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Radial artery harvesting has been routinely performed by endoscopy. We present a reduced cost technique using a reusable retractor and thermal welding shears. The combination of reusable and disposable tools allows patients to benefit from endoscopic radial artery harvesting with decreased morbidity and favorable cosmetic results.
Polycyclic aromatic hydrocarbons (PAHs) adsorbed to ambient PM(10) were determined at three sites in Thessaloniki, northern Greece, during the period June 1997-July 1998. Ambient PAH profiles exhibited significant seasonal and spatial variations. Source PAH profiles were obtained for a number of urban, industrial and geological sources including cement, fertilizer and asphalt production, quarry operations, metal electroplating, metal welding and tempering, steel manufacture, lead and bronze smelters, metal scrap incineration, oil burning, non-catalyst equipped passenger cars, diesel fueled taxies and buses, paved road dust and soil dust. Principal component analysis (PCA) and diagnostic ratios were employed to compare ambient and source PAH profiles in an attempt to recognize compositional patterns. Similarities between the ambient PAH profiles and the profiles of certain sources, such as vehicular emissions, oil burning and metal industries, were identified.
An injection moulded free flow isotachophoresis (FFITP) microdevice with integrated carbon fibre loaded electrodes with a separation chamber of 36.4mm wide, 28.7 mm long and 100 microm deep is presented. The microdevice was completely fabricated by injection moulding in carbon fibre loaded polystyrene for the electrodes and crystal polystyrene for the remainder of the chip and was bonded together using ultrasonic welding. Two injection moulded electrode designs were compared, one with the electrode surface level with the separation chamber and one with a recessed electrode. Separations of two anionic dyes, 0.2mM each of amaranth and acid green and separations of 0.2mM each of amaranth, bromophenol blue and glutamate were performed on the microdevice. Flow rates of 1.25 ml min(-1) for the leading and terminating electrolytes were used and a flow rate of 0.63 ml min(-1) for the sample. Electric fields of up to 370 V cm(-1) were applied across the separation chamber. Joule heating was not found to be significant although out-gassing was observed at drive currents greater than 3 mA.
OBJECTIVES: The aim of the present study was to investigate the composition, morphology, bulk structure and ionic release of two brands of titanium orthodontic brackets: Orthos2 (Ormco, USA) and Rematitan (Dentaurum, Germany). METHODS: Five specimens of each group were examined with computerized X-ray microtomography, to reveal the morphology and structure of brackets, whilst resin-embedded and metallographically polished specimens were subjected to SEM/EDS analysis and Vickers microhardness measurements. Brackets were also maintained in 0.9% saline for 2 months and the ionic release in the immersion medium was determined with Inductively Coupled Plasma Atomic Emission Spectroscopy. The results of the hardness and ionic release measurements were statistically analyzed with two-way ANOVA and Tukey's test (alpha = 0.05). RESULTS: Orthos2 brackets consisted of two parts, the base (commercially pure Ti grade II) and the wing (Ti-6Al-4V alloy), joined together by laser welding, producing large gaps along the base-wing interface. The base was of lower hardness (Hv = 145), than the wing (Hv = 392) and incorporated a standard foil base-mesh pad. Rematitan brackets consisted of commercially pure Ti grade IV, with a single-piece manufacturing pattern of virtually identical hardness (p > 0.05) at the base and wings, featuring a laser-etched base-mesh pad. The hardness of the Rematitan brackets was significantly lower than the hardness of the Orthos2 wings, but double the hardness of the Orthos2 base. Released Ti levels were below the threshold level (1 ng/ml) of analysis for both materials, whilst traces of Al (3 ppm) and V (2 ppm) were found in the immersion media for Ti-6Al-4V alloy. SIGNIFICANCE: The structural and hardness differences found may influence the torque transfer characteristics from activated archwires to the brackets and the crevice corrosion potential at the base-wing interface (Orthos2). The detection of Al and V in the immersion medium (Orthos2) may imply a different biological response from the two types of Ti brackets.
