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The author has considered trauma from the point of view of three main indices: frequency, gravity and average duration of incapacity of each patient in days. An important conclusion is made that further progressive replacement of manual labour by mechanized one will influence positively the basic indices of traumatism in timber industry.
The identification of Pseudomonas species in practice can be improved by testing the utilization of different organic compounds as single sources of carbon. The introduction of this kind of technique into routine laboratory work requires a simplification of the test system. In order to meet these requirements the methyleneblue reduction disc test (M.R.D.-test) had been developed. In this test discs loaded with different organic compounds are introduced into suspensions of the strain examined as single source of carbon. Before to these bacterial suspensions a mineral salts solution containing methyleneblue as a redox indicator had been added. With the help of this method the utilization of a large number of different organic compounds as single sources of carbon can be tested in a way which is neither laborious nor time consuming. The disc once prepared can be stored for some time, single strains can be tested without any difficulty as they are isolated during routine laboratory work.
We have worked out a simplification of the procedure described by Schmitz et al. (Biochim. Biophys. Acta (1973) 323, 98--112) for the preparation of brush border membranes from small intestine. The procedure ultimately adopted is simple, rapid, does not necessarily require scraping and can be started from fresh or frozen material. It can be scaled up easily, allowing a quick production of large amounts of brush border membrane vesicles. These vesicles prove to be excellently suited for transport studies, as suggested by our measurements of D-glucose transport. Using these vesicles, the mode of choline transport across the brush border membrane was also investigated. Choline transport was found to occur by a saturable component with a Km of 83 +/- 4 micrometer (at 20 degrees C) and by a non-saturable component. It is independent of the presence of Na+ and appears to be non-electrogenic.
The automated continuous flow system for the extraction and fluorimetric analysis of histamine based on the principle of Shore et al. (1959) has been improved. With lower consumption of reagents and further simplification of the working conditions, histamine can be determined quantitatively in a routine fashion in aqueous samples, with or without protein content, up to a concentration of approximately 0.1 ng/ml. The rate of analysis is 30 samples/h.
In order to obtain physical insight from a mathematical solution of the cochlear mechanics problem, a delicate balance is required between simplifications and refinements in modeling. For the study of the transition of long to short waves (deep-water waves) a closed-form solution is advantageous; this can, however, only be obtained at the cost of further simplification. In previous work the course of the impedance function z(x) was, therefore, reduced to the extreme: in the neighbourhood of the resonance location z(x) was assumed to be a linear function of x - the so-called 'straight-line approximation'. This restriction is removed in the present paper. A 'hyperbolical approximation' of the impedance function z(x) is introduced and it is shown that with this function the two-dimensional cochlea model can be solved in closed form. The computation results show that, for not too large values of the damping parameter delta, the response in the neighbourhood of the resonance location is almost as well represented by the formerly used 'straight-line approximation' as by the 'hyperbolic approximation'. Hence the principal aspects of cochlear resonance are well brought to light with the 'straight-line approximation'. This implies that in the case under consideration the dominant part played by short waves is confirmed. When a larger range of x values is to be considered, the hyperbolic approximation is advantageous. The computed response functions agree better with experimental data from the literature. However, it is clear that really satisfactory agreement seems not possible with a two-dimensional model.
The correction of the lower part of the septum serves the operation principle after Cottle. In the following work is a simplification shown to help discover the "Premaxilla-Area". Because of the possibility of mucous membrane perforation and irritation of the nasopalatinus nerve the building of an isolated inferior tunnel is purposely avoided. In any case the main aim is the least traumatical exposure of structures.
