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Computer evidence concerning the chemotactic signal in Dictyostelium discoideum.

Observed pulsatile aggregation of cellular slime mould amoebae is simulated on a computer. One spatial dimension is considered. In the simulation, attractant is rapidly secreted by the cells, after a delay period, when a superthreshold attractant concentration is sensed. Cells are refractory to further signals after secretion. Once secreted, the attractant diffuses and is hydrolysed. Movement results if a cell's extending pseudopods sense a supercritical increase of attractant; if increases are sensed on both sides, a sufficiently large difference can also initiate movement. The movement continues for a period independently of further signals, but then can be reversed by a attractant increase (at the back of the cell) that surpasses a high threshold. After 100s, motion stops and the threshold for movement reverts to normal. With the above rules, and with parameter values taken, as far as possible, from the literature, the simulation provides the observed pattern of aggration. Outward moving waves of attractant and organized inward pulsatile 'steps' of cell movement surround a cell that sevretes autonomously every few minutes. Other rules fail to give this picture, or give it only for a relatively narrow range of parameter values. It appears that of the various possible signals for chemotaxos, the most likely to be used by the amoebae is a temporal increase of attractant as sensed by extending pseudopods. Nonetheless, we connot rule out the 'classical' hypothesis that cells directly sense concentration differences.

Cell Aggregation↗

[Therapeutic results of colposcopically controled collection of cervix tissue in atypical smears of women up to the age of 35 years].

The case series consists of 106 women consecutively collected during 1968 to 1973 from those with a vaginal smear belonging to Papanicolou's groups III and attending the gynaecological department in Umeå. Probably the series is a fair random sample of the population (congruent to 150,000 people) of the area served by the clinic. The extension of the colposcopically delimited atypical transformation zone (with its upper bordèrline against normal cervical villi) in most cases being small, the surgical procedure--a small cone congruet to ring biopsy--was accordingly insignificant. In 9 cases only a large conization was performed. As only a small part of the cervical tissue was usually removed it is probable that the enzymatic and mechanical properties of the cervix as well as its capacity as a sperm reservoir could be preserved. The median of the observation time is 26 months, range 3 months to 5 years. At the follow up the colposcopic and histological picture has so far shown no sign of atypia in 91 subjects. The same applies cytologically to the patients subjected to a large conization. Two women have moved away from the district. A relapse occurred in 4 patients, who after a large conization have remained cytologically negative. Throughout the investigation the term a typia has been used to characterize the cytological, colposcopic and histological changes, the degree and extension of this atypia being taken into considertion. Thus the abstruse nomenclature in common use is avoided. Cytological atypia is cellular in character, while histologically it includes the degree of structural derangement of the epithelial architecture as well. Colposcopically the angioarchitecture and the capillary distance seem to be the most important features. The correlation between the colposcopic and the cytological and histological findings is high when the degree of atypia is marked. It is inferred, therefore, that the descriptive term atypia should replace the superfluos bulk of terms in the fields in question.

Colposcopy↗

[Preliminary application of functional magnetic resonance imaging to neurosurgery].

BACKGROUND & OBJECTIVE: Motor functional deficit may be caused by surgery resection of brain tumors around the central sulcus. This study was to evaluate the application of functional magnetic resonance imaging (fMRI) to neurosurgery through identifying motor hand functional cortex and depicting the relationship between the cortex and tumor with fMRI before surgery. METHODS: Routine MRI and fMRI were performed on 31 patients with brain tumor around the central sulcus. Of the 31 cases of brain tumor, 10 were metastases, 11 were gliomas, 6 were meningiomas, 2 were arterial-venal malformation (AVM), and 2 were arachnoid cysts. fMRI was performed using FFE-EPI sequence. Sixteen continuent slices with 4 mm thickness and 0 gap parallel to bicommissural line were scanned during the rest, and actions of opening and closing of hand were imaged. A total of 1,280 functional original pictures and statistical Z-score maps were obtained. RESULTS: The activation areas of motor hand functional cortex were showed in all patients except 2 whose heads moved obviously during the scanning. The minimal distance between the functional cortex and tumor was measured. There were 3 types of activation of motor hand functimal cortex, including activation spots in or near the tumor, deformation and shift of cortex activation area, normal shape and location of cortex activation area. Other activation areas in different places of brain in individual patients were also appeared. CONCLUSION: fMRI may help to identify the relationship between the brain tumors near central sulcus and the location of motor hand functional cortex, therefore, provide reference for neurosurgery.

Adolescent↗

Hemoglobin Suan-Dok (alpha 2 109 (G16) Leu replaced by Arg beta 2): an unstable variant associated with alpha-thalassemia.

