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Posters as an educational strategy.

Posters are visual aids that are well suited to use as independent sources of information or as support for other presentation formats. By design, the message displayed is brief, constant, and interactive with the viewer. Guidelines for developing a poster include careful delineation of content, knowledge of audience needs, and the environment or setting for the poster. The application of basic design elements, such as simplicity of composition, attractive color combinations, and title spacings, results in a presentation mode that is both attracting and lingering.

Audiovisual Aids↗

A HISTORICAL MEDICAL COLLECTION, AND SOME OF THE PROBLEMS IT PRESENTS.

The organization of a historical collection in a medical library presents many problems. Among these are space limitations, choice of material to be included, and classification. This paper discusses the organization of the historical collection particularly as it relates to books and journals in the Rudolph Matas Medical Library of Tulane University. The problem of classification is discussed at length. The principal classification systems are reviewed, particularly that of the National Library of Medicine Classification. The expansion of the NLM scheme to suit our purpose is presented. This includes classifying Americana imprints by subject rather than state, changing the termination date of Americana to 1900, grouping the history of specialties with books on the history of medicine, and recognizing the problem involved in reclassifying books on military medicine and surgery. The selection and arrangement of periodicals relating to the history of medicine is also discussed.

Book Classification↗

The hepatic extracellular matrix. I. Components and distribution in normal liver.

The unique nature of the hepatic extracellular matrix (ECM) is predicated by the special configuration of the space of Disse. Whereas other epithelial organs have two basement membranes (BM) and a substantial ECM interposed between endothelial and epithelial cells, the liver lobule has no BM and only an attenuated ECM, consisting mostly of fibronectin, some collagen type I, and minor quantities of types III, IV, V, and VI. This configuration, together with the abundant fenestrations and gaps of the sinusoidal endothelial cells, seems ideally suited to facilitate the rapid bidirectional exchange of macromolecules normally taking place between plasma and hepatocytes. During organogenesis, the liver anlage is vascularized by continuous capillaries with BM, but by day 13.5 of development (in the rat) the vessels in the immediate proximity of hepatocytes become fenestrated, lacking specialized junctions and BM, suggesting that the hepatocytes produce signals capable of modulating the endothelial phenotype. In regeneration, hepatocyte proliferation precedes vascular proliferation resulting in the formation of hepatocyte clusters that, temporarily, lack sinusoids. Eventually, vascular proliferation follows and the normal hepatocyte-vascular relationships are restored. During this period laminin synthesis by Ito cells is prominent. As soon as hepatocytes become stable, secretion of the sinusoid phenotype-maintaining factors resumes and laminin synthesis and secretion terminates. The interplay between extracellular matrix and liver cells is essential for normal homeostasis and its modification results in deranged hepatic function.

Adult↗

Local bupivacaine-epinephrine infiltration combined with general anesthesia for adult tonsillectomy.

CONCLUSION: Use of a solution of bupivacaine (5 mg/ml)-epinephrine (5 microg/ml) (BE) is beneficial in reducing intraoperative bleeding and decreasing the operation time in adult (adeno)tonsillectomy patients. OBJECTIVE: Pain and intra- and postoperative bleeding are problems associated with tonsillectomy/adenotonsillectomy. In order to make tonsillectomy/adenotonsillectomy better suited to outpatient surgery, solutions to these problems should be found. One possibility may be the combination of local and general anesthesia. The aim of this study was to find out if such a combination is beneficial in tonsillectomy/adenotonsillectomy. MATERIAL AND METHODS: We performed a prospective, randomized, double-blind, controlled study on 64 adult (adeno)tonsillectomy patients to investigate the possible benefits of infiltrating the peritonsillar space with a BE solution. RESULTS: In the recovery room, the BE group experienced less pain than a control group infiltrated with saline; subsequently there was no significant difference between the groups concerning pain. The average volume of intraoperative bleeding and the operation time were significantly smaller in the BE group. Postoperative bleeding from the tonsillar fossae occurred in 19% (6/31) of the patients in the BE group and in 18% (6/33) in the saline group.

Adenoidectomy↗

1-Mb resolution array-based comparative genomic hybridization using a BAC clone set optimized for cancer gene analysis.