Radon gas concentrations have been monitored as part of the operation of a tunnel (the Exploratory Studies Facility-ESF) at Yucca Mountain to ensure worker safety. The objective of this study was to examine the potential use of the radon data to estimate large-scale formation properties of fractured tuffs. This objective was examined by developing a numerical model, based upon the characteristics of the ESF and the Topopah Spring welded (TSw) tuff unit, capable of predicting radon concentrations for prescribed ventilation conditions. The model was used to address two specific issues. First, it was used to estimate the permeability and porosity of the fractures in the TSw at the length scale of the ESF and extending tens of meters into the TSw, which surrounds the ESF. Second, the model was used to understand the mechanism leading to radon concentrations exceeding a specified level within the ESF. The mechanism controlling radon concentrations in the ESF is a function of atmospheric barometric fluctuations being propagated down the ESF along with ventilated air flow and the slight suction induced by the ventilation exhaust fans at the South Portal of the ESF. These pressure fluctuations are dampened in the TSw fracture continuum according to its permeability and porosity. Consequently, as the barometric pressure in the ESF drops rapidly, formation gases from the TSw are pulled into the ESF, resulting in an increase in radon concentrations. Model calibration to both radon concentrations measured in the ESF and gas-phase pressure fluctuations in the TSw yielded concurrent estimates of TSw fracture permeability and porosity of 1 x 10(-11) m2 and 0.00034, respectively. The calibrated model was then used as a design tool to predict the effect of adjusting the current ventilation-system operation strategy for reducing the probability of radon gas concentrations exceeding a specified level.
The Integrative Action of the Nervous System by the British physiologist Charles Sherrington was published 100 years ago. Its goal was to explain how the nervous system welds a collection of disparate body parts and organs into a unified individual. Sherrington postulated that the reflex is the simplest unit of nervous integration. He introduced the concept of the synapse as the site where elementary reflexes interact to enable more complex and unified behavior and argued that a synaptic nervous system facilitated the evolution of the cerebrum and cerebellum. The concept of the synapse as a physiological entity provided a theoretical schema into which the richly varied phenomenology of nineteenth century reflex physiology could be assimilated. Sherrington's book also provided the conceptual framework for a century of research into the mechanisms of synaptic transmission and the neuronal discharges associated with perception and action.
PROBLEM: Eye injury is currently a leading cause of visual impairment and monocular blindness in the United States. Information regarding consumer products associated with eye injuries can have important implications for the prevention of these injuries. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to describe the types of consumer products associated with emergency department treated eye injuries in the United States from 1998 through 2002. RESULTS: The leading product type associated with eye injuries was welding equipment followed by household cleaners, basketball equipment, workshop equipment, and adhesives. Eye injuries attributed to hardware, tools, construction, sports, toys, and lawn equipment were more common among males. In females, eye injuries attributable to chemicals, housewares, storage and organization, and bed and bath items were more common. Differences were also apparent across the age spectrum. CONCLUSION: This study identified specific products and categories of products frequently associated with eye injury and prevention initiatives should focus on these items. IMPACT ON INDUSTRY: This study has identified consumer products associated with eye injuries requiring medical treatment in the United States. Manufacturers of these products could be encouraged to add or strengthen safety messages regarding the potential for eye injury.
BACKGROUND: Chylous ascites is the accumulation of triglyceride-rich, free, milk-like peritoneal fluid caused by the presence of intestinal lymph in the abdominal cavity. Primary chylous ascites is uncommon. We present our experience in the diagnosis and treatment of this condition. METHODS: Twelve patients (7 adults, 5 children) affected by primary chylous ascites were studied. Diagnostic investigations included abdominal sonography scans, lymphoscintigraphy, and lymphography combined with computed tomography (CT) with intravenous and intralymphatic lipid-soluble contrast, and laparoscopy. Magnetic resonance imaging was used when lymphography and lymphatic CT were not able to define the dysplasia well, or in the presence of lymphatic dilatation. Surgical treatment included laparoscopy (12/12), drainage of ascites (12/12), the search for and treatment of abdominal and retroperitoneal chylous leaks (12/12), exeresis of lymphodysplastic tissues (12/12), ligation of incompetent lymph vessels (9/12), carbon dioxide laser treatment (cut and welding effects) of the dilated lymph vessels using an operating microscope for magnification (9/12), and chylovenous and lymphovenous microsurgical shunts (7/12). RESULTS: Eight patients did not have a relapse of the ascites, and three patients had a persistence of a small quantity of ascites with no protein imbalance. Postoperative lymphoscintigraphy in seven patients confirmed better lymph flow and less lymph reflux. Median follow-up was 5 years (range, 3 to 7 years). We observed early relapse of chylous ascites in only one case that required a peritoneal-jugular shunt and led to good outcome. CONCLUSION: Primary chylous ascites is closely correlated to lymphatic-lymphonodal dysplasia that does not involve a single visceral district alone. Medical preoperative treatment played an essential role in the global management of this complex pathology. We demonstrated that the use of laparoscopy is remarkably advantageous for confirming diagnosis, for draining the ascites, and for evaluating the extension of the dysplasia. Our diagnostic work-up provided us with an exact diagnostic assessment and allowed us to plan a precise surgical approach.