The spatial arrangement of coenzyme NAD+ in remote and adjacent binding sites in various stoichiometric complexes with tetrameric glyceraldehyde-3-phosphate dehydrogenase from rabbit muscle was examined via EPR spectroscopy. An adenosine N6-15N,2H17 spin-labeled derivative of coenzyme NAD+ (SL-NAD+) was chemically synthesized for this work. The spectral simplifications and narrow line widths afforded by 15N and 2H substitution enabled experimental EPR spectra to be deconvoluted into their three component spectra: (a) unbound coenzyme, (b) bound coenzyme without adjacent site occupied, and (c) bound coenzyme with adjacent site occupied. Binding of SL-NAD+ in adjacent active centers of R axis-related subunits resulted in resolved dipolar interactions which characterized intersubunit distances. Binding to distant subunits related by the P and Q axes gave no dipolar interaction. Once the first NAD+ site was occupied, EPR spectra at various stoichiometries provided evidence for nonpreferential spatial binding of SL-NAD+ to the three unoccupied sites. EPR spectral simulations indicated a separation of 12.8 A for the unpaired electrons of spin label moieties of R axis-related coenzymes. Molecular modeling based on x-ray crystallographic data predicted 11-13 A. The angles and distance relating to interacting spin-labels were calculated from atomic coordinates based on molecular modeling of both anti-anti and anti-syn (adenine-ribose) conformations of SL-NAD+. Computer-generated line shapes indicated best agreement with experimental EPR results when the anti-anti geometry was employed. Comparison of EPR spectra from soluble and ammonium sulfate-precipitated enzymes indicated that the NAD+-binding domains are positioned equivalently in the two physical states. Since the observed dipolar line shapes are critically dependent on the distance and geometry relating to the interacting SL-NAD+, these data provide direct evidence for a high degree of conservation of quaternary structure of the enzyme in the hydrated crystalline state. Studies on the enzyme isolated from human erythrocytes also indicated a close correlation with the rabbit muscle enzyme in both the arrangement of NAD+-binding domains and negative cooperativity of coenzyme binding.
The present discussion on the natural history, growth rate pathophysiology, morbidity, and possible treatment of benign prostatic hyperplasia (BPH) reinforces the need to objectify mechanical BPH-induced obstruction with pressure-flow study. Different methods for the quantification of BPH-induced obstruction exist and the grade of simplification depends on their working mechanism. To review the limitations of the current concepts, 118 BPH patients were selected for computerized pressure-flow data analysis according to quadratic passive urethral resistance relation (PURR) function. The CHESS classification differs from all other concepts due to its two-dimensional character and was developed as a result of the following way of thinking: (1) the whole individual pressure-flow plot is the most accurate basis for further analysis; (2) PURR as the true low-pressure flank of the individual plot is the most favorable definition for mechanical obstruction; (3) PURR quantification requires at least two parameters, footpoint and curvature/slope, with regard to the documented missing significant correlation of both; and (4) a two-parameter-based classification is two-dimensional (CHESS classification).
Cognitions (conceptual constructs) concerning treatment and compliance with treatment were investigated in 39 children with insulin-dependent diabetes mellitus (mean age, 13.8 +/- 3.0 years; duration of diabetes mellitus, 5.1 +/- 3.2 years). A structured interview and a scale exploring diabetes-related cognitions were administered to each child. Results were as follows: the complexity of treatment of IDDM was perceived as the main obstacle to compliance by 90% of subjects; despite adequate knowledge of the prescribed treatment regimen, the children had created a mental representation of what their treatment should be and were highly compliant to this subjective construction. Most of the complex elements of therapy (urine and blood glucose monitoring, diet) were partly eliminated, with the child developing an idiosyncratic therapeutic regimen with which he or she complied scrupulously. The impact of patient education could be improved by taking this tendency towards simplification into account and by working out with the child the most acceptable regimen capable of ensuring optimal metabolic control.
The linear-quadratic (LQ) dose-effect equation has been shown to be capable of providing a number of new insights into clinical radiotherapy. However, even in the most straightforward application of the formalism, i.e. to fractionated radiotherapy, the level of mathematics required to solve the associated equations could be a significant barrier to the wider application of the LQ method. In this paper it is shown that a wide range of problems arising in fractionated radiotherapy are capable of being analysed with the aid of one basic graph. It is further demonstrated that the extrapolated response dose, which forms the conceptual fulcrum of the LQ method is an additive quantity, and that the analysis of treatments involving several component parts can be simplified by using this property. The main features of these simplifications are demonstrated using some representative worked examples.
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The basic application provides essential data for ceramic veneer fabrication. Three-dimensional information divides the space for body and enamel components. The second body shade selection improves shade matching in the middle one-third of the tooth and enhances the appearance of the enamel component. Dentists are encouraged to recognize the influence each component has upon the total shade composition. A format is established for recording clinical information. The use of available ceramic systems is seemingly unlimited. The method presented provides flexibility for recording the most detailed shade information in simple graphic and verbal terms. Technical simplification is a by-product of complete, precise work information. Clinical judgements based on color and ceramic knowledge, as well as experience, can be conveniently converted into concise component descriptions. Using the suggested guidelines with reasonable care, a comfortable experience base for prescribing difficult shades can quickly develop.