Array-based comparative genomic hybridization (aCGH) is a recently developed tool for genome-wide determination of DNA copy number alterations. This technology has tremendous potential for disease-gene discovery in cancer and developmental disorders as well as numerous other applications. However, widespread utilization of a CGH has been limited by the lack of well characterized, high-resolution clone sets optimized for consistent performance in aCGH assays and specifically designed analytic software. We have assembled a set of approximately 4100 publicly available human bacterial artificial chromosome (BAC) clones evenly spaced at approximately 1-Mb resolution across the genome, which includes direct coverage of approximately 400 known cancer genes. This aCGH-optimized clone set was compiled from five existing sets, experimentally refined, and supplemented for higher resolution and enhancing mapping capabilities. This clone set is associated with a public online resource containing detailed clone mapping data, protocols for the construction and use of arrays, and a suite of analytical software tools designed specifically for aCGH analysis. These resources should greatly facilitate the use of aCGH in gene discovery.

Cell Line, Tumor↗

Hardware-assisted visibility sorting for unstructured volume rendering.

Harvesting the power of modern graphics hardware to solve the complex problem of real-time rendering of large unstructured meshes is a major research goal in the volume visualization community. While, for regular grids, texture-based techniques are well-suited for current GPUs, the steps necessary for rendering unstructured meshes are not so easily mapped to current hardware. We propose a novel volume rendering technique that simplifies the CPU-based processing and shifts much of the sorting burden to the GPU, where it can be performed more efficiently. Our hardware-assisted visibility sorting algorithm is a hybrid technique that operates in both object-space and image-space. In object-space, the algorithm performs a partial sort of the 3D primitives in preparation for rasterization. The goal of the partial sort is to create a list of primitives that generate fragments in nearly sorted order. In image-space, the fragment stream is incrementally sorted using a fixed-depth sorting network. In our algorithm, the object-space work is performed by the CPU and the fragment-level sorting is done completely on the GPU. A prototype implementation of the algorithm demonstrates that the fragment-level sorting achieves rendering rates of between one and six million tetrahedral cells per second on an ATI Radeon 9800.

Algorithms↗

A mutational analysis of Caenorhabditis elegans in space.

The International Caenorhabditis elegans Experiment First Flight (ICE-First) was a project using C. elegans as a model organism to study the biological effects of short duration spaceflight (11 days in the International Space Station). As a member of the ICE-First research team, our group focused on the mutational effects of spaceflight. Several approaches were taken to measure mutational changes that occurred during the spaceflight including measurement of the integrity of poly-G/poly-C tracts, determination of the mutation frequency in the unc-22 gene, analysis of lethal mutations captured by the genetic balancer eT1(III;V), and identification of alterations in telomere length. By comparing the efficiency, sensitivity, and convenience of these methods, we deduced that the eT1 balancer system is well-suited for capturing, maintaining and recovering mutational events that occur over several generations during spaceflight. In the course of this experiment, we have extended the usefulness of the eT1 balancer system by identifying the physical breakpoints of the eT1 translocation and have developed a PCR assay to follow the eT1 chromosomes. C. elegans animals were grown in a defined liquid media during the spaceflight. This is the first analysis of genetic changes in C. elegans grown in the defined media. Although no significant difference in mutation rate was detected between spaceflight and control samples, which is not surprising given the short duration of the spaceflight, we demonstrate here the utility of worms as an integrating biological dosimeter for spaceflight.

Animals↗

The hepatic extracellular matrix. II. Ontogenesis, regeneration and cirrhosis.

The unique nature of the hepatic extracellular matrix (ECM) is predicted by the special configuration of the space of Disse. Whereas other epithelial organs have two basement membranes (BM) and a substantial ECM interposed between endothelial and epithelial cells, the liver lobule has no BM and only an attenuated ECM, consisting mostly of fibronectin (FN), some collagen type I, and minor quantities of types III, IV, V, and VI. This configuration, together with the abundant fenestrations and gaps of the sinusoidal endothelial cells, seems ideally suited to facilitate the rapid bidirectional exchange of macromolecules normally taking place between plasma and hepatocytes. During organogenesis, the liver anlage is vascularized by continuous capillaries with BM, but by day 13.5 of development (in the rat) the vessels in the immediate proximity of hepatocytes become fenestrated, lacking specialized junctions and BM, suggesting that the hepatocytes produce signals capable of modulating the endothelial phenotype. In regeneration, hepatocyte proliferation precedes vascular proliferation resulting in the formation of hepatocyte clusters that, temporarily, lack sinusoids. Eventually, vascular proliferation follows and the normal hepatocyte-vascular relationships are restored. During this period laminin synthesis by Ito cells is prominent. As soon as hepatocytes become stable, secretion of the sinusoid phenotype-maintaining factors resumes and laminin synthesis and secretion terminates. The interplay between extracellular matrix and liver cells is essential for normal homeostasis and its modification results in deranged hepatic function.

