The frustrations of coronary stenting.
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By perturbing a G(o) model toward a realistic protein Hamiltonian by adding non-native interactions, we find that the folding rate is in general enhanced as ruggedness is initially increased, as long as the protein is sufficiently large and flexible. Eventually, the rate drops rapidly toward zero when ruggedness significantly slows conformational transitions. Energy landscape arguments for thermodynamics and kinetics are coupled with a treatment of non-native collapse to elucidate this effect.
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Many types of tumors (e.g. virus-induced tumors, melanomas, tumors over-expressing certain oncogenes) often express antigens that can induce T-cell-mediated tumor-specific immune responses. Nonetheless, many such tumors manage to circumvent the induction of an effective anti-tumor T-cell response, as is apparent from the many tumor-bearing patients. Therefore, optimally designed vaccination protocols may evoke a more powerful and competent T-cell-mediated anti-tumor response, allowing the host to effectively deal with at least some cancers. These vaccination approaches might include immunization with whole (tumor) cell-based vaccines, entire tumor antigens or selected T-cell epitopes derived from tumor antigens. This survey is an update of several anti-tumor vaccination approaches employed, and on novel possibilities to target the anti-tumor immune response to preselected tumor-derived T-cell epitopes.
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A study was undertaken to assess the evaluation and treatment of chronic intractable rectal pain. Sixty consecutive patients, 23 males and 37 females with a mean age of 69 (range, 29-87) years and a mean length of symptoms of 4.5 years, were evaluated by questionnaire, office examination, anal manometry, electromyography, cinedefecography, and pudendal nerve study. In all cases, organic abdominopelvic and anorectal etiologies for the pain were excluded by extensive radiologic and endoscopic evaluation. All patients had failed conservative and medical therapy. Ninety-five percent of patients had one or more associated factors: constipation or dyschezia (57 percent), prior pelvic surgery (43 percent), prior anal surgery (32 percent), prior spinal surgery (8 percent), irritable bowel syndrome (10 percent), or psychiatric disorders (depression or anxiety; 25 percent). Possible etiologies for the pain included levator spasm or anismus in 62 percent, coccygodynia in 8 percent, and pudendal neuropathy in 24 percent of patients. Therapy for pain control included electrogalvanic stimulation (EGS) in 29, biofeedback (BF) in 14, and steroid caudal block (SCB) in 11 patients. Pain control was assessed by an independent observer at a mean of 15 (range, 2-36) months after completion of therapy. Continued successful pain relief was classified by patients as good or excellent after EGS in 38 percent, after BF in 43 percent, and after SCB in 18 percent; overall success was reported by 47 percent of patients. The presence of levator spasm, coccygodynia, or pudendal neuropathy did not influence outcome. The routine use of physiologic investigation of rectal pain may not be justifiable. Moreover, more than half of the patients were refractory to all three therapeutic options used in this study.
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"This article describes the migration context of three sets of Western democracies and then explores plausible linkages between the scale, timing, and characteristics of migration, and the substance and process of migration policies, on the one hand, and support for government, on the other. Trying to move beyond plausibility, I discuss indirect indicators of the impact of immigration on Western publics: attitudes toward immigration policy and immigrants, support for extremist parties, and acts of violence and disorder linked to anti-immigrant or racist motives."
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Shortly after William Heberden published his original description of the clinical features of angina pectoris in 1772, he received an intriguing letter from an unnamed physician who suffered from the disease. The case of "Dr. Anonymous" is significant as the earliest account of ischemic heart disease clearly associated with ventricular arrhythmias. This astute observer not only predicted his own sudden death, but also offered his body in the benevolent hope that autopsy correlation would contribute to the understanding of the cause of angina pectoris.
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