Freezing of prokaryotic and eukaryotic microorganisms is the main interest in the study of cold stress responses of living organisms. In parallel, applications which arise from this approach are of two types: (i) optimization of the frozen starters used in food processing; and (ii) improvement of the ex situ preservation of microorganisms in collections. Currently, cryopreservation of microorganisms in collections is carried out in cryotubes, and bibliographical references related to freezing microorganisms packaged in straws are scarce. In this context, a preliminary study was completed to evaluate the technological potential of ionomeric resin straws compared to polycarbonate cryo-tubes. Survival under freezing stress was tested on three microorganisms selected for their biotechnological interest: two lactic acid bacteria, Lactococcus lactis subsp. cremoris and Lactobacillus delbrueckii subsp. bulgaricus and a deuteromycete fungus, Geotrichum candidum. The stress was carried out by repeated freezing-thawing cycles to artificially accelerate the lethal effect of freezing on the microorganisms. Two main results were obtained: (i) the survival rate values (per freezing-thawing cycle) seems to depend on the thermal type of the studied microorganism, and (ii) there was no, under our experimental conditions, significant difference between straws and tubes. However, conservation in the resin straws lead to a slight increase in the survival of L. cremoris and G. candidum compared to microtubes. In those conditions, straws seems an alternative system to securely store frozen microorganisms with three main characteristics: (i) a high resistance to thermal stress, (ii) a safe closing by hermetic weld, and (iii) a system for inviolable identification.
Human exposure to highly nickel-polluted environments, such as those associated with nickel refining, electroplating, and welding, has the potential to produce a variety of pathologic effects. Among them are skin allergies, lung fibrosis, and cancer of the respiratory tract. The exact mechanisms of nickel-induced carcinogenesis are not known and have been the subject of numerous epidemiologic and experimental investigations. These mechanisms are likely to involve genetic and epigenetic routes. The present review provides evidence for the genotoxic and mutagenic activity of Ni(II) particularly at high doses. Such doses are best delivered into the cells by phagocytosis of sparingly soluble nickel-containing dust particles. Ni(II) genotoxicity may be aggravated through the generation of DNA-damaging reactive oxygen species (ROS) and the inhibition of DNA repair by this metal. Broad spectrum of epigenetic effects of nickel includes alteration in gene expression resulting from DNA hypermethylation and histone hypoacetylation, as well as activation or silencing of certain genes and transcription factors, especially those involved in cellular response to hypoxia. The investigations of the pathogenic effects of nickel greatly benefit from the understanding of the chemical basis of Ni(II) interactions with intracellular targets/ligands and oxidants. Many pathogenic effects of nickel are due to the interference with the metabolism of essential metals such as Fe(II), Mn(II), Ca(II), Zn(II), or Mg(II). Research in this field allows for identification of putative Ni(II) targets relevant to carcinogenesis and prediction of pathogenic effects caused by exposure to nickel. Ultimately, the investigations of nickel carcinogenesis should be aimed at the development of treatments that would inhibit or prevent Ni(II) interactions with critical target molecules and ions, Fe(II) in particular, and thus avert the respiratory tract cancer and other adverse health effects in nickel workers.
