the veterinary literature. Hypothesis: Genetic epilepsy occurs in BCs and is frequently characterized by a severe clinical course and poor response to medical treatment. Animals: Forty-nine BCs diagnosed with IE. Methods: Medical records, seizure data, treatment data, and pedigree information of affected dogs were collected. Cases were classified phenotypically as affected or not affected; mild, moderate, or severe clinical course; active epilepsy (AE) or remission; and drug resistant or not drug resistant. Results: Clinical manifestations were classified as having a moderate (33%) or severe clinical course (49%), characterized by a high prevalence of cluster seizures and status epilepticus. Survival time was significantly decreased in dogs <2 years of age at seizure onset, and in dogs with a severe clinical course. Drug resistance was apparent in 71% of 24 dogs treated with ,2 antiepileptic drugs. The epilepsy remission rate was 18%. Median age at onset was significantly higher and initial seizure frequency was significantly lower in dogs with remission compared with dogs with AE. Pedigree analyses indicated a strong genetic founder effect in the appearance of epilepsy, resembling autosomal recessive inheritance. Conclusion and Clinical Importance: The present study confirms the occurrence of genetically mediated epilepsy with a frequent severe clinical course and drug resistance in BCs. The results provide information about the long-term prognosis of IE in BCs for veterinarians and concerned owners, and may benefit breeders as well. [source]

Inhibition of 304 stainless steel corrosion in acidic solution by Ferula gumosa (galbanum) extract

M. Behpour
Abstract The inhibition effect of the extract of galbanum (Ferula gummosa Boiss.) on the corrosion of 304 stainless steel in 2 M HCl solution was studied by weight loss measurements, Tafel polarization, and electrochemical impedance spectroscopy (EIS) methods. It was found that the inhibition efficiency (IE) increases as the extract concentration is increased. Tafel polarization method revealed the mixed mode inhibition of galbanum extract (GE) with predominant control of anodic reaction. The effect of temperature on the corrosion behavior of steel indicates that inhibition efficiency of the natural substance increases with the rise in temperature. At all temperatures, the adsorption of the extract components onto the steel surface was found to follow the Temkin adsorption isotherm. [source]

Horizontal transfer of the insect growth regulator pyriproxyfen to larval microcosms by gravid Aedes albopictus and Ochlerotatus triseriatus mosquitoes in the laboratory

B. Dell Chism
Abstract., The insect growth regulator (IGR) pyriproxyfen is highly active against mosquitoes (Diptera: Culicidae). Through continuous emersion of large larvae (instars 3,4) the concentration causing 50% inhibition of adult emergence (EI50) was determined as 0.200 p.p.b. for Aedes albopictus (Skuse) and 3.5 to 7 times less for Ochlerotatus triseriatus (Say): IE50 0.0288 p.p.b. As a possible method of application to larval microscosms of these species that oviposit in water containers and phytotelmata, the horizontal transfer of pyriproxyfen to larval microcosms by adult mosquitoes was evaluated under laboratory conditions. Gravid females were forced to walk on surfaces treated with pyriproxyfen (tarsal contact exposure) and then allowed to oviposit in larval microcosms. Using replicate bioassay cages, each with an oviposition container, and a factorial experimental design, we assessed Ae. albopictus for the effects of (i) pyriproxyfen concentration (0.2, 0.3 and 0.4 mg/cm2) contacted by gravid females, and (ii) the number of treated gravid females added to bioassay cages (one, three or five females/cage), on the mortality of larvae in oviposition containers. Only 0.2 mg/cm2 treatment rate was tested on Oc. triseriatus. A significant (P < 0.05) curvilinear response in inhibition of emergence (IE) was achieved on both species. Densities of one or three treated Oc. triseriatus females/cage yielded IE rates of only 21,27%, whereas five treated females/cage resulted in 70% inhibition. With Ae. albopictus, densities of three or five treated females/cage yielded 48,67% and 59,73% IE, respectively, whereas one treated female/cage gave only 4,30% inhibition. Use of IGR-treated oviposition containers to achieve horizontal transfer of pyriproxyfen to mosquito oviposition sites could be a field management technique based on mosquito biology and behaviour. In binary choice tests with Ae. albopictus, horizontal transfer of pyriproxyfen from a container with a treated ovistrip (0.3 or 0.4 mg/cm2) to an untreated microcosm resulted in 14,38% inhibition. In larval bioassays, pyriproxyfen activity declined markedly within 10 days. Forcibly exposing gravid female mosquitoes to pyriproxyfen-treated paper surface did not affect their fecundity. However, from the 1st to 2nd gonotrophic cycles the egg hatch rate declined by 30% (P < 0.05). Some variation of results could be due to interactions between females at the oviposition site, possibly causing disproportionate transfer of pyriproxyfen to larval microcosms. Comparative studies of the oviposition behaviour of each mosquito are warranted and would potentially provide information needed to improve the technique. [source]

