bluuebunny/crossref_metadata_2025 huggingface dataset:
Intratendinous strain fields of the intact supraspinatus tendon: the effect of glenohumeral joint position and tendon region
Authors: Bey Michael J. , Song Hee Kwon , Wehrli Felix W. , Soslowsky Louis J.
Published: October 2002

Rotator cuff tears are a common shoulder pathology and are hypothesized to relate to excessive tissue deformation. Few data exist, however, describing deformation of the rotator cuff as an intact, functional unit. Our purpose was to determine regional variations of intratendinous rotator cuff strain over a range of clinically relevant joint positions. A novel, MRI‐based technique was utilized to quantify intratendinous strains in cadaveric shoulder specimens at 15°, 30°, 45°, and 60° of glenohumeral abduction in the scapular plane. The strain data were grouped into superior, middle, and inferior locations across the region where most rotator cuff tears occur clinically. A repeated measures ANOVA assessed the effects of joint position and tendon region on intratendinous strain. Few differences in intratendinous strain existed across tendon regions, but joint position had a pronounced effect. Specifically, intratendinous strain increased with increasing joint angle, and the 60° strain was significantly greater than the 15° strain across all tendon regions. These data suggest that joint position plays a larger role in rotator cuff mechanics than previously believed. Future studies will utilize this technique for quantifying intratendinous strain to assess the effects of partial‐thickness rotator cuff tears. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Progressive surgical dissection for tendon transposition affects length‐force characteristics of rat flexor carpi ulnaris muscle
Authors: Smeulders Mark J. C. , Kreulen Michiel , Joris Hage J. , Baan Guus C. , Huijing Peter A.
Published: October 2002

Extramuscular connective tissue and muscular fascia have been suggested to form a myo‐fascial pathway for transmission of forces over a joint that is additional to the generally accepted myo‐tendinous pathway. The consequences of myo‐fascial force transmission for the outcome of conventional muscle tendon transfer surgery has not been studied as yet. To test the hypothesis that surgical dissection of a muscle will affect its length‐force characteristics, a study was undertaken in adult male Wistar rats. During progressive dissection of the flexor carpi ulnaris muscle, isometric length‐force characteristics were measured using maximal electrical stimulation of the ulnar nerve. After fasciotomy, muscle active force decreased by approximately 20%. Further dissection resulted in additional decline of muscle active force by another 40% at maximal dissection. The muscle length at which the muscle produced maximum active force increased by approximately 0.7 mm (i.e. 14% of the measured length range) after dissection. It is concluded that, in rats, the fascia surrounding the flexor carpi ulnaris muscle is a major determinant of muscle length‐force characteristics. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
Heart failure in frail elderly patients: diagnostic difficulties, co‐morbidities, polypharmacy and treatment dilemmas
Authors: Lien Christopher T.C. , Gillespie Neil D. , Struthers Allan D. , McMurdo Marion E.T.
Published: October 2002

Background:

Heart failure (HF) is difficult to diagnose and treat in older patients. Symptoms may be non‐specific and the presence of co‐morbidities and polypharmacy complicate treatment strategies. There are, however, few data to quantify the extent of these problems in the very elderly.

Methods:

A retrospective study of 116 patients (median age 86; range 65–98) with an established diagnosis of HF during their hospital admission. Main outcome measures: the accuracy of diagnosis of heart failure according to the European Society of Cardiology (ESC) definition. The aetiology and frequency of associated co‐morbidities and the nature of drug treatment.

Results:

The specificities of clinical signs, chest X‐rays and abnormal ECGs for heart failure (ESC definition) were 50%, 20% and 9%, respectively. Only 28% of patients were admitted for worsening symptoms which could be attributed to HF. None of the patients had HF as their only medical problem. Co‐morbidities included chest disease (30%), incontinence (29%), cerebrovascular disease (26%), musculoskeletal problems (41%). Barthel (activities of daily living) score was ≤16/20 in 35%. Mental state questionnaire (MSQ) score was ≤7/10 in 38%. Ninety percent were taking four or more different medications. Thirty‐nine percent were on psychotropic drugs. On discharge, a total of 88% of patients returned home to live independently and 35% were monitored by regular day hospital attendance.

Conclusion:

Heart failure in frail elderly patients is often compounded by other major illnesses and polypharmacy which have a profound impact on their functional status. This has implications for the most effective targeting of evidence based treatment.
Left ventricular systolic dysfunction in a cardiac transplant recipient treated with carvedilol
Authors: Gardner Roy S. , McGowan James , McDonagh Theresa A.
Published: October 2002

A 49‐year‐old cardiac transplant recipient with idiopathic left ventricular systolic dysfunction was treated with carvedilol. After 8 months, his ejection fraction, measured by radionuclide ventriculography, had increased from 14 to 30% with an associated improvement in symptoms.
Is the elevated slope relating ventilation to carbon dioxide production in chronic heart failure a consequence of slow metabolic gas kinetics?
Authors: Witte Klaus K.A. , Clark Andrew L.
Published: October 2002

Objective

Patients with heart failure have slow metabolic gas exchange kinetics, which may contribute to the elevated slope of the relationship between ventilation and carbon dioxide production (Ve/Vco2 slope).

Setting

A tertiary referral centre for cardiology.

Subjects

Eleven patients with stable chronic heart failure and 11 age‐matched controls.