Titanium dioxide is frequently used in the production of paints, paper, plastics, welding rod-coating material, and cosmetics, because of its low toxicity. However, recent studies have shown that nano-sized or ultrafine TiO(2) (UF-TiO(2)) (<100 nm in diameter) can generate pulmonary fibrosis and lung tumor in rats. Cytotoxicity induced by UF-TiO(2) in rat lung alveolar macrophages was also observed. This generates great concern about the possible adverse effects of UF-TiO(2) for humans. The cytotoxicity and genotoxicity of UF-TiO(2) were investigated using the methyl tetrazolium cytotoxicity (MTT) assay, the population growth assay, the apoptosis assay by flow cytometry, the cytokinesis block micronucleus (CBMN) assay, the comet assay, and the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene mutation assay. WIL2-NS cells were incubated for 6, 24 and 48 h with 0, 26, 65 and 130 microg/ml UF-TiO(2). Significant decreases in viability were seen in the MTT assay at higher doses; for example, 61, 7 and 2% relative viability at 130 microg/ml for 6, 24 and 48-h exposure (P<0.01). A dose-dependent relationship was observed, while a time-dependent relationship was seen only at the highest dose (130 microg/ml) after exposure for 24 and 48 h. Treatment with 130 microg/ml UF-TiO(2) induced approximately 2.5-fold increases in the frequency of micronucleated binucleated cells (P<0.01). In addition, a significant reduction in the cytokinesis block proliferation index was observed by the CBMN assay (P<0.05). In the comet assay, treatment with 65 microg/ml UF-TiO(2) induced approximately 5-fold increases in olive tail moment (P<0.05). In the HPRT mutation assay, treatment with 130 microg/ml UF-TiO(2) induced approximately 2.5-fold increases in the mutation frequency (P<0.05). The results of this study indicate that UF-TiO(2) can cause genotoxicity and cytotoxicity in cultured human cells.
The hypothesis that neurotoxins may play a role in neurodegenerative disorders remains an elusive one, given that epidemiologic studies often provide conflicting results. Although these conflicting results may result from methodological differences within and between studies, the complexity of chemical disruption of the central nervous system cannot be ignored in attempts to evaluate this hypothesis in different neurodegenerative disorders. Spencer provides a detailed review of the complex processes involved in defining the neurotoxic potential of naturally occurring and synthetic agents. Even concepts such as exposure and dose, as often reported in studies attempting to evaluate the risk imparted by a potential compound, can be deceptive. For example, although dose reflects "that amount of chemical transferred to the exposed subject", factors such as time and concentration in the organism, the ability to access the central nervous system, and how a compound reaches the central nervous system (routes of administration) or secondarily affects other organ systems leading to central nervous system disruption are clearly important to the concept of neurotoxic risk in neurodegenerative disorders. These factors would appear to explain the observed disagreements between studies using animal or neuronal models of neurotoxicity and population-based studies in humans. The importance of these factors and how a potential neurotoxin is investigated are clearly seen in the data on AD and aluminum. In contrast, the impact of MTPT on the central nervous system is more direct and compelling. Added complexity in the study of neurotoxins in human neurodegeneration is derived from data showing that agents may have additive, potentiating, synergistic, or antagonistic effects. Therefore, data from studies evaluating EMF risks could be readily confounded by the presence or absence of heavy metals (eg, arc welding). Other factors that may conceal neurotoxic causes for a given disorder focus on additional features such as genetic predispositions, physiologic changes that occur in aging, and even nutritional status that can support or hinder the affect of a given agent on the central nervous system. Finally, many studies that investigate exposure risk do not readily incorporate the five criteria proposed by Schaumburg for establishing causation. For example, if we apply Schaumburg's first criterion, epidemiologic studies often determines the presence of an agent through history, yet they cannot readily confirm exposure based on environmental or clinical chemical analyses to fulfill this criterion for causation. Additional limitations in research design along with the populations and methods that are sued to study neurotoxins in human neurodegenerative disorders often fail to meet other criteria such as linking the severity and onset with duration and exposure level. Therefore, although studies of agents such as MTPT provide compelling models of neurotoxins and neurodegeneration in humans, disorders such as ALS, PD, and particularly AD will require additional effort if research is to determine the contribution (presence or absence) of neurotoxins to these neurologic disorders.