An abnormal hemoglobin variant was detected in a seven-year old Thai girl. The clinical and hematological pictures were indistinguishable from hemoglobin H disease. Upon cellulose acetate electrophoresis at pH 8.5 an abnormal hemoglobin variant was found together with hemoglobins A and H. The variant moved slightly behind HbF and amounted to approximately 9%. Globin chain synthesis studies of peripheral blood reticulocytes incubated with tritiated leucine revealed that the total radioactivity ratio alpha-chain + variant alpha-chain/beta-chain was 0.59, while the ratio variant alpha-chain/beta-chain was 0.12. The variant hemoglobin was somewhat unstable under heat denaturation and in the isopropanol test. Structural studies by component isolation, globin chain separation, peptide mapping and aminoacid analysis of abnormal peptides showed that the leucine residue 109 of the alpha-chain was replaced by arginine. This hemoglobin mutant has not been described before and is named Hemoglobin Suan-Dok.

Adult↗

[Pathogenetic interpretation of left ventricle obstruction in hypertrophic obstructive myocardiopathy].

Nine patients affected from IHSS have been studied by 2D-echocardiography examination. Following detected pictures the Authors try to explain the pathogenesis of the dynamic obstruction of the L.V. The Authors conclude ascribing it to the postero-medial papillary muscle that move abnormally towards the IVS. Instead the SAM could be ascribed to the chordee of the mitral value, but these are considered unable to obstruct L.V. The differences between SAM and L.V. obstruction are underlined and discussed.

Cardiomegaly↗

[Deep subacute accidental hypothermia. A case with an unusual clinical picture and course].

A case of a patient with core temperature of 24.4 degrees C, presenting an unusual clinical picture, is described. A 68 year-old man was found outdoors after being exposed to five to eight hours of coldness. He was found awake, with dry clothes and an alcohol foetor. After eight hours the serum ethanol was measured as 6 mmol/l. He could not speak but was able to move all four extremities. A sinus bradycardia of 23 beats per minute was present but no other arrhythmia was seen. The temperature rose to 31.2 degrees C within four hours and body temperature was normal after 10 hours. The only treatment given was passive rewarming with blankets and 2.5 l isotonic NaCl warmed to 40 degrees C given intravenously. This clinical picture supports the assumption that ethanol protects the myocardium against arrhythmias in deep hypothermia.

Aged↗

MOTION PICTURE STUDIES ON DEGRANULATION OF HORSE EOSINOPHILS DURING PHAGOCYTOSIS.

Horse eosinophil function has been studied in vitro by means of phase contrast cinemicrophotography. Locomotion of horse eosinophils was inhibited by serum factors reacting with glass surfaces. Under appropriate conditions which eliminated this inhibitory effect, eosinophils moved about and ingested some particles as rapidly as did neutrophils. Eosinophils were attracted to and readily engulfed such diverse materials as yeast cell walls, foreign erythrocytes, and antigen-antibody precipitates. Specific antibody was required for phagocytosis of red cells, and greatly accelerated the uptake of yeast cell walls. Horse eosinophil granules situated adjacent to material being engulfed disrupted with discharge of granule contents into or alongside the phagocytic vacuole. Granule disruption resulted in a clear zone and deposition of amorphous, phase-dense material. A heat-labile serum factor was required for degranulation of eosinophils ingesting foreign red cells, but not for degranulation during engulfment of yeast cell walls or antigen-antibody precipitates. Horse eosinophils were incapable under these conditions of engulfing an entire human red cell. The eosinophil commonly put out a large pseudopod to surround about half the red cell, and then appeared to constrict this pseudopod distally to cut the erythrocyte in half. It is concluded that eosinophils are phagocytic cells, resembling neutrophils in many of their properties. Any specific functions of eosinophils, distinguishing them from other phagocytes, remain to be discovered.

Animals↗

Microanatomy of the structures contributing to abdominal cutaneous nerve entrapment syndrome.

BACKGROUND: Family physicians commonly see patients who complain of abdominal pain, the cause of which cannot be readily diagnosed. Often this pain results from abdominal cutaneous nerve entrapment syndrome. METHODS: Photomicrographs were obtained of the pertinent structures of the ninth thoracolumbar nerve where it passes through the rectus muscle channel. Standard hematoxylin and eosin staining techniques were used after the paraffin autopsy tissue block was positioned to show the entire length of the rectus neurovascular bundle from anterior to posterior surfaces of the muscle (anatomically front to back). Gomori trichrome staining with aniline blue was also done to differentiate further the connective tissue structures. RESULTS: The photomicrographs presented here support the first author's earlier clinical and gross anatomic findings, especially regarding the fibrous ring in the rectus muscle, through which the neurovascular bundle travels. Special attention is given to the rectus fibrous ring, which is so important in producing the syndrome of abdominal cutaneous nerve entrapment. This structure is clearly delineated, and its role in the pathophysiology of this syndrome is described. CONCLUSIONS: Three pictures presented here show the relevant microstructures involved in abdominal cutaneous nerve entrapment syndrome. The photomicrographs confirm the existence of a fibrous ring within which the neurovascular bundle can move freely. If this bundle is pushed or pulled too far from behind or in front, however, compression of the bundle against the ring causes nerve ischemia and symptoms of abdominal cutaneous nerve entrapment. Family physicians can save their patients unnecessary pain and expense by being aware of this syndrome.