Spectrally accelerated biconjugate gradient stabilized method for scattering from and propagation over electrically large inhomogeneous geometries

Baris Babaoglu
Abstract Scattering from and propagation over rough-terrain profiles, as well as reentrant surfaces are investigated using an integral equation (IE)-based spectrally accelerated biconjugate gradient stabilized (SA-BiCGSTAB) method, with a storage requirement and a computational cost of O(N) per iteration, where N is the surface unknowns in the discretized IE. Numerical results in the form of current and path loss are presented and compared with previously published as well as measured results in order to assess the accuracy and efficiency of this method. © 2005 Wiley Periodicals, Inc. Microwave Opt Technol Lett 46: 158,162, 2005; Published online in Wiley InterScience ( DOI 10.1002/mop.20930 [source]

Fibronectin-binding proteins of Staphylococcus aureus mediate activation of human platelets via fibrinogen and fibronectin bridges to integrin GPIIb/IIIa and IgG binding to the Fc,RIIa receptor

J. Ross Fitzgerald
Summary Staphylococcus aureus is a leading cause of infective endocarditis (IE). Platelet activation promoted by S. aureus resulting in aggregation and thrombus formation is an important step in the pathogenesis of IE. Here, we report that the fibrinogen/fibronectin-binding proteins FnBPA and FnBPB are major platelet-activating factors on the surface of S. aureus from the exponential phase of growth. Truncated derivatives of FnBPA, presenting either the fibrinogen-binding A domain or the fibronectin-binding BCD region, each promoted platelet activation when expressed on the surface of S. aureus or Lactococcus lactis, indicating two distinct mechanisms of activation. FnBPA-promoted platelet activation is mediated by fibrinogen and fibronectin bridges between the A domain and the BCD domains, respectively, to the low affinity form of the integrin GPIIb/IIIa on resting platelets. Antibodies recognizing the FnBPA A domain or the complex between the FnBPA BCD domains and fibronectin were essential for activation promoted by bacteria expressing the A domain or the BCD domain respectively. Activation was inhibited by a monoclonal antibody (IV-3) specific for the Fc,RIIa IgG receptor on platelets. We propose that the activation of quiescent platelets by bacteria expressing FnBPs involves the formation of a bridge between the bacterial cell and the platelet surface by (i) fibronectin and fibrinogen interacting with the low affinity form of GPIIb/IIIa and (ii) by antibodies specific to FnBPs that engage the platelet Fc receptor Fc,RIIa. Platelet activation by S. aureus clinical IE isolates from both the exponential and stationary phases of growth was completely inhibited by monoclonal antibody IV-3 suggesting that the IgG,Fc,RIIa interaction is of fundamental importance for platelet activation mediated by this organism. This suggests new avenues for development of therapeutics against vascular infections. [source]

The Nurse Project: an analysis for nurses to take back our work

Janet M Rankin
This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can ,talk back' and ,act back' to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work. [source]

Joint control for flexible-joint robot with input-estimation approach and LQG method