Design

Each subject underwent maximal bicycle‐based peak exercise testing with metabolic gas exchange analysis and three further repeated tests at 15%, 25% and 50% of the load achieved at peak exercise. The ventilation and carbon dioxide production from each of these steady‐state tests was used to re‐calculate the Ve/Vco2 slope and compared with the Ve/Vco2 slope derived from the maximal test.

Results

Peak oxygen consumption [mean (S.D.)] was lower in heart failure patients [18.2 (4.0) vs. 31.2 (6.3) ml/kg per min; P<0.001] than in controls. The Ve/Vco2 slope was steeper in patients than controls [32.7 (8.3) vs. 27.1 (1.6); P<0.05]. There was no difference between the Ve/Vco2 slope reconstructed from the three steady state tests and resting data and that gained from the maximal test [35.3 (7.8) vs. 25.9 (3.2); P‐0.43].

Conclusions

The elevated slope of the relationship between ventilation and carbon dioxide production is not a consequence of the short stages of a standard incremental exercise test combined with delayed metabolic gas kinetics in heart failure patients.
ARFGAP1 promotes the formation of COPI vesicles, suggesting function as a component of the coat
Authors: Yang Jia-Shu , Lee Stella Y. , Gao Minggeng , Bourgoin Sylvain , Randazzo Paul A. , Premont Richard T. , Hsu Victor W.
Published: October 2002

The role of GTPase-activating protein (GAP) that deactivates ADP-ribosylation factor 1 (ARF1) during the formation of coat protein I (COPI) vesicles has been unclear. GAP is originally thought to antagonize vesicle formation by triggering uncoating, but later studies suggest that GAP promotes cargo sorting, a process that occurs during vesicle formation. Recent models have attempted to reconcile these seemingly contradictory roles by suggesting that cargo proteins suppress GAP activity during vesicle formation, but whether GAP truly antagonizes coat recruitment in this process has not been assessed directly. We have reconstituted the formation of COPI vesicles by incubating Golgi membrane with purified soluble components, and find that ARFGAP1 in the presence of GTP promotes vesicle formation and cargo sorting. Moreover, the presence of GTPγS not only blocks vesicle uncoating but also vesicle formation by preventing the proper recruitment of GAP to nascent vesicles. Elucidating how GAP functions in vesicle formation, we find that the level of GAP on the reconstituted vesicles is at least as abundant as COPI and that GAP binds directly to the dilysine motif of cargo proteins. Collectively, these findings suggest that ARFGAP1 promotes vesicle formation by functioning as a component of the COPI coat.
Cytosolic free Ca2+ changes and calpain activation are required for β integrin–accelerated phagocytosis by human neutrophils
Authors: Dewitt Sharon , Hallett Maurice B.
Published: October 2002

Phagocytosis of microbes coated with opsonins such as the complement component C3bi is the key activity of neutrophils. However, the mechanism by which opsonins enhance the rate of phagocytosis by these cells is unknown and has been difficult to study, partly because of the problem of observing and quantifying the events associated with phagocytosis. In this study, C3bi-opsonized particles were presented to neutrophils with a micromanipulator, so that the events of binding, pseudopod cup formation, engulfment, and completion of phagocytosis were clearly defined and distinguished from those involved with chemotaxis. Using this approach in combination with simultaneous phase contrast and Ca2+ imaging, the temporal relationship between changes in cytosolic free Ca2+ concentration and phagocytosis were correlated. Here we show that whereas small, localized Ca2+ changes occur at the site of particle attachment and cup formation as a result of store release, rapid engulfment of the particle required a global change in cytosolic free Ca2+ which resulted from Ca2+ influx. This latter rise in cytosolic free Ca2+ concentration also liberated a fraction of β2 integrin receptors which were initially immobile on the neutrophil surface, as demonstrable by both fluorescence recovery after laser bleaching and by visualization of localized β2 integrin labelling. Inhibitors of calpain activation prevented both the Ca2+-induced liberation of β2 integrin and the rapid stage of phagocytosis, despite the persistence of the global Ca2+ signal. Therefore, we propose that Ca2+ activation of calpain causes β2 integrin liberation, and that this signal plays a key role in the acceleration of β2 integrin–mediated phagocytosis.
Cutaneous electrical stimulation may enhance sensorimotor recovery in chronic stroke
Authors: Peurala S H , Pitkänen K , Sivenius J , Tarkka I M
Published: October 2002

Objective: To investigate whether cutaneous electrical stimulation has a role in the enhancement of sensorimotor function in chronic stroke.

Subjects and setting: Fifty-nine patients with chronic stroke received cutaneous stimulation during their three-week-long inpatient rehabilitation. Thirty-two received active treatment in the paretic hand and eight received no-current placebo treatment in the paretic hand. Nineteen patients received active stimulation of the paretic foot. None received stimulation in both upper and lower limbs.

Intervention: Cutaneous stimulation was delivered twice daily via a special glove/sock electrode.

Main outcome measures: Modified Motor Assessment Scale, 10-metre walking test, paretic limb function, limb skin sensation and somatosensory evoked potentials (SEP) were performed before and after the treatment.

Results: Modified Motor Assessment Scale ( p < 0.001), 10-metre walking test ( p < 0.05), paretic hand function ( p < 0.01), upper limb skin sensation ( p < 0.01) and SEP normality classification of paretic upper limb ( p < 0.01) and paretic lower limb ( p < 0.5) improved significantly in the treatment group ( n = 51) after three weeks of stimulation. When active hand treatment and placebo hand treatment were compared, a significant improvement in the sensory and motor function was observed only in the actively treated group.