Animals↗

Confocal microscopic analysis of morphogenetic movements.

Confocal microscopy is an excellent means of imaging cellular dynamics within living zebrafish embryos because it provides a means of optically sectioning tissues that have been labeled with specific fluorescent probe molecules. In order to study genetically encoded patterns of cell behavior that are involved in the formation of germ layers and various organ primordia, it is possible to vitally stain an entire zebrafish embryo with one or more fluorescent probe molecules and then examine morphogenetic behaviors within specific cell populations of interest using time-lapse confocal microscopy. There are two major advantages to this "bulk-labeling" approach: (1) the applied fluorescent probe (a contrast-enhancing agent) allows all of the cells within an intact zebrafish embryo to be rapidly stained; (2) the morphogenetic movements and shape changes of hundreds of cells can then be examined simultaneously in vivo using time-lapse confocal microscopy. The neutral fluorophore Bodipy 505/515 and its sphingolipid-derivative Bodipy-C5-ceramide are particularly useful, nonteratogenic vital stains for imaging cellular dynamics in living zebrafish embryos. These photostable fluorescent probes (when applied with 2% DMSO) percolate through the enveloping layer epithelium of the embryo, and localize in yolk-containing cytoplasm and interstitial space, respectively, owing to their different physiochemical characteristics. Bodipy-ceramide, for instance, remains highly localized to interstitial fluid once it accumulates within a zebrafish embryo, allowing the boundaries of deep cells to be clearly discerned throughout the entire embryo. Through the use of either of these fluorescent vital stains, it is possible to rapidly convert a developing zebrafish embryo into a strongly fluorescent specimen that is ideally suited for time-lapse confocal imaging. For zebrafish embryos whose deep cells have been intentionally "scatter-labeled" with fluorescent lineage tracers (e.g., fluorescent dextrans), sequential confocal z-series (i.e., focus-throughs) of the embryo can be rendered into uniquely informative 3D time-lapse movies using readily available image-processing programs. Similar time-lapse imaging, combined with rapidly advancing computer-assisted visualization techniques, may soon be applied to study the dynamics of GFP-fusion proteins in vivo, as well as other types of synthetic probe molecules designed to reveal the cytological processes associated with the patterning and morphological transformations of the zebrafish's embryonic tissues.

Animals↗

When conversation is better than computation.

While largely ignored in informatics thinking, the clinical communication space accounts for the major part of the information flow in health care. Growing evidence indicates that errors in communication give rise to substantial clinical morbidity and mortality. This paper explores the implications of acknowledging the primacy of the communication space in informatics and explores some solutions to communication difficulties. It also examines whether understanding the dynamics of communication between human beings can also improve the way we design information systems in health care. Using the concept of common ground in conversation, proposals are suggested for modeling the common ground between a system and human users. Such models provide insights into when communication or computational systems are better suited to solving information problems.

Communication↗

Undersampling correction for array detector-based satellite spectrometers.

Array detector-based instruments are now fundamental to measurements of ozone and other atmospheric trace gases from space in the ultraviolet, visible, and infrared. The present generation of such instruments suffers, to a greater or lesser degree, from undersampling of the spectra, leading to difficulties in the analysis of atmospheric radiances. We provide extended analysis of the undersampling suffered by modern satellite spectrometers, which include the Global Ozone Monitoring Experiment, Scanning Imaging Absorption Spectrometer for Atmospheric Chartography, Ozone Monitoring Instrument, and Ozone Mapping and Profiler Suite. The analysis includes basic undersampling, the effects of binning into separate detector pixels, and the application of high-resolution Fraunhofer spectral data to correct for undersampling in many useful cases.

Journal Article↗

Photomodulation of conformational states. I. Mono- and bicyclic peptides with (4-amino)phenylazobenzoic acid as backbone constituent.