We have used a structural equation model (SEM) to analyze the interrelationships among exposure markers, magnetic resonance imaging (MRI) signal index, and neurobehavioral effects. Based on exposure groups, we assessed blood manganese, MRI measurements of pallidal index (PI), and neurobehavioral core test battery (WHO-NCTB) on 111 male workers occupationally exposed to manganese, including welders, smelter workers, and welding rod manufacturing workers. Latent variables were constructed to represent the neurobehavioral effects in an integrated way. The structural equation model revealed that airborne manganese and blood manganese contribute to PI significantly. Manganese exposure in the ambient air may lead to an increase in the internal dose, not only indirectly, by increasing blood manganese level, but also directly, independent of blood concentration. PI significantly contributed to a decrease in neurobehavioral test scores. We found that airborne manganese contributed to PI, and that PI is the most effective predictor of neurobehavioral performance, after adjusting for age and level of education. In conclusion, PI on MRI reflects target organ dose of occupational manganese exposure.
The manganese (Mn) research health program (MHRP) symposium was a full day session at the 22nd International Neurotoxicology Conference. Mn is a critical metal in many defense and defense-related private sector applications including steel making and fabrication, improved fuel efficiency, and welding, and a vital and large component in portable power sources (batteries). At the current time, there is much debate concerning the potential adverse health effects of the use of manganese in these and other applications. Due to the significant use of manganese by the Department of Defense, its contractors and its suppliers, the Manganese Health Research Program (MHRP) seeks to use the resources of the federal government, in tandem with manganese researchers, as well as those industries that are involved with manganese, to determine the exact health effects of manganese, as well as to devise proper safeguard measures for both public and private sector workers. Humans require manganese as an essential element; however, exposure to high levels of this metal is sometimes associated with adverse health effects, most notably within the central nervous system. Exposure scenarios vary extensively in relation to geographical location, urban versus rural environment, lifestyles, diet, and occupational setting. Furthermore, exposure may be brief or chronic, it may be to different types of manganese compounds (aerosols or salts of manganese with different physical and/or chemical properties), and it may occur at different life-stages (e.g., in utero, neonatal life, puberty, adult life, or senescence). These factors along with diverse genetic composition that imposes both a background and disease occurrence likely reflect on differential sensitivity of individuals to manganese exposure. Unraveling these complexities requires a multi-pronged research approach to address multiple questions about the role of manganese as an essential metal as well as its modulation of disease processes and dysfunction. A symposium on the Health Effects of Manganese (Mn) was held on Wednesday, September 14, 1005, to discuss advances in the understanding on role of Mn both in health and disease. The symposium was sponsored by the Manganese Health Research Program (MHRP). This summary provides background on the MHRP, identifies the speakers and topics discussed at the symposium, and identifies research needs and anticipated progress in understanding Mn health- and disease-related issues.
Manganese (Mn), an element found in many foods, is an important and essential nutrient for proper health and maintenance. It is toxic in high doses, however, and exposure to excessive levels can result in the onset of a neurological disorder similar to, but distinct from, Parkinson's disease. Historically, Mn neurotoxicity was most commonly associated with various occupations, such as Mn mining, welding and steel production. More recently, increases in both blood and brain Mn levels have been observed in persons with liver disease or those receiving prolonged parenteral nutrition. Additionally, rodent data suggest that iron deficiency and anemia may be risk factors for Mn neurotoxicity. Clinically, brain Mn accumulation can be monitored in vivo using non-invasive magnetic resonance imaging (MRI) due to the paramagnetic nature of this element. Indeed, MRI has been used in a variety of settings to evaluate the brain Mn deposition in various populations. This review focuses on the use of MRI technology in studies related specifically to Mn neurotoxicity. Thus, we will examine reports using MRI to confirm brain Mn accumulation in human populations, and conclude with data from non-human primate and rodent models of Mn neurotoxicity.