Conclusions: Cutaneous stimulation had positive effects in the motor performance, limb sensation and the configuration of SEP of the paretic limb in chronic stroke patients.
Enzyme recovery during gas/liquid two‐phase flow microfiltration of enzyme/yeast mixtures
Authors: Mercier‐Bonin Muriel , Fonade Christian
Published: October 2002

The effect of a gas/liquid two‐phase flow on the recovery of an enzyme was evaluated and compared with standard crossflow operation when confronted with the microfiltration of a high‐fouling yeast suspension. Ceramic tubular and flat sheet membranes were used. At constant feed concentration (permeate recycling) and transmembrane pressure, the results obtained with the tubular membrane were dependent on the two‐phase flow pattern. In comparison with single‐phase flow performances at the same liquid velocity, the enzyme transmission was maintained at a high level with a bubble flow pattern but it decreased by 70% with a slug flow, whatever the flow rate ratio. Identical results were obtained with flat sheet membranes: for the highest flow rate ratio, the enzyme transmission was reduced by 70% even though the permeate flux was improved by 240%. During diafiltration experiments with the tubular membrane, it was found that a bubble flow pattern led to a 13% higher enzyme recovery compared to single‐phase flow conditions, whereas with a slug flow the enzyme recovery was strongly reduced. With bubble flow conditions, energy consumption was minimal, confirming that this flow pattern was the most suitable for enzyme recovery. © 2002 Wiley Periodicals, Inc. Biotechnol Bioeng 80: 610–621, 2002.
Rapid HPLC measurement of buflomedil in plasma in poisoning cases
Authors: Forfar‐Bares I. , Pehourcq F. , Jarry C.
Published: October 2002

A rapid high‐performance liquid chromatographic method for the determination of buflomedil in human plasma is described. It requires a single liquid–liquid extraction step from 1 mL of plasma with diethyl ether followed by chromatography on a Nova Pak C18 reversed‐phase column and detection by ultaviolet light. Metoclopramide was used as internal standard. The method is sensitive with a quantification limit at 500 ng/mL. It was used for the determination of buflomedil in biological fluids in poisoning cases. Copyright © 2002 John Wiley & Sons, Ltd.
Simulation of special loading conditions by means of non‐linear constraints imposed through Lagrange multipliers
Authors: Gutiérrez M. A. , Askes H.
Published: October 2002

This paper discusses the necessity and handling of non‐linear constraint equations to describe the behaviour of properties of the loading system such as, e.g. smooth free‐rotating loading platens. An exact, non‐linear formulation for a smooth loading platen is derived and its incorporation into the equilibrium equations is presented. For this purpose, the Lagrange multiplier method is used. The solution of the equilibrium equations by means of a Newton–Raphson algorithm is also outlined. The proposed approach is validated on a patch of two finite elements and applied to a compression‐bending test on a pre‐notched specimen. It is observed that use of a linearized approximation of the boundary constraint can lead to errors in the description of the motion of the constrained nodes. Thus, the non‐linear formulation is preferable. Copyright © 2002 John Wiley & Sons, Ltd.
Problems associated with the use of Cayley transform and tangent scaling for conserving energy and momenta in the Reissner–Simo beam theory
Authors: Jelenić Gordan , Crisfield Michael A.
Published: October 2002

Conservation of the total energy and the total momenta in time‐stepping schemes for non‐linear 3D beams of the Reissner–Simo type is achieved via a particular treatment of large 3D rotations, which involves a rotational update using Cayley transformation, an interpolation of incremental tangent‐scaled rotations and a non‐linear update formula for angular velocities. In this note we investigate the side‐effects of this procedure. Copyright © 2002 John Wiley & Sons, Ltd.
Regeneration of phenol‐saturated activated carbon in an electrochemical reactor
Authors: Zhang Huiping , Ye Liyi , Zhong Hui
Published: October 2002

The regeneration of phenol‐saturated activated carbon in an electrochemical reactor was investigated in order to develop a novel regeneration method of activated carbon. The regeneration of spent activated carbon saturated with phenol was conducted in a stirred electrochemical reactor under different operating conditions. The influences of operating parameters, such as regeneration current intensity and time, on regeneration efficiency were systematically investigated. The regeneration efficiency can reach over 80% under continuous stirring in the reactor, and it only decreases by less than 5% after four regeneration cycles. Electrochemical regeneration in the stirred electrochemical reactor is shown to be an effective method for the regeneration of phenol‐saturated activated carbon with a much higher regeneration efficiency compared with a process using NaOH solution.