Abdominal Muscles↗

Clinical picture and management of subperiosteal hematoma of the orbit.

A subperiosteal hematoma was seen in a 14-year-old boy following a blow to his head during a car accident. The involved orbit exhibited exophthalmus and inability of the eye to move above the horizontal. X-rays revealed a hairline fracture of the skull and a hemotympanum was found on the injured side. A subperiosteal hematoma of the orbital roof was suspected. Needle aspiration of the blood from the orbital hematoma resulted in an almost immediate cure of all orbital and occular problems.

Accidents, Traffic↗

The prediction of variability occurring in fluidized bed coating equipment. II. The role of nonuniform particle coverage as particles pass through the spray zone.

The purpose of this work was to evaluate the relative importance of particle circulation and particle-to-particle mass coating distribution on the overall mass coating distribution obtained in a Wurster process. A series of batch coating experiments was carried out over a range of operating conditions, in order to evaluate the particle-to-particle variation in the mass distribution of coating material deposited during batch coating operations. Results showed that the major component of variance was due to the variation in the amount of coating received per particle per pass through the spray zone. The variation in the number of times a particle passed through the spray zone was considerably less important. Two models were developed to explain the results of the experimental program. The first model categorized particles moving through the spray zone as either receiving coating or not. Thus, the distribution of coating material per particle per pass is described by a Bernoulli probability distribution. Using this picture of the spray process, the number of particles receiving coating during any given pass through the spray zone was found to vary between 2 and 6%. A second model was developed to explain the major cause of variation. This model explains the variation in terms of the hindering or sheltering effect that particles close to the source of the spray have on particles farther away. Although the agreement of model predictions with experimental results is only fair, it is believed that this model captures the main cause of particle-to-particle variation occurring in batch coating operations and thus is the first model to explain this phenomenon.

Technology, Pharmaceutical↗

The role of the ECHO model in outcomes research and clinical practice improvement.

In the articles that follow in this Special Report supplement to The American Journal of Managed Care, the reader will note that various types of outcomes--humanistic and economic, as well as clinical--are measured to achieve a balanced picture of the comprehensive impact of the healthcare interventions implemented. Clinical research has only recently evolved to a state in which a balanced-systems approach to outcomes measurement is moving to the forefront. It is therefore important to understand the historical context of the outcomes movement within which the multidimensional approach developed. A description of this historical context is provided below, followed by an overview of the ECHO (Economic, Clinical, and Humanistic Outcomes) Model and case examples of the balance-of-outcomes model as implemented in a large integrated delivery system.

Delivery of Health Care, Integrated↗

Quantitative methods in diagnostic gynaecological pathology.

In gynaecological pathology it is often useful to analyse the histological pattern quantitatively. To enable the results to be generally useful certain criteria should be fulfilled--the observations should be reproducible by other pathologists in a consistent manner and should be able to be validated. Some methods of assessing the relevant features of a section, such as pattern grading, are very subjective and do not readily conform to these criteria. Mitosis counting is perhaps somewhat more objective than pattern grading but there is considerable overlap in the counts as one moves along the clinical grade, say from benign to malignant, making it necessary to analyse other features in parallel. Using stereological methods of pattern analysis, many features of the histological pictures can be analysed simultaneously with a high degree of objectivity and accuracy. Significant features of the pattern can then be identified by discriminant multivariate analysis.

DNA, Neoplasm↗

The development of vision in the zebrafish (Danio rerio).

We studied the development and maturation of the visual system by determining when zebrafish begin to see and to move their eyes. This information was correlated with the time courses of the development of the retina, the retinofugal projection, the retinal image, and the extraocular muscles, to obtain an integrated picture of early visual development. Two visual behaviors were monitored over 48-96 hr postfertilization (hpf). The startle response (body twitch) was evoked by an abrupt decrease in light intensity. The optokinetic response (tracking eye movements) was evoked by rotation of a striped drum. Visually evoked startle developed over 68-79 hpf, more than 20 hr after the onset of a touch-evoked startle. It was not seen in eyeless fish, excluding a role for nonretinal light senses. Tracking eye movements developed over 73-80 hpf. They were always in the direction of drum rotation, even when the fish had been light deprived from blastula stage, ruling out a "trial and error" period of learning to track the drum. The image formed by the ocular lens was examined in intact fish made transparent by suppressing the formation of melanin. The eye was initially far sighted and gradually improved, so that by 72 hpf the image plane coincided with the photoreceptor layer. The extraocular muscles assumed their adult configuration between 66 and 72 hpf. Thus, the retinal image and functional extraocular muscles appeared nearly simultaneously with the onset of tracking eye movements and probably represent the last events in the construction of this behavior.