Chien-Yu Ji
Abstract In this work, the input-estimation (IE) algorithm and the linear quadratic Gaussian (LQG) controller are adopted to design a control system. The combined method can maintain higher control performance even when the system variation is unknown and under the influence of disturbance input. The IE algorithm is an on-line inverse estimation method involving the Kalman filter (KF) and the least-square method, which can estimate the system input without additional torque sensor, while the LQG control theory has the characteristic of low sensitivity of disturbance. The design and analysis processes of the controller will also be discussed in this paper. The joint control of the flexible-joint robot system is utilized to test and verify the effectiveness of the control performance. According to the simulation results, the IE algorithm is an effective observer for estimating the disturbance torque input, and the LQG controller can effectively cope with the situation that the disturbance exists. Finally, higher control performance of the combined method for joint control of the robotic system can be further verified. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Follicular lymphoma frequently originates in the salivary gland

Satoko Nakamura
The aim of the present study was to examine the clinicopathological presentations of follicular lymphomas (FL) of the salivary glands, as compared to mucosa-associated lymphoid tissue (MALT) lymphomas. A total of 27 primary salivary gland lymphomas were examined: 6 FL (five, grade 1; one, grade 2); 19 MALT lymphomas; and two diffuse large B-cell lymphomas. The FL patients ranged in age from 24 to 73 years, with a mean of 49 years, which was younger than that of MALT patients (mean: 64 years; P < 0.05). Four of the six FL arose from the submandibular gland, which was the origin of only five out of a total of 19 MALT lymphomas. One FL patient was in clinical stage (CS) IE, two in CS IIE, and two in CS III and IV. As regards the MALT lymphoma patients, 13 (68%) were in CS IE and five (26%) in CS IIE. None of the FL patients had clinical diagnosis of autoimmune disease but eight MALT lymphoma patients had autoimmune disease. The present study found a relatively high incidence of FL in the salivary glands. The observed differences in age of onset, background of autoimmune disease, and lesion site suggests that the pathogenesis of FL may differ from that of MALT lymphoma. [source]

Prävention und Therapie der Osteoporose.

Stellenwert von Calcium und Vitamin D
Eine Monotherapie mit Vitamin D und Calcium ist zur Behandlung der postmenopausalen Osteoporose nicht geeignet. Die Supplementation von Calcium und Vitamin D3 ist aber generell als Basistherapie bei Patienten mit Risikofaktoren und obligat als additive Begleittherapie bei jeder medikamentösen Osteoporosetherapie indiziert und sogar unerlässlich (siehe DVO-Leitlinien). Nach mehrjähriger Behandlung mit effektiven Antiosteoporotika wird oft Calcium plus Vitamin D allein im Sinne einer "Erhaltungstherapie" fortgeführt. Die Datenlage zur fraktursenkenden Wirkung von Calcium und/oder Vitamin D erlaubt folgende Einschätzungen: , Wirkung gesichert: Verminderung von Schenkelhalsfrakturen bei Frauen in Altenheimen mit einem Calcium- und Vitamin-D-Mangel durch die kombinierte Gabe von Vitamin D plus Calcium. , Wirkung wahrscheinlich: Verminderung von peripheren Frakturen bei Frauen und Männern im höheren Lebensalter mit Calcium- und Vitamin-D-Mangel durch die kombinierte Gabe von Vitamin D plus Calcium. , Wirkung möglich: Verminderung von peripheren Frakturen und Wirbelkörperfrakturen bei Männern und Frauen in allen Altersklassen durch eine Optimierung der Calcium- und Vitamin-D-Versorgung. Bei älteren Menschen muss die Vitamin-D-Gabe wegen der mangelhaften Produktion in der Haut Sommer wie Winter erfolgen. Die Serumkonzentration an 25-Hydroxyvitamin D sollte mindestens 20 ng/mL und durchschnittlich 30 ng/mL betragen. Um diesen Spiegel zu erreichen, ist eine tägliche Aufnahme von ca. 800 IE (20 ,g) Vitamin D erforderlich. Eine Vitamin-D- und Calcium-Zufuhr ist insbesondere in der Schwangerschaft und Stillzeit angezeigt. Wir empfehlen in unserer Ambulanz zur Prävention der Therapie der Osteoporose als Basistherapie die "1000er Regel": täglich 1000 mg Calcium und 1000 IE Vitamin D3. Vitamin D reduziert ferner das Sturzrisiko, verbessert die Muskelkraft und besitzt noch zahlreiche positive Wirkungen auf andere Organsysteme. Das Auftreten von Nierensteinen oder einer Gefäßverkalkung ist bei Osteoporose-Patienten in der empfohlenen Dosis und bei normaler Flüssigkeitszufuhr nicht zu befürchten. Der Einsatz aktiver Vitamin-D-Metabolite ist auf Grund der Studiendatenlage zur Therapie der postmenopausalen Osteoporose nicht zu empfehlen und nur bei Funktionsstörungen der Leber und/oder Niere zu diskutieren. Ein unkritischer Einsatz von hydroxylierten Formen des Vitamin D bei Sturzpatienten ist auch aus Kostengründen nicht sinnvoll. Eine Substitution mit anderen Mineralien, Vitaminen oder Spurenelementen ist nur bei Vorliegen von nachgewiesenen Mangelzuständen sinnvoll und vertretbar. [source]