© 2002 Society of Chemical Industry
Fast and robust Delaunay tessellation in periodic domains
Authors: Thompson Karsten E.
Published: October 2002

An algorithm is presented for constructing three‐dimensional Delaunay tessellations in periodic domains. Applications include mesh generation for periodic transport problems and geometric decomposition for modelling particulate structures. The algorithm is a point insertion technique, and although the general framework is similar to point insertion in a convex hull, a number of new issues are introduced by periodicity. These issues are discussed in detail in the context of the computational algorithm. Examples are given for the tessellation of random points and random sphere packings. Performance data for the algorithm are also presented. These data show an empirical scaling of the computation time with size of O(N1.11) and tessellation rates of 7000–14000 tetrahedrons per second for the problems studied (up to 105 points). A breakdown of the performance is given, which shows the computational load is shared most heavily by two specific parts of the point‐insertion procedure. Copyright © 2002 John Wiley & Sons, Ltd.
Current Awareness in prenatal diagnosis
Authors:   John Wiley & Sons, Ltd.
Published: October 2002

In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre‐implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted
Early amniocentesis with the filtration technique: neonatal outcome in 123 singleton pregnancies
Authors: Farrán I. , Sánchez M. A. , Mediano C. , Plaja A. , Guzmán A. , de la Riva A. M. , Cabero L.
Published: October 2002

Objective

To evaluate results of a prospective study of pregnancies in which early amniocentesis with the filtration technique was performed at 10–13 weeks' gestation (mean 12.3 weeks' gestation).

Methods

123 singleton pregnancies in which early amniocentesis with the modified filtration technique was performed at 10–13 weeks' gestation (mean 12.3 weeks' gestation). The amniotic fluid was aspirated into the syringe and reinjected through the filter.

Results

All the procedures were performed successfully by a single needle insertion. Neither dry taps nor filtration failures occurred. The mean time of amniocentesis was 4.02 min (95% confidence interval, 3 min and 36 s to 4 min and 18 s). The karyotyping success rate was 99.2%. Temporary amniotic fluid leakage occurred in three women (2.4%). There were 110 (89.4%) live births. Two cases of stillbirth occurred at week 38 and week 40. Two unintended losses occurred within three weeks after sampling (1.62%). Another additional unintended fetal death was notified at the 20‐week screening ultrasonography. The total fetal‐loss rate was 10.6%. In one case, talipes equinovarus was detected at the 20‐week screening ultrasound study.

Conclusions

Further studies are needed to determine the risk of amniotic leakage and its relation to duration of the procedure in patients undergoing early amnifiltration. Copyright © 2002 John Wiley & Sons, Ltd.
Early second trimester (13 to 20 weeks) transabdominal chorionic villus sampling (TA‐CVS): a safe and alternative method for both high and low risk populations
Authors: Brambati Bruno , Tului Lucia , Camurri Lamberto , Guercilena Stefano
Published: October 2002

Objective

To assess feasibility, effectiveness and risk of prenatal diagnosis by TA‐CVS at 13–14 and 15–20 weeks' gestation.

Methods

CVS was performed transabdominally by free‐hand single needle insertion technique under continuous ultrasound visualization on 1844 pregnant women, aged 18 to 48, at 13 to 20 weeks' gestation, whose primary indication was chromosomal anomalies and single gene defects in 85% and 15% of cases, respectively Clinical follow‐up of women undergoing TA‐CVS at 13 to 20 weeks' was prospectively obtained; the population was split in two groups of 13–14 (series B) and 15–20 weeks' (series C) gestation. Statistical evaluation included a group of TA‐CVS cases performed at 11–12 weeks (series A).

Results

Sampling was feasible in 98.2%, 99.1% and 95.8% of cases of series A, B and C, respectively. Sampling was successful in all cases of the three series and a second insertion was required in 1.5%, 1.3% and 0.9%, respectively. A trend towards lower fetal loss rate is apparent (1.02%, 0.86%, and 0.46 in series A, B, and C, respectively), although differences were not statistically significant. No post‐procedural complications were reported for series B and C, while spotting was present in 1.8% of cases for series A. Karyotyping was totally successful by short term culture and was also available by long term culture in 99% of cases for series A, B and C when the amount of chorionic tissue was more than 15 mg.

Conclusion

TA‐CVS appears highly effective and safe and might be offered as a valuable alternative to early as well as mid‐trimester amniocentesis. Copyright © 2002 John Wiley & Sons, Ltd.
Screening for chromosomal anomalies in the first trimester: does repeat maternal serum screening improve detection rates?
Authors: Spencer Kevin , Cuckle Howard S.
Published: October 2002

Objective

To assess the within person biological variability of first trimester maternal serum biochemical markers of trisomy 21 across the 10–14 week gestational period. To evaluate whether repeat sampling and testing of free β‐hCG and PAPP‐A during this period would result in an improved detection rate.

Methods

Women presenting at the first trimester OSCAR clinic have blood collected prior to ultrasound dating and nuchal translucency measurement. All samples are analysed for free β‐hCG and PAPP‐A before an accurate estimate of gestation is available. In 10% of cases the gestation is prior to the minimum time for NT measurement (11 weeks) and these women are rebooked for a repeat visit to the clinic at the appropriate time. Our fetal database was interrogated to obtain cases in which two maternal blood samples had been collected and analysed in the 10–14 week period. Using data from the marker correlations and statistical modelling, the impact of repeat testing on detection rate for trisomy 21 at a fixed 5% false positive rate, was assessed.

Results

261 pairs of data were available for analysis collected over a 3 year period. The correlation between free β‐hCG in sample 1 and sample 2 was 0.890 and that for PAPP‐A was 0.827. The average within person biological variation for free β‐hCG was 21% and 32% for PAPP‐A. The increase in detection rate when using both sets of marker data was 3.5% when using serum biochemistry and maternal age, and 1.3% when using nuchal translucency, serum biochemistry and maternal age.