The thioredoxin reductase active-site fragment H-Ala-Cys-Ala-Thr-Cys-Asp-Gly-Phe-OH [134-141], which is known for its high tendency to assume an almost identical conformation as in the intact enzyme, was backbone cyclized with the photoresponsive (4-amino)phenylazobenzoic acid (APB) to produce a monocyclic and disulfide-bridged bicyclic APB-peptide. Light-induced reversible cis/trans isomerization occurs at identical extents in both the linear and the two cyclic forms. Nuclear magnetic resonance conformational analysis clearly revealed that in the bicyclic APB-peptide both as a trans- and cis-azo-isomer the constraints imparted by the bicyclic structure do not allow the molecule to relax into a defined low energy conformation, thus making the molecule a frustrated system that flip-flops between multiple conformational states. Conversely, the monocyclic APB peptide folds into a well-defined lowest energy structure as a trans-azo-isomer, which upon photoisomerization to the cis-azo configuration relaxes into a less restricted conformational space. First femtosecond spectroscopic analysis of the dynamics of the photoreaction confirm a fast first phase on the femtosecond time scale related to the cis/trans isomerization of the azobenzene moiety followed by a slower phase in the picosecond time scale that involves an adjustment of the peptide backbone. Due to the well- defined photoresponsive two-state transition of this monocyclic peptide molecule, it represents a model system well suited for studying the ultrafast dynamics of conformational transitions by time-resolved spectroscopy.

Aminobenzoates↗

Transabdominal ultrasound measurement of the lumbar spinal canal. Its value for evaluation of lumbar spinal stenosis.

Lumbar spinal stenosis, most commonly caused by hypertrophic changes in the soft tissues of the spinal canal, is itself a clinical entity, but in the early phase it can also serve as a factor influencing general back disorder morbidity. It can be identified reliably by measuring the anteroposterior diameter of the dural sac on myelography films and/or the transverse area of the dural sac on computed tomography (CT) scans. In the present study, 76 patients with general back disorders were examined with ultrasound (US) transabdominally through the intervertebral disc. In those 50 patients (66%) in which all three of the lowest lumbar intervertebral spaces could be visualized, the measurements made by US differed by +/- 5 mm from those obtained by myelography and +/- 25 mm2 from those made by CT. In a subset of ten patients with spinal stenosis, US was able to demonstrate the small size of the dural sac, but the cause of the stenosis could not be reliably evaluated. In addition to diagnosing central spinal stenosis, ultrasonography is also well suited for screening purposes.

Abdomen↗

Three-dimensional computed tomographic reformation of the spine, skull, and brain from axial images.

Three-dimensional (3D) images were reconstructed from axial computed tomographic scans using the new 3D83 (General Electric Co.) software. Images were reformatted as a movie in multiple frames, each consisting of a discrete 3D scene, and were rotated 360 degrees in 3D space. Improvement in shading and surface algorithm has been made from the previous 3D82 program so that 3D images now have a realistic appearance. Soft tissue and bone modes are available; the latter reconstructs best in 3D because of its high density pixels, which provide a more exclusive threshold. 3D reconstructions of the spine were the most rewarding because the complex anatomy of the spine seems to be best suited for 3D imaging. By hemisection of the spine by subregion, the intervertebral foramina can be evaluated for stenosis. Some drawbacks in this program are the need for user interaction, the lengthy time of reconstruction, and the dependence on high quality axial images.

Brain↗

Crystallization and preliminary X-ray data for the A-isozyme of O-acetylserine sulfhydrylase from Salmonella typhimurium.

The A-isozyme of O-acetylserine sulfhydrylase, a pyridoxal phosphate-dependent enzyme isolated from Salmonella typhimurium catalyzes the synthesis of L-cysteine from O-acetyl-L-serine and sulfide. The pyridoxal form of the enzyme has been crystallized in two different forms. One form is in the orthorhombic space group P2(1)2(1)2(1) with cell constants a = 144.4 A, b = 96.9 A and c = 54.3 A and contains two monomers each of molecular weight 34,000 per asymmetric unit. The second form is in a hexagonal space group with unit cell dimensions a = b = 115 A, and c = 348 A and contains two 68,000 dimers per asymmetric unit. Complete native enzyme data sets have been collected for both crystal forms using an R-Axis II detector. A search for suitable heavy-atom derivatives is underway. Although both crystal forms diffract X-rays to better than 2.5 A, the orthorhombic form is more suited to a detailed structural analysis due to the extended lifetime in the X-ray beam and the relative size of the unit cell.