UV-enhanced Expression of a Reporter Gene is Induced at Lower UV Fluences in Transcription-coupled Repair Deficient Compared to Normal Human Fibroblasts, and is Absent in SV40-transformed Counterparts,

Murray A. Francis
ABSTRACT UV irradiation enhances transcription of a number of cellular and viral genes. We have compared dose responses for alterations in expression from reporter constructs driven by the human and murine cytomegalovirus (CMV) immediate early (IE) promoters in cells from patients with deficiencies in nucleotide excision repair (complementation groups of xeroderma pigmentosum and Cockayne syndrome) following UV exposure, or infection with UV-damaged recombinant vectors. Results suggest that unrepaired damage in active genes triggers increased reporter activity from constructs driven by the CMV promoters in human fibroblasts. Similar to human fibroblasts, HeLa cells and cells from Li,Fraumeni syndrome patients (characterized by an inherited mutation in the p53 gene) also displayed an increase in reporter activity following UV exposure; however, this response was absent in all simian virus 40 (SV40)-transformed cell lines examined. This suggests that a pathway affected by SV40-transformation (other than p53) plays an essential role in UV-enhanced expression from the CMV IE promoter. [source]

Key issues with implementing LOPA

William Bill Bridges
Abstract This article writen by one of the originators of LOPA, focuses on problems observed with LOPA. One the biggest issues is that organizations use LOPA without following the rules for LOPA, especially the rules related to maintaining, testing, and record-keeping for each independent protection layer (IPL) and for each "optimized" initiating event (IE). Another issue is that many companies and analysts overuse LOPA. The LOPA book authors expected the number of scenarios going to LOPA (after a HAZOP/PHA) would be 1 to 10% (max) of those uncovered in a qualitative analysis (maybe after 100 HAZOP nodes, you would do 1,10 LOPA). A PHA team would recommend (or use) LOPA only if the scenario was too complex for the PHA/HAZOP team. It appears that most companies are using LOPA for every scenario that has a severe consequence; this result in doing LOPA on much more than 10% of the scenarios. Many times, there is weak definition of the consequence that is being avoided, so an independent layer of protection does not always match up well with the consequence. LOPA is also overworked when it is used. Many of us on the original LOPA book authorship considered LOPA a single analyst job, after a PHA/HAZOP. Instead, the trend appears to be that companies (or perhaps their consultants) make LOPA part of the PHA (in situ), therefore involving the whole PHA team. LOPA is used in PHA team settings, which distracts PHA teams from their primary task of brainstorming to identify the accident scenarios that can occur. This article focuses on preventing these problems and also summarizes the many benefits LOPA has produced for the industry. © 2010 American Institute of Chemical Engineers Process Saf Prog, 2010 [source]