Conclusion

Repeat sampling and testing of maternal serum biochemical markers is unlikely to substantially improve first trimester screening performance. Copyright © 2002 John Wiley & Sons, Ltd.
Distributed power generation versus grid extension: an assessment of solar photovoltaics for rural electrification in Northern Ghana
Authors: Nässén Jonas , Evertsson Josefine , Andersson Björn A.
Published: October 2002

The competitiveness of distributed solar photovoltaic (PV) power generation for rural electrification in northern Ghana is assessed and compared with the conventional option of extending the national grid and increasing the capacity for centralised power generation. A model is constructed to calculate the life‐cycle cost (LCC) of the two options and to test the sensitivity of different parameters. All calculations are based on information from the GEF/UNDP pilot region in the East Mamprusi District. In addition to the economic aspect, issues of quality and environmental effects are discussed. The LCC of distributed PV is lower than that of a grid extension for an electricity demand corresponding to solar home systems of 140 Wp or smaller. Thus, distributed PV is cost competitive for purposes of lighting, entertainment, information and basic public facilities, such as schools and hospitals. The LCC for the option of grid extension with central power generation is dominated by the cost of low‐voltage micro‐grids within the communities. Important factors are the density of households and the penetration (fraction of households electrified), as they affect the line length per connected household. The relatively low cost of regional medium‐voltage grids makes the geographical location of each community less important than expected. Battery replacement every fifth year makes up the major part of the LCC of solar home systems and is also responsible for the large energy input in the production of the systems. This could limit both future cost reductions of distributed PV and its potential to mitigate greenhouse gas emissions. Copyright © 2002 John Wiley & Sons, Ltd.
Progress in the technique of upgrading metallic structures with advanced polymer composites
Authors: Hollaway L C , Cadei J
Published: October 2002

The use of advanced polymer composite (APC) materials to upgrade and to rehabilitate metallic structures offers an attractive solution for short‐term retrofits and long‐term rehabilitation. The basic principles of plate bonding metallic structures are similar to those used for the plate bonding of reinforced concrete (RC) structural units, but metallic adherends pose a different and a more difficult set of problems from those for RC systems.

This paper reviews the problems encountered in plate bonding onto metallic structures and discusses how these problems might be overcome. Initially, the paper investigates some of the in‐service problems associated with APC and metallic adherends and reviews their solutions. The weakest link in the bonded joint is the adhesive, and a review of the various solutions is included. Another potential area for concern is the durability of the APC and adhesive and a review of this area has been undertaken. The degradation of metallic structures has been covered in the literature, and consequently, this area is not covered. To date, few upgradings of metallic structures with APC plates, have been undertaken and generally these have not been published, therefore, a review of the practical applications of this technique to metallic structures is included, discussing some case histories.
Designing buildings for fire safety: a risk perspective
Authors: Bennetts I D , Thomas I R
Published: October 2002

This paper considers the basis of current regulation for fire safety. It recognizes that regulation and design of buildings for fire safety are both really about managing the risks associated with fire events. A picture of the range of fire events and their effects is presented from the available statistical data. It is found that fatalities in fire are associated with factors other than the behaviour of the building structure. Fire, by its nature, is quite different from other ‘loads’ for which buildings are designed. The various measures used to manage the risks associated with fire are presented and the effectiveness of these measures are discussed. The effects of fires in buildings are complicated, and various methods of assessing the associated risk have been developed. These methods are based on a number of assumptions that are not always recognized. Acts of destruction are then considered in comparison with the ‘normal’ range of fire events and the characteristics associated with extreme acts such as the World Trade Center attack are considered. It is recognized that these events fall well outside those currently envisaged. Risk management of fire events and acts of destruction is considered. Current fire‐safety measures are aimed at mitigating the risks associated with common acts of destruction in the form of arson. However, in the case of extreme acts of destruction, the most cost‐effective way to manage the risk is to prevent the occurrence of such events.
Context‐based compression of binary images in parallel
Authors: Ageenko Eugene , Forsell Martti , Fränti Pasi
Published: October 2002

Binary images can be compressed efficiently using context‐based statistical modeling and arithmetic coding. However, this approach is fully sequential and therefore additional computing power from parallel computers cannot be utilized. We attack this problem and show how to implement the context‐based compression in parallel. Our approach is to segment the image into non‐overlapping blocks, which are compressed independently by the processors. We give two alternative solutions about how to construct, distribute and utilize the model in parallel, and study the effect on the compression performance and execution time. We show by experiments that the proposed approach achieves speedup that is proportional to the number of processors. The work efficiency exceeds 50% with any reasonable number of processors. Copyright © 2002 John Wiley & Sons, Ltd.
Surgical Strategy in a Kindred with a Rare RET Protooncogene Mutation of Variable Penetrance with Regard to Multiple Endocrine Neoplasia
Authors: Colombo‐Benkmann Mario , Brämswig Jürgen , Höppner Wolfgang , Gellner Reinhold , Hengst Karin , Böcker Werner , Senninger Norbert
Published: October 2002