Crystallization↗

New alcohol dehydrogenases for the synthesis of chiral compounds.

The enantioselective reduction of carbonyl groups is of interest for the production of various chiral compounds such as hydroxy acids, amino acids, hydroxy esters, or alcohols. Such products have high economic value and are most interesting as additives for food and feed or as building blocks for organic synthesis. Enzymatic reactions or biotransformations with whole cells (growing or resting) for this purpose are described. Although conversions with whole cells are advantageous with respect to saving expensive isolation of the desired enzymes, the products often lack high enantiomeric excess and the process results in low time-space-yield. For the synthesis of chiral alcohols, only lab-scale syntheses with commercially available alcohol dehydrogenases have been described yet. However, most of these enzymes are of limited use for technical applications because they lack substrate specificity, stability (yeast ADH) or enantioselectivity (Thermoanaerobium brockii ADH). Furthermore, all enzymes so far described are forming (S)-alcohols. Quite recently, we found and characterized several new bacterial alcohol dehydrogenases, which are suited for the preparation of chiral alcohols as well as for hydroxy esters in technical scale. Remarkably, of all these novel ADHs the (R)-specific enzymes were found in strains of the genus Lactobacillus. Meanwhile, these new enzymes were characterized extensively. Protein data (amino acid sequence, bound cations) confirm that these catalysts are novel enzymes. (R)-specific as well as (S)-specific ADHs accept a broad variety of ketones and ketoesters as substrates. The applicability of alcohol dehydrogenases for chiral syntheses as an example for the technical use of coenzyme-dependent enzymes is demonstrated and discussed in this contribution. In particular NAD-dependent enzymes coupled with the coenzyme regeneration by formate dehydrogenase proved to be economically feasible for the production of fine chemicals.

Alcohol Dehydrogenase↗

[Ultrasound evaluation of the acromioclavicular joint--a correlation of anatomical and sonographical findings].

AIM: To compare ultrasound imaging to the anatomy of the acromioclavicular joint. METHODS: 13 cadaveric acromioclavicular joints were examined by ultrasound (11 MHz linear array transducer) to determine the limits of the joint capsule and the width of the joint space. The results were compared to macroscopic sections. RESULTS: Anatomical variations were observed. The joint space of one specimen was completely filled by fibrous tissue, leaving 12 specimens for a complete study. A hypoechoic meniscoid disc was attached to the superior joint capsule, resulting in a convex curvature of the cranial part. The mean sonographic width of the joint space was 3.9 mm +/- 1.7 mm standard deviation (SD). The mean distance of the joint capsule from the articular bone rim of the clavicle, the acromion, and from the middle of the joint space was 1.1 +/- 1.0 mm, 1.3 +/- 0.7 mm, and 2.1 +/- 0.9 mm, respectively. The distance from the joint space to the capsular insertion on the clavicle and on the acromion was 4.4 +/- 1.4 mm and 5.3 +/- 2 mm, respectively. The mean difference between ultrasound and anatomical measurements in the vertical (cranio-caudal) plane was 0.5 +/- 0.5 mm (SD), whereas the mean difference between measurements in the horinzontal (medio-lateral) plane was 1.3 +/- 1.1 mm (SD). CONCLUSION: Due to low cost, safety and wide availability, sonography is suited for the evaluation of the acromioclavicular joint. However, when interpreting the results, errors in measuring, limitations in resolution of the system used, and the anatomy of the acromioclavicular joint and its anatomical variants have to be taken into consideration.

Acromioclavicular Joint↗

[Magnetic resonance tomographic diagnosis of periarticular cystic space-occupying lesions in the knee joint].

The MR images of the knee joint of 100 successively examined patients were evaluated in retrospect with regard to periarticular cystic lesions. There were 18 popliteal cysts, 8 meniscal cysts and 4 ganglion cysts. Localisation and internal structure of the lesions were of main importance in respect of differential diagnosis. All meniscal cysts were associated with horizontal meniscal tears. Spin-echo and 3D gradient-echo images did not enable differentiation because of signal intensity values. A spin-echo sequence with long repetition time in double-echo technique was best suited to assess the periarticular cystic lesions as well as the intraarticular pathological changes which were often concomitant.

Adult↗