Initiating events and independent protection layers

John F. Murphy
Abstract Layer of protection analysis (LOPA) is a semiquantitative tool for analyzing and assessing process risk. The tool has grown greatly in popularity and usefulness since the publication of the first CCPS/AIChE guidebook on the subject, Layer of Protection Analysis, Simplified Process Risk Assessment (LOPA). This article is a summary of a new CCPS guideline book that includes the following: Initiating events (IEs). Independent protection layers (IPLs). Criteria for identifying the value of each prospective IE and prospective IPL. Example IE and IPL data. This book is a necessary reference for those applying the LOPA methodology. © 2009 American Institute of Chemical Engineers Process Saf Prog, 2009 [source]

Investigation of reduction of Cu(II) complexes in positive-ion mode electrospray mass spectrometry

Luca Gianelli
The electrospray ionization mass spectrometry (ESI-MS) behavior of seven Cu(II) complexes with tetradentate ligands has been studied. An unexpected reduction process, in positive ion mode, of the Cu oxidation state was observed, and shown to be due to charge transfer between the metal complex and the solvent molecules in the gas phase. Ion trap collision-induced dissociation experiments and deuterated solvents were used to support the proposed mechanism that is not a common electrochemical redox reaction at the ESI tip, but a gas-phase process. A series of solvents (acetonitrile, methanol, ethanol, propanol and iso -butanol) were tested, and a correlation between ionization energy (IE) and the amount of Cu(I) produced in ESI has been demonstrated for the alcohols, although some other solvent properties should also be taken into account. The electrochemical reduction potential of the complexes in solution is also an important parameter, since complexes more easily reduced in solution are also easier to reduce in the gas phase. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Assessment of cognitive function in systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis by computerized neuropsychological tests

John G. Hanly
Objective Computerized neuropsychological testing may facilitate screening for cognitive impairment in systemic lupus erythematosus (SLE). This study was undertaken to compare patients with SLE, patients with rheumatoid arthritis (RA), and patients with multiple sclerosis (MS) with healthy controls using the Automated Neuropsychological Assessment Metrics (ANAM). Methods Patients with SLE (n = 68), RA (n = 33), and MS (n = 20) were compared with healthy controls (n = 29). Efficiency of cognitive performance on 8 ANAM subtests was examined using throughput (TP), inverse efficiency (IE), and adjusted IE scores. The latter is more sensitive to higher cognitive functions because it adjusts for the impact of simple reaction time on performance. The results were analyzed using O'Brien's generalized least squares test. Results Control subjects were the most efficient in cognitive performance. MS patients were least efficient overall (as assessed by TP and IE scores) and were less efficient than both SLE patients (P = 0.01) and RA patients (P < 0.01), who did not differ. Adjusted IE scores were similar between SLE patients, RA patients, and controls, reflecting the impact of simple reaction time on cognitive performance. Thus, 50% of SLE patients, 61% of RA patients, and 75% of MS patients had impaired performance on ,1 ANAM subtest. Only 9% of RA patients and 11% of SLE patients had impaired performance on ,4 subtests, whereas this was true for 20% of MS patients. Conclusion ANAM is sensitive to cognitive impairment. While such computerized testing may be a valuable screening tool, our results emphasize the lack of specificity of slowed performance as a reliable indicator of impairment of higher cognitive function in SLE patients. [source]

Duloxetine compared with placebo for treating women with symptoms of overactive bladder