Prophylactic thyroidectomy is recommended for carriers of RET protooncogene mutations owing to their nearly complete penetrance for medullary thyroid carcinoma (MTC).
However, this guideline is challenged by mutations exhibiting variable penetrance of C‐cell pathology. A 38‐year‐old woman presented with pathologic basal and pentagastrin‐stimulated calcitonin levels. Genetic analysis revealed a heterozygous RET protooncogene germline mutation in codon 791 (exon 13)
(TATTyr?TTTPhe), followed by thyroidectomy and systematic central lymph node dissection. Histology showed C‐cell hyperplasia (CCH) only. Three additional carriers were identified among family members. The 71‐year‐old father refused surgery despite pathologic calcitonin levels. The index patient’s 37‐year‐old sister had normal basal and stimulated calcitonin levels, and her 6‐year‐old son had a 10‐fold rise of calcitonin after pentagastrin stimulation.
Both patients underwent the same operation as the index patient. The sister had 25 hyperplastic C‐cells, but the her son had extensive CCH without MTC. The eldest uncle of the index patient had died of metastatic MTC at the age of 52 with unknown carrier status.
Despite variable penetrance, each carrier of a RET protooncogene germline mutation should undergo thyroidectomy, even if basal and stimulated calcitonin levels are normal because at present no test can exclude or predict the age of development of MTC. Moreover,
pathologic calcitonin levels cannot differentiate between CCH and MTC.
Central lymph node dissection is recommended, as lymph node metastases occur early, significantly worsening the prognosis.
Assessment of Early Brain Damage in Carotid Endarterectomy: Evaluation of S‐100B Serum Levels and Somatosensory Evoked Potentials in a Pilot Study
Authors: Mussack Thomas , Biberthaler Peter , Geisenberger Thomas , Gippner‐Steppert Cornelia , Steckmeier Bernd , Mutschler Wolf , Jochum Marianne
Published: October 2002

The release of the neuronal protein S‐100B into the circulation has been suggested as an early indication of cellular brain damage. The objective of this prospective pilot study was to determine S‐100B serum levels in patients undergoing cross‐clamping during carotid endarterectomy (CEA) and to correlate the results with the monitoring of somatosensory evoked potentials (SSEP)
and the neurological short‐term outcome. Arterial blood samples of 21
patients were drawn before oral intubation, cross‐clamping, and unclamping, as well as before extubation and 6 hours later. Recording of SSEP was obtained during carotid occlusion and reperfusion. If loss of SSEP appeared, cerebral ischemia was assumed and an intraluminal shunt was placed. During cross‐clamping, S‐100B serum levels of 14
patients increased significantly from 0.05 ng/ml to 0.21 ng/ml, but returned to baseline levels after unclamping. In 5 cases, loss of SSEP amplitudes occurred but was reversed by the shunt insertion. No significant differences of S‐100B serum values, neurological examination, and carotid duplex surveillance became obvious in this group when compared to the patients with undisturbed SSEP. However, 2
patients with complete disappearance of postcentral SSEP components suffered from neurological deficits in the postoperative period. S‐100B serum levels remained highly elevated 6 hours after extubation (0.78
ng/ml and 0.41 ng/ml) compared to the baseline values (0.15 ng/ml and
0.07 ng/ml). During CEA a transitory increase of the S‐100B serum levels appears to present an impairment of the blood–brain barrier integrity without any neurological deficits. In contrast, persistently elevated S‐100B serum levels seem to be associated with transient loss of SSEP and development of neurological deficits.
Spigelian Hernias: Repair and Outcome for 81 Patients
Authors: Larson David W. , Farley David R.
Published: October 2002

Spigelian hernia is a rare partial abdominal wall defect. The frequent lack of physical findings along with vague associated abdominal complaints makes the diagnosis elusive.
A retrospective review of Mayo Clinic patients was performed to find all patients who had undergone surgical repair of a Spigelian hernia from 1976 to 1997. Patients were scrutinized for presentation, work‐up,
therapy, and outcome. The goal of this study was to obtain long‐term outcome. The study was set in a tertiary referral center. There were 76
patients in whom 81 Spigelian hernias were repaired. Symptoms most commonly included an intermittent mass (n = 29), pain
(n = 20), pain with a mass (n = 22),
and bowel obstruction (n = 5). Five patients were asymptomatic. Preoperative imaging was performed in 21 patients and correctly diagnosed the hernia in 15. Spigelian hernias were repaired by primary suture closure (n = 75), mesh
(n = 5), and laparoscopic (n = 1)
techniques. Eight patients (10%) required emergent operations.
Thirteen hernias (17%) were found to be incarcerated at the time of the operation. Overall mean follow‐up for the 76 patients was 8 years,
with three hernia recurrences identified. Spigelian hernia is rare and requires a high index of suspicion given the lack of consistent symptoms and signs. An astute physician may couple a proper history and physical examination with preoperative imaging to secure the diagnosis.
Mesh and laparoscopic repairs are viable alternatives to the durable results of standard primary closure. Given the high rate of incarceration/strangulation, the diagnosis of Spigelian hernia is an indication for surgical repair.
History of the ISS/SIC: Robert Danis, a True General Surgeon
Authors: Kinnaert Paul
Published: October 2002

Robert Danis created his Prize in 1947 to reward a surgeon‐member of the Société Internationale de Chirurgie (presently ISS‐SIC), "author of the most important and personal work in connection with surgical treatment of fractures."
Consequently, many people believe that Robert Danis was an orthopedic surgeon. In fact, he was a man interested in all fields of surgical activity, not only in bone and joint surgery.
Efficacy and Safety of Doxazosin for Perioperative Management of Patients with Pheochromocytoma
Authors: Prys‐Roberts Cedric , Farndon John R.
Published: October 2002