Over the past few years considerable amount of clinical syndromes describing brain stem levels of lesion were reported. This work was undertaken to establish, if possible, a simplification of criterions of axial lesions in head injuries. 125 patients with severe head injuries were strictly selected. Statistical analysis of careful examination of clinical pattern was performed and correlated, when possible, with anatomical lesions. Only four homogeneous groups were isolated:--group I represents the cortico-sub-cortical level,--group II représents the diencéphalie level,--group III represents the upper brain stem level with two subdivisions dependent upon the mechanism of herniation : central or uncus,--group IV represents the lower brain stem level.
In the free standing center of ambulatory surgery of Nice, proctology with carbon dioxide laser is a basic activity. Among 177 cases of proctology operated during 1989, we find 91 hemorroïdectomies realized with CO2 laser in strictly ambulatory surgery (no hospitalisation). This work's interet is demonstrating adaptation to the laser makes many advantages to the classic operation of Milligan and Morgan: simplification of the surgical technique easy post-operative course, no hospitalisation and quicker return to work, leading to a lower cost of this pathology. Complications are rare and excellent results noted.
The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the provision of health care because it enables the decision-maker to compare the 'value' of different health care programmes and in a way which, potentially at least, reflects social preferences about the appropriate pattern of provision. The index depends on a combination of a measure of morbidity and the risk of mortality. Methodological debate has tended to concentrate on the technicalities of producing a scale of health; and philosophical argument has concentrated on the ethics of interpersonal comparison. There is little recognition of the fragility of the theoretical assumptions underpinning the proposed combination of morbidity and risk of mortality. The context in which the proposed indices are being developed is examined in Section 2. Whilst most working in the field of health measurement eschew over-simplification, it is clear that the application of micro-economics to management is greatly facilitated if a single index can be agreed. The various approaches to combining morbidity and mortality are described in Section 3. The crucial assumptions concern the measurement and valuation of morbidity; the procedures used for scaling morbidity with mortality; and the role of risk. The nature of the valuations involved are examined in Section 4. It seems unlikely that they could ever be widely acceptable; the combination with death and perfect health poses particular problems; and aggregation across individuals compounds the problem. There are also several technical difficulties of scaling and of allowing for risk which have been discussed elsewhere and so are only considered briefly in Section 5 of this paper.(ABSTRACT TRUNCATED AT 250 WORDS)
In previous work the antitumoral cytotoxicity of beta-nitrostyrenes obtained by simplification of the aristolochic acid molecule was demonstrated. The effect of modifying the three characteristic parts of the beta-nitrostyrene molecule has now been investigated. The results obtained in vitro and in vivo allow hypothesis of a mechanism of action for the various beta-nitrostyrene and nitrovinyl compounds studied and definition of the maximum simplification compatible with retention of biological activity.
Issuing from a possibility of classification of tumour-associated antigens (TAA), corresponding to themodern state of recognition, the present situation of the immunological tumour diagnostics is discussed. The direct proof of tumour-associated antigens in the blood or in other body fluids, as one of the fundamental possibilities, is hitherto practically matured only for the alpha-fetoprotein and in this case only contribute to the diagnostics of liver carcinomas and malignant teratoblastomas. The determination of the carcinoembryonal antigen (CEA) in the serum or plasm has at present no essential diagnostic significance, may however, be used for the control of the therapeutic effect of cancer of the colon, rectum as well as the stomach. It is reserved for prospective studies to estimate the valency of the determination of CEA or fetal sulphoglycoproteid antigen in the gastric juice for the recognition of early carcinomas of the stomach. At present the proof of an immune response of the tumor carrier to TAA in vitro seems to be more favourable as a second way of the immunological tumour diagnostics. Sensitivity as well as specificity might here at first higher be estimated, when they are theoretically established. Whereas the inhibition test of leucocyte migration and technically similar variants in apparently sufficient specifity have an insufficient sensitivity and thus give too many falsely negative results the mobility test of the electrophoresis of macrophages in the modification of the immunological tumour profile distinguishes itself by a high certainty and by evidence on the probable localisation of the organ and the primary tumour (up to now verified for the cancer of colon and rectum, carcinomas of the stomach). Apart from the research of further principles, however, even for this test technological simplifications are to be found, before a broader use in routine work becomes practicable.
In the present work the immune adherence hemagglutination test (IAHA) was standardized in a simplified procedure. This test showed good reproducibility, better than the classical mice serum neutralization test (SN). The tests showed high correlation degree: high titers in one test corresponded to high titers in the other one, and the same occurred with low titers. The IAHA test is extremely simple, fast to perform, and of low cost when compared to tests such as SN or indirect immunofluorescence (IIF). It also proved to be useful in less sophisticated laboratories or even as a screening test for the titration of rabies antibodies.