William D. Steers
OBJECTIVE To evaluate duloxetine (a serotonin-noradrenaline reuptake inhibitor) in women with symptoms of overactive bladder (OAB), as it has been shown to increase the bladder capacity in an animal model. PATIENTS AND METHODS In all, 306 women (aged 21,84 years) were recruited and randomly assigned to placebo (153) or duloxetine (80-mg/day for 4 weeks increased to 120-mg/day for 8 weeks; 153). Symptoms of OAB were defined as bothersome urinary urgency and/or urge urinary incontinence (UI) for ,3 months. Participants were also required to have a mean daytime voiding interval (VI) of ,2 h and urodynamic observations of either detrusor overactivity (DOA) or urgency which limited bladder capacity to <400 mL, both with no stress UI (SUI). The primary efficacy analysis compared the treatment effects on mean change from baseline to endpoint in the mean number of voiding episodes (VE)/24 h. The secondary efficacy analyses compared the treatment effects on the number of UI episodes (IE)/24 h, in the Incontinence Quality of Life questionnaire (I-QOL) score, and on the mean daytime VI. Safety was assessed with vital signs, adverse event reporting, routine laboratory testing, electrocardiogram, and the measurement of postvoid residual urine volumes (PVR). RESULTS Patients randomized to duloxetine had significant improvements over those randomized to placebo for decreases in VE and IE, for increases in the daytime VI, and for improvements in I-QOL scores at both doses of duloxetine. Urodynamic studies showed no significant increases in maximum cystometric capacity or in the volume threshold for DOA. The most common treatment-emergent adverse events with duloxetine (nausea, 31%; dry mouth, 16%; dizziness, 14%; constipation, 14%; insomnia, 13%; and fatigue, 11%) were the same as those reported by women with SUI and were significantly more common with duloxetine than placebo. Laboratory assessments, vital signs and electrocardiograms were stable relative to baseline, with no relevant differences detected between groups. There was a significant difference in the change in PVR with duloxetine (<5 mL mean increase) but no patient reported hesitancy or retention. CONCLUSION In this trial, duloxetine was better than placebo for treating women with ,wet' and ,dry' symptoms of OAB associated with DOA or a bladder capacity of <400 mL. [source]

Industrial ecology, life cycles, supply chains: differences and interrelations

Stefan Seuring
Within recent years, various concepts have arisen in environmental management that directly address the flow of material (and information) along life cycles or supply chains and thereby relate to inter-organizational management aspects. These include industrial ecology (IE), life-cycle management, closed-loop supply chains, integrated chain management and green/environmental or sustainable supply chain management. It is not clear how these concepts relate to each other and whether or how they are different. Starting with sustainable development three criteria are identified that allow the comparison of the four concepts. Building on definitions the concepts are discussed and analysed using the three criteria while also identifying a distinctive feature of each approach. The criteria reveal that the concepts take a specific approach to study material flows in their particular system boundaries. This also relates to the time frame usually applied within the concept as well as the relevant actor network taken into account. Beyond these differences, it arises that the concepts have their strengths on different levels, which leads to a framework for the interrelation of the concepts. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source]

Policy implications of industrial ecology conceptions

Hilde N. Opoku
The way industrial ecology (IE) is conceptualized determines the concept's potential. Different conceptualizations of IE suggest different political solutions and different focuses on the environment. It is not in itself problematic that the debate points in different political directions. The problem occurs when ideologically based argumentation is not made explicit, but instead presented as necessary premises in order to meet IE objectives. An analysis of the implications when two of these conceptions are implemented as strategies for solid waste management illustrates this claim. This author suggests that the contributors to the field make a clear distinction between scientific discussions regarding the analytical framework and policy principles, and discussions regarding practical applications. Only then can the assumption that the concept of industrial ecology has the potential to be a robust and unifying analytical framework and policy principle stand. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source]

Highly selective single nucleotide polymorphism recogniton by a chiral (5S) PNA beacon,

CHIRALITY, Issue 1 2009
Filbert Totsingan
Abstract A chiral peptide nucleic acid (PNA) beacon containing a C-5 modified monomer based on L-lysine was synthesized. The terminal amino group of the lysine side chain was linked to a spacer for future applications on surfaces. The PNA beacon bears a carboxyfluorescein fluorophore and a dabcyl quencher at opposite ends. The DNA binding properties were compared with those of a homologous PNA beacon containing only achiral monomers. Both beacons underwent a fluorescence increase in the presence of complementary DNA, with higher efficiency and higher selectivity (evaluated using single mismatched DNA sequences) observed for the chiral monomer containing PNA. Ion exchange (IE) HPLC with fluorimetric detection was used in combination with the beacon for the selective detection of complementary DNA. A fluorescent peak corresponding to the PNA beacon:DNA duplex was observed at a very low detection limit (1 nM). The discriminating capacity of the chiral PNA beacon for a single mismatch was found to be superior to those observed with the unmodified one, thus confirming the potency of chirality for increasing the affinity and specificity of DNA recognition. Chirality, 2009. © 2008 Wiley-Liss, Inc. [source]