Despite adverse side effects, phenoxybenzamine has been widely used for the preoperative management of patients with pheochromocytoma. Doxazosin, a specific a 1‐adrenoceptor antagonist, has a pharmacologic profile more suited to controlling blood pressure in such patients. A sequential study of 35 patients with pheochromocytoma encompassed a definite and prescribed change in preoperative drug management from phenoxybenzamine to doxazosin. Hemodynamic, pharmacologic, and biochemical indicators of a‐ and b‐adrenoceptor blockade were measured before, during, and after anesthesia and surgery in 8 patients pretreated with phenoxybenzamine and 27 patients pretreated with doxazosin. Doxazosin (2–16 mg/day) was as effective as phenoxybenzamine in controlling arterial pressure and heart rate before and during surgery, but doxazosin caused fewer undesirable side effects both before and after surgery. Following phenoxybenzamine therapy substantial a 1‐adrenoceptor blockade, detected as a right shift of phenylephrine dose‐response curves, persisted for more than 2 days postoperatively, whereas after doxazosin it was undetectable on the first postoperative day. Doxazosin provided safe, efficacious pre‐ and perioperative control of arterial pressure. In patients with predominantly norepinephrine‐secreting tumors, pretreatment 24‐hour urinary norepinephrine excretion gave an indication of the daily doxazosin requirement.
Eosinophilic/T-Cell Chorionic Vasculitis
Authors: Fraser Robert B. , Wright James R.
Published: October 2002

Chorionic vasculitis is the hallmark of a fetal response in chorioamnionitis. There are five highly characteristic findings: (1) leukocyte migration is not concentric but rather radiates toward the infected amniotic fluid; (2) the infiltrate is primarily neutrophils; (3) multiple chorionic vessels, first veins and then arteries, are usually involved; (4) the infiltrate never extends into the vasculature of stem villi; and (5) it is rare in the absence of chorioamnionitis (or its precursors). Here we describe a new form of chorionic vasculitis characterized by an infiltrate composed primarily of eosinophils and CD3+ T lymphocytes that very focally involves a single chorionic vessel (artery or vein), that radiates away from the amniotic fluid (i.e., toward the intervillous spaces), and that may extend into the stem villous vasculature; this lesion occurs in the absence of any evidence of chorioamnionitis. During the past 7+ years, using accepted placental review criteria, we have examined 7104 placentas and identified 14 cases of eosinophilic/T-cell chorionic vasculitis (or related lesions). Although the frequency of diagnosis in the placentas examined was 0.197%, its true incidence cannot be estimated because of its very focal nature and the limited nature of placental disk sampling. Its etiology and significance are unknown, but it may represent a focal immune-mediated vasculitis.
Intravascular Inflammatory Myofibroblastic Tumors in Infancy
Authors: Sebire Neil James , Ramsay Alan , Sheppard Mary , Malone Marian , Harding Brian , Risdon Rupert Anthony
Published: October 2002

Inflammatory myofibroblastic tumor (IMT), previously described as inflammatory pseudotumor, can occur at any age but is a recognized soft tissue tumor of childhood. Less than 10 previous cases have been described of IMT affecting the heart, in patients ranging from 5 months to 17 years of age. We present three unusual, but similar, cases of IMT in infants, which were all predominantly intravascular in location, one of which was associated with death due to angiodestructive lesions of the coronary and cerebral arteries. These cases demonstrate an apparently distinct phenotype, with a predominant intravascular location of the tumor. Furthermore, this series highlights the difficulty in categorizing such lesions as benign versus malignant on histological grounds alone. IMT should be considered in the differential diagnosis of unusual pediatric intravascular spindle cell lesions.
Rhabdoid Tumor of the Kidney is a Component of the Rhabdoid Predisposition Syndrome
Authors: Lee Hwei-Yee , Yoon Chui-Shuen , Sevenet Nicolas , Rajalingam Vasanthi , Delattre Olivier , Walford Norman Q.
Published: October 2002

The rhabdoid predisposition syndrome (RPS) is characterized by pedigrees in which two or more individuals carry germline mutations of the hSNF5/INI1 tumor suppressor gene. The tumors associated with the syndrome include atypical teratoid/rhabdoid tumor (AT/RT), choroid plexus carcinoma, medulloblastoma, and extrarenal rhabdoid tumor. Rhabdoid tumor of the kidney (RTK) has not been described as part of the RPS. We report a case of a 7-month-old boy with RTK whose sister had a malignant cerebellar tumor followed by a malignant lung and pleural tumor of childhood with typical rhabdoid histology. Molecular genetic analysis of the RTK and tissue from the pleural tumor revealed in both cases identical nonsense mutations of the hSNF5/INI1 gene on chromosome 22q11.2, where thymidine was substituted for cytosine in base 472. The proband had an identical germline mutation. This is the fifth genetically analyzed RPS pedigree and the first to include an RTK.
Cyclooxygenase-2 Expression in Pediatric Sarcomas
Authors: Dickens David S. , Kozielski Rafal , Khan Javed , Forus Anne , Cripe Timothy P.
Published: October 2002