Potential health effects of static magnetic fields have received far less attention than, for example, power frequency or radiofrequency fields. Static fields are found in certain occupational settings, e.g. in the aluminium and chloralkali industries, in arc-welding processes, and certain railways systems. Magnetic resonance imaging (MRI) for medical diagnosis is another source. This paper summarizes the epidemiological evidence of static magnetic field exposure and long-term health effects. There are only a few epidemiological studies available, and the majority of these have focused on cancer risks. There are some reports on reproductive outcomes, and sporadic studies of other outcomes. Overall, few occupational studies have focused specifically on effects of static magnetic field exposure, and exposure assessment have consequently been poor or non-existent. Results from studies that have estimated static magnetic field exposure have not indicated any increased cancer risks, but they are generally based on small numbers of cases and crude exposure assessment. Control of confounding has been limited, and it is likely that the "healthy worker" effect have influenced the results. A few studies have reported results on reproductive outcomes among aluminium workers and MRI operators, but limitations in study designs prevent conclusions. A problem in epidemiological studies of static magnetic fields is that workers in exposed occupations are also exposed to a wide variety of other potentially harmful agents, including some known carcinogens. In conclusion, the available evidence from epidemiological studies is not sufficient to draw any conclusions about potential health effects of static magnetic field exposure.
Solar ultraviolet radiation (UVR) has always been part of the environment of man. UVB is required for the conversion of 7-deoxycholesterol to vitamin D, which is critically important in the maintenance of healthy bones and research is making clear that it has other potential roles in maintenance of human health. Exposure to UVR, whether of solar or artificial origin, also carries potential risks to human health. UVR is a known carcinogen and excessive exposure-at least to solar radiation in sunlight-increases risk of cancer of the lip, basal cell, and squamous cell carcinoma of the skin and cutaneous melanoma, particularly in fair skin populations. There is also evidence that solar UVR increases risk of several diseases of the eye, including cortical cataract, some conjunctival neoplasms, and perhaps ocular melanoma. Solar UVR may also be involved in autoimmune and viral diseases although more research is needed in these areas. Artificial UVR from tanning beds, welding torches, and other sources, may contribute to the burden of disease from UVR. This brief review will assess the human evidence for adverse health effects from solar and artificial UVR and will attempt to assign a degree of certainty to the major disease-exposure relationships based on the weight of available scientific evidence.
OBJECTIVE: The aim of this preliminary study was to compare wound healing of rat oral tissues after surgical procedure with diode laser or scalpel. Healing was evaluated histologically, immunohistochemically, and by measurement of 2 nitric oxide synthase isoforms (eNOS and iNOS) as intracellular messenger molecules with important immune functions. The instruments were also evaluated for performance and ease of use. STUDY DESIGN: Twenty-four standardized incisions were performed in the hard palate of 12 male Wistar rats. Each rat received 2 incisions on the opposite sides of the palate by using a steel scalpel (control group) and a diode laser (808 nm) at a power output of 4 W and 6 W (test group). Histological and immunohistochemical analyses were performed on tissue samples after 7 and 14 days. The expression of eNOS and iNOS was confirmed by RT-PCR (reverse transcriptase-polymerase chain reaction) and Western blot analysis. RESULTS: Scalpel repair was found to be equivalent to or better than laser repair at the intervals measured. Histological analysis showed that incision wound repair after laser surgical procedure was related to parameters and beam characteristics. Diode laser at a power output of 6 W showed the worst results of tissue repair, especially after 7 days. On the contrary, the extent of epithelial damage lateral to the wound edge and the extent of collagen denaturation were near equal with scalpel incision and laser irradiation at 4 W after 14 days. Biochemical analysis of RT-PCR and Western blots also confirmed histological results with a greater concentration of eNOS and iNOS after 7 days of laser surgical procedure. CONCLUSIONS: Clinical and histological findings change over time for different treatments. Diode laser tends to produce more pronounced changes than conventional scalpel surgical procedure (due to tissue thermal damage), with corresponding greater inflammatory reaction and delay in tissue organization only at the initial stage. Thus, long-term histology is critical for predicting treatment results. The clinical use of low-level diode laser for tissue welding of oral mucosa should be investigated further, since it appears to be a good alternative to scalpel incision and suture repair.