Diagnosis and therapy of aortic prosthetic fistulas: trends over a 30-year experience

A retrospective study was carried out of patients from a single institution over a 30-year period. Thirty-one patients presented with 33 fistulas, four non-enteric and 27 enteric. In 25 of 27 patients with a prosthesis-related enteric fistula gastrointestinal bleeding was present. Angiography revealed the fistula in five patients endoscopy in three, and barium studies, echography and computed tomography each revealed one fistula. Six patients died before and five died during operation. In 20 patients various techniques were used for treatment. In-hospital mortality decreased from six of eight patients before 1970, to seven of ten between 1971 and 1980, and to four of 13 after 1981. In the long term, patients treated with an extra-anatomic reconstruction had a poorer prognosis than those treated by in situ reconstruction. This experience shows that diagnostic tests often fail to reveal a prosthesis-related fistula and that mortality can be substantially reduced by early exploration in patients with negative diagnostic studies.     

Severe B cell deficiency and disrupted splenic architecture in transgenic mice expressing the E41K mutated form of Bruton's tyrosine kinase

To identify B-cell signaling pathways activated by Bruton's tyrosine kinase (Btk) in vivo, we generated transgenic mice in which Btk expression is driven by the MHC class II Ea gene locus control region. Btk overexpression did not have significant adverse effects on B cell function, and essentially corrected the X-linked immunodeficiency (xid) phenotype in Btk- mice. In contrast, expression of a constitutively activated form of Btk carrying the E41K gain-of-function mutation resulted in a B cell defect that was more severe than xid. The mice showed a marked reduction of the B cell compartment in spleen, lymph nodes, peripheral blood and peritoneal cavity. The levels in the serum of most immunoglobulin subclasses decreased with age, and B cell responses to both T cell-independent type II and T cell-dependent antigens were essentially absent. Expression of the E41K Btk mutant enhanced blast formation of splenic B cells in vitro in response to anti-IgM stimulation. Furthermore, the mice manifested a disorganization of B cell areas and marginal zones in the spleen. Our findings demonstrate that expression of constitutively activated Btk blocks the development of follicular recirculating B cells.     

PREPARATION OF HYDROTHERMALLY TREATED LRC/WATER FUEL SLURRIES

The hot-water coal drying process is a means of thermally beneficiating and dewatering lignite and subbituminous coal for the purpose of preparing dense low-rank coal/water fuel. In hot-water coal drying, which is a form of hydrothermal treatment, low-rank coal in a water slurry is treated at elevated temperatures of 513 to 623  K and at pressures in excess of the equivalent saturated steam pressures lo minimize vaporization of the water. This produces a coal product which contains less than one-third the inherent moisture of the raw coal and which is resistant to moisture reabsorption. The hydrothermally treated coal/water slurry resulting from the process can be concentrated by mechanical means (centrifuge, pressure filter)to form a pumpable coal/water fuel with greater than 60 weight percent bone-dry solids content and with an energy content greater than 15·4 MJ/Kg (6600 Btu/lb). Hydrothermal treatment also beneficiates the coal by reducing oxygen and minerals. Over 94 percent of the energy content of the raw coal remains in the product. Low-rank coal/water fuel is typically a pseudoplastic fluid, and for some low-rank coals, the slurry is stable towards settling, without the use of additives.     

Special care units for people with Alzheimer's disease. Only for the privileged few?

The number of Special Care Units (SCUs) for people with Alzheimer's disease (AD) in nursing homes have increased dramatically in the past 10 years. Despite the rapid increase in number of SCUs and the concern that most SCUs report higher costs than traditional nursing home units where residents with AD are integrated with cognitively intact residents, the evaluation of costs has been largely unsystematic and noncomparative. Studies are urgently needed to assess comparative costs so that administrators and policy makers can make informed decisions. This article reviews studies that examine the costs of care in SCUs and presents cost-related data comparing the outcomes of care for residents with AD on a SCU and on traditional units in one long-term care setting.     

Influences of DNA isolation and RNA contamination on carcinogen-DNA adduct analysis by 32P-postlabeling

OBJECTIVE: To determine the views of junior hospital doctors on their working conditions, NHS reforms and training, and to compare their views with those of consultants and managers. SUBJECTS: A questionnaire was distributed to 52 junior doctors, 19 consultants and 14 middle or senior grade managers in an acute NHS trust. CONCLUSIONS: Junior doctors had strong feelings about several areas covered in the questionnaire; in particular, more structured training without the requirement to undertake a higher degree would be welcomed. Shift systems are unpopular and the reduction of 'non-medical' tasks with a reduction in work intensity is perceived to be more important than further reductions in hours available for work.     

Bilateral brachial plexus neuritis following parvovirus B19 and cytomegalovirus infection

A man, 23 years of age, had a typical erythema infectiosum, complicated by a severe bilateral brachial plexus neuritis. Motor function recovered slowly and only partially after 6 months. An infection by human parvovirus B19 was demonstrated, with strongly positive and gradually declining IgM antibodies and viral DNA detectable in serum for more than 3 months. There was also clear evidence of a recent infection by cytomegalovirus. The interaction between these two viruses could be responsible for this rare and severe complication of common infections in this patient.     

Perinatal High-Fat Diet Influences Ozone-Induced Responses on Pulmonary Oxidant Status and the Molecular Control of Mitophagy in Female Rat Offspring

Previous research has shown that a perinatal obesogenic, high-fat diet (HFD) is able to exacerbate ozone-induced adverse effects on lung function, injury, and inflammation in offspring, and it has been suggested that mitochondrial dysfunction is implicated herein. The aim of this study was to investigate whether a perinatal obesogenic HFD affects ozone-induced changes in offspring pulmonary oxidant status and the molecular control of mitochondrial function. For this purpose, female Long-Evans rats were fed a control diet or HFD before and during gestation, and during lactation, after which the offspring were acutely exposed to filtered air or ozone at a young-adult age (forty days). Directly following this exposure, the offspring lungs were examined for markers related to oxidative stress; oxidative phosphorylation; and mitochondrial fusion, fission, biogenesis, and mitophagy. Acute ozone exposure significantly increased pulmonary oxidant status and upregulated the molecular machinery that controls receptor-mediated mitophagy. In female offspring, a perinatal HFD exacerbated these responses, whereas in male offspring, responses were similar for both diet groups. The expression of the genes and proteins involved in oxidative phosphorylation and mitochondrial biogenesis, fusion, and fission was not affected by ozone exposure or perinatal HFD. These findings suggest that a perinatal HFD influences ozone-induced responses on pulmonary oxidant status and the molecular control of mitophagy in female rat offspring.     

Novel Miniature and Broadband Millimeter-Wave Monolithic Star Mixers

In this paper, three monolithic star mixers using a new miniature dual balun are proposed. The first one is a double spiral transformer mixer, and the second one is a trifilar transformer mixer. Both of these are fabricated using a commercial GaAs pseudomorphic HEMT process. The third is a 3-D transformer mixer, which is fabricated using a commercial CMOS process. These mixers exhibit bandwidths over 25-45 GHz (57%) with local oscillator isolations better than 20 dB. These star mixers are smaller than (lambda/6timeslambda/6) for the mixer core area. Compared with traditional star mixers, these mixers demonstrate 80% size reduction, and achieve good performance with the smallest chip size among all star mixers using monolithic microwave integrated circuit processes.