Therapies for metastatic pediatric sarcomas have reached maximum tolerated doses, but continue to provide suboptimal cure rates. Additionally, these treatments are associated with numerous short- and long-term side effects. Therefore, the search for newer, less toxic therapeutic agents is warranted. Overexpression of the inducible enzyme, cyclooxygenase-2 (COX-2), has been discovered in a variety of adult solid tumors and numerous studies have shown COX-2 inhibitors to have significant antiproliferative effects. Therefore, we sought to determine the expression of COX-2 in pediatric sarcomas. We evaluated rhabdomyosarcoma (RMS), osteosarcoma (OS), and Ewing sarcoma (EWS) samples for COX-2 expression by immunohistochemical analysis as well as by cDNA microarray analysis. COX-2 expression was detected in 48/58 (82.8%) tumors by immunohistochemistry and in an additional 52/59 (88.1%) tumors tested by microarray gene analysis. There was a trend toward increased COX-2 expression in metastatic rhabdomyosarcoma and osteosarcoma, though it did not reach clinical significance. The degree of COX-2 immunoreactivity did not vary significantly with other clinicopathologic features such as age, gender, or histologic classification. We conclude that the majority of these pediatric sarcoma samples express COX-2 to varying degrees. Therefore, studies testing the efficacy of COX-2 inhibitors in the treatment of pediatric sarcomas are warranted.
Inhibition of the human chemokine receptor CXCR4 by antisense phosphorothioate oligodeoxyribonucleotides
Authors: Kusunoki Akiko , Saitou Takeshi , Miyano-Kurosaki Naoko , Takaku Hiroshi
Published: October 2002

The CXC chemokine receptor CXCR4/fusion, a major coreceptor for the T‐cell line T‐tropic (X4) HIV‐1 virus, plays a critical role in T‐tropic virus fusion and entry into permissive cells. In the present study, we describe the effects of an antisense phosphorothioate oligodeoxyribonucleotide (anti‐S‐ODN) on the inhibition of CXCR4 gene expression in X4 HIV‐1 infected HeLa‐CD4 cells, to find more efficacious therapeutic possibilities for human immunodeficiency virus type 1 (HIV‐1) infection. The naked antisense phosphorothioate oligodeoxyribonucleotide (anti‐S‐ODN‐1), containing the AUG initiation codon at the center of the oligodeoxyribonucleotide, showed a slightly higher inhibitory effect on HIV‐1 gag p24 production among all sequences tested. We also examined the concomitant use of a basic peptide transfection reagent, nucleosomal histone proteins (RNP), for the delivery of the anti‐S‐ODN‐1. The anti‐S‐ODN‐1 encapsulated with RNP had higher inhibitory effects on p24 products than the naked anti‐S‐ODN‐1. When the anti‐S‐ODN‐1 encapsulated with RNP was incubated with HeLa‐CD4 cells, the surface levels of this chemokine receptor showed high suppression, indicating sequence‐specific inhibition. The activities of unmodified oligodeoxyribonucleotide are effectively enhanced by using a basic peptide, RNP.
Carbamoylphosphate requirement for synthesis of the active center of [NiFe]‐hydrogenases
Authors: Paschos Athanasios , Glass Richard S. , Böck August
Published: October 2002

The iron of the binuclear active center of [NiFe]‐hydrogenases carries two CN and one CO ligands which are thought to confer to the metal a low oxidation and/or spin state essential for activity. Based on the observation that one of the seven auxiliary proteins required for the synthesis and insertion of the [NiFe] cluster contains a sequence motif characteristic of O‐carbamoyl‐transferases it was discovered that carbamoyl phosphate is essential for formation of active [NiFe]‐hydrogenases in vivo and is specifically required for metal center synthesis suggesting that it is the source of the CO and CN ligands. A chemical path for conversion of a carbamoyl group into cyano and carbonyl moieties is postulated
Expansion of the zinc metallo‐hydrolase family of the β‐lactamase fold
Authors: Daiyasu Hiromi , Osaka Kazuya , Ishino Yoshizumi , Toh Hiroyuki
Published: October 2002

Recently, the zinc metallo‐hydrolase family of the β‐lactamase fold has grown quite rapidly, accompanied by the accumulation of sequence and structure data. The variety of the biological functions of the family is higher than expected. In addition, the members often have mosaic structures with additional domains. The family includes class B β‐lactamase, glyoxalase II, arylsulfatase, flavoprotein, cyclase/dehydrase, an mRNA 3′‐processing protein, a DNA cross‐link repair enzyme, a DNA uptake‐related protein, an alkylphosphonate uptake‐related protein, CMP‐N‐acetylneuraminate hydroxylase, the romA gene product, alkylsulfatase, and insecticide hydrolases. In this minireview, the functional and structural varieties of the growing protein family are described.
Stimulation of nuclear sphingosine kinase activity by platelet‐derived growth factor
Authors: Kleuser Burkhard , Maceyka Michael , Milstien Sheldon , Spiegel Sarah
Published: October 2002

Subcellular fractionation revealed that a significant fraction of total sphingosine kinase, the enzyme that phosphorylates sphingosine to form the bioactive lipid metabolite sphingosine‐1‐phosphate, resides in the nuclei of Swiss 3T3 cells, localized to both the nuclear envelope and the nucleoplasm. Platelet‐derived growth factor, in addition to rapidly stimulating cytosolic sphingosine kinase, also induced a large increase in nucleoplasm‐associated activity after 12–24 h that correlated with progression of cells to the S‐phase of the cell cycle and translocation of sphingosine kinase–green fluorescent protein fusion protein to the nuclear envelope. Our results add sphingosine kinase to the growing list of lipid‐metabolizing enzymes associated with the nucleus, and suggest that sphingosine‐1‐phosphate may also play a role in signal transduction in the nucleus.