Animals↗

The strategy to be "paperless" via a cost-effective filmless plan.

The group of folks assigned to the project were identified, and on April 23, 2001, an Request For Information (RFI) was released to 11 preidentified Picture Archiving Communication System (PACS) vendors. Our project was unique in 2 respects. First, there was an aggressive timeline. Second there was specific outpatient environment requirements. There was a need to move images and other patient-related data between several sites while depending heavily on the Wide Area Network (WAN) design rather than the typical Local Area Network (LAN) configuration. We learned quickly that there was not one live site, at which we could visit to observe our vision in action, nor had any solution been built to accomplish our specific objectives. The months of May, June, and July consisted of vendor meetings, RFI response reviews and, clinical and corporate visits ending on August 9, 2001 when our prime vendor of choice was selected. During this process, we identified deal breakers outlining specific needs for "go live," which is targeted for Q2 (2nd Quarter) 2002. The biggest workflow opportunity is to be paperless as well as filmless. By this we not only mean traditional RIS information but also patient documents (insurance information, physician script) as well as modality-patient-specific information. All of this information needs to be available electronically to accomplish) any patient record, any place, any time! The month of August was filled with WAN and LAN solution investigations. The solution of choice will be both cost effective and challenged to achieve 99.9% reliability. A cost-benefit analysis was performed and reviewed to better understand our return on investment. The months of September and October have been dedicated to Computerized Radiography (CR) technology. The TEAM reviewed 3 solutions, which consisted of both sit-down sessions as well as clinical site assessments. Again, "deal breaker" criteria were summarized and a solution chosen. Contract negotiations will soon conclude, and an aggressive implementation will begin!

Ambulatory Care Facilities↗

Multiple brain networks for visual self-recognition with different sensitivity for motion and body part.

Multiple brain networks may support visual self-recognition. It has been hypothesized that the left ventral occipito-temporal cortex processes one's own face as a symbol, and the right parieto-frontal network processes self-image in association with motion-action contingency. Using functional magnetic resonance imaging, we first tested these hypotheses based on the prediction that these networks preferentially respond to a static self-face and to moving one's whole body, respectively. Brain activation specifically related to self-image during familiarity judgment was compared across four stimulus conditions comprising a two factorial design: factor Motion contrasted picture (Picture) and movie (Movie), and factor Body part a face (Face) and whole body (Body). Second, we attempted to segregate self-specific networks using a principal component analysis (PCA), assuming an independent pattern of inter-subject variability in activation over the four stimulus conditions in each network. The bilateral ventral occipito-temporal and the right parietal and frontal cortices exhibited self-specific activation. The left ventral occipito-temporal cortex exhibited greater self-specific activation for Face than for Body, in Picture, consistent with the prediction for this region. The activation profiles of the right parietal and frontal cortices did not show preference for Movie Body predicted by the assumed roles of these regions. The PCA extracted two cortical networks, one with its peaks in the right posterior, and another in frontal cortices; their possible roles in visuo-spatial and conceptual self-representations, respectively, were suggested by previous findings. The results thus supported and provided evidence of multiple brain networks for visual self-recognition.

Adolescent↗

Exploring the effects of population mobility on cervical screening coverage.

London has the lowest cervical screening coverage in England and in 1998/1999 accounted for 11 of the 13 health authorities that fell below the national 80% coverage target. There are several factors which may contribute to the difference in coverage between the capital and the rest of the country. London's population is much more diverse, there is greater deprivation and there are well-established structural differences in primary care. London has high levels of population mobility which will also affect the ability of GPs to achieve high population coverage. This paper explores the possible size of the effect that population mobility is likely to have on coverage of the cervical screening programme in London. The analysis estimates the size of 'missing populations' that may not receive an invitation for a smear test, or artificially inflate the list size of registered patients. A simple model suggests that in some London Health Authorities up to 14% of residents, and 11% of patients on GP lists, may miss out on invitations for screening as a result of population mobility. Moreover the large differences between list and resident populations in some areas mean that the current government target of 80% coverage of the registered population will be largely unattainable for many London Health Authorities and Primary Care Trusts. Moving towards a resident-based system, whereby the numbers screened are related to the number of residents, avoids some of the problems associated with list inflation and gives a fairer picture of coverage of the eligible population.

Adult↗