Comparison of surface temperature in 13-lined ground squirrel (Spermophilus tridecimlineatus) and yellow-bellied marmot (Marmota flaviventris) during arousal from hibernation.

Surface temperatures (Ts) of eight 13-lined ground squirrels and seven yellow-bellied marmots were measured during arousal from hibernation using infrared thermography (IRT) and recorded on videotape. Animals aroused normally in 5 degrees C cold rooms. Body temperatures were recorded during arousal using both cheek pouch and interscapular temperature probes. Warming rate in arousal was exponential. Mean mass specific warming rates show the squirrels warm faster (69.76 degrees C/h/kg) than the marmots (4.49 degrees C/h/kg). Surface temperatures (Ts) for 11 regions were measured every few minutes during arousal. The smaller ground squirrel shows the ability to perfuse distal regions without compromising rise in deep body temperature (Tb). All squirrel Ts's remained low as Tb rose to 18 degrees C, at which point, eyes opened, squirrels became more active and all Ts's rose parallel to Tb. Marmot Ts remained low as Tb rose initially. Each marmot showed a plateau phase where Tb remained constant (mean Tb 20.3+/-1.0 degrees C, duration 9.4+/-4.1 min) during which time all Ts's rose, and then remained relatively constant as Tb again began to rise. An anterior to posterior Ts gradient was evident in the ground squirrel, both body and feet. This gradient was only evident in the feet of the marmots.

An infrared thermographic study of surface temperature in the euthermic woodchuck (Marmota monax).

Surface temperatures were measured in euthermic woodchucks (Marmota monax) using infrared thermography across a range of ambient temperatures from -10 degrees C to 32 degrees C. The woodchuck keeps surface temperature of the peripalpebral region uniformly high, while head and body surfaces change proportionally with ambient temperature. When ambient temperature was below 0 degrees C, all surface temperatures increased which prevents freezing. At no point did the animals appear to be unable to regulate heat exchange. This species appears to be especially well adapted to the higher temperatures it encounters in its range. Vasomotion in the feet and to a lesser extent in the pinnae was used to regulate heat loss. At ambient temperature of 32 degrees C, mean temperatures of nose surfaces were 0.2 degrees C and 0.3 degrees C less than ambient temperature suggesting a type of counter current cooling mechanism may be present.

Anxiolysis with oral midazolam in pediatric patients undergoing dermatologic surgical procedures.

BACKGROUND: Pediatric patients undergoing dermatologic surgical procedures often experience high levels of anxiety. Oral midazolam is a short-acting benzodiazepine that can ameliorate procedure-related anxiety. OBJECTIVE: Our purpose was to determine the safety and efficacy of oral midazolam as an adjuvant anxiolytic agent for pediatric patients undergoing dermatologic surgical procedures. METHODS: A prospective series of pediatric patients undergoing dermatologic surgical procedures who received oral midazolam were monitored, and efficacy and complications were recorded. RESULTS: Oral midazolam provided good to excellent anxiolytic effects in most pediatric patients undergoing painful dermatologic surgical procedures. Because midazolam does not provide analgesic effects, local anesthesia is necessary. Complications were uncommon and minor. CONCLUSION: Oral midazolam is an effective anxiolytic agent in pediatric patients undergoing dermatologic surgical procedures.

Heat loss in Dumbo: a theoretical approach.

A flat plate model was used to calculate heat loss from the pinnae of the animated elephant Dumbo. In conditions of high wind velocity and large gradients, Dumbo could potentially dissipate more heat than he produces. This suggests that he may need the large ears to help lose the excess heat produced while flying.

Sensitivity of the platelet immunofluorescence test (PIFT) and the MAIPA assay for the detection of platelet-reactive alloantibodies: a report on two U.K. National Platelet Workshop exercises.

This report presents the results of two National Workshop exercises which were designed to evaluate interlaboratory and interassay variation in sensitivity of techniques used for the detection of platelet-reactive alloantibodies. Most workshop participants used the platelet immunofluorescence test. Sensitivity of this assay was improved when fluorescence was measured by flow cytometer rather than by microscope. The MAIPA assay was found to be highly sensitive but required considerable technical expertise, and the choice of antiglycoprotein IIb/IIIa (CD61/41) monoclonal antibody was found to have a significant effect on its ability to detect anti-HPA-1a.

Cosmetic procedures we all perform.

Dermatologic surgery has always been an integral part of dermatology. Over the past two decades, the scope of dermatologic surgery has greatly expanded to include procedures more traditionally thought of as cosmetic surgery, such as hair transplantation, liposuction, sclerotherapy, or soft tissue augmentation (Zyderm, Zyplast, Fibrel). Also, many dermatologic surgeons are expertly trained to reconstruct large surgical defects with flaps and skin grafts. Although these complex procedures are becoming synonymous with dermatologic surgery, procedures such as "simple" excision, electrosurgery, cryosurgery, curettage, or scissors surgery remain extremely important. These basic procedures are utilized daily in the office to treat a wide variety of skin lesions that may have a cosmetic or reconstructive aspect to them.

Basal cell carcinoma: when to treat it yourself, and when to refer.

Basal cell carcinoma (BCC) is the most common skin cancer and frequently affects older adults. Most BCCs are seen on the sun-exposed skin of light-skinned individuals. Because early diagnosis reduces morbidity and the expense of treatment, it is essential that you are able to recognize these lesions. Their various clinical presentations determine the proper treatments, some of which may be carried out in your office and others which require referral. Several effective surgical and nonsurgical modalities are available. Selecting the best method is based on such factors as the type, size, and anatomic location of the lesion; cost of treatment; and your familiarity with the treatment.

Review of the problems involved in using enzymes in blood group serology--provision of freeze-dried ICSH/ISBT protease enzyme and anti-D reference standards. International Council for Standardization in Haematology. International Society of Blood Transfusion.

Proteolytic enzyme preparations and techniques used routinely in blood group serology for the detection of atypical patient antibodies prior to transfusion vary widely and are often poorly standardised. Recent advances have been made in the use of biochemical methods to standardise and stabilise the potency of the enzyme preparations used. A joint working party of the International Council for Standardization in Haematology (ICSH) and the International Society of Blood Transfusion (ISBT) has investigated possibilities for the provision of standards for the protease preparations and techniques. The specification for these standards was that the performance of enzyme reference preparation in the reference technique should be of equivalent sensitivity to the ICSH/ISBT LISS spin indirect antiglobulin test using a titration series of a reference weak anti-D, and be free from false-positive reactions. The working party circulated materials for evaluation in inter-laboratory trials, followed by a laboratory workshop meeting to achieve agreement on the specification for reference materials and methods. Reference freeze-dried papain at 0.6 azoalbumin units and weak anti-D preparations (91/562) have been prepared and validated to meet these specifications. The performance of a test enzyme preparation in the technique for which it is recommended for use should be at least equal to that of the reference papain preparation, by the reference two-stage technique in terms of sensitivity, using a titration series of the reference anti-D, and freedom from false-positive reactions, using six fresh inert sera. The reference papain and weak anti-D can also be used to calibrate the level of proteolytic activity required in other procedures in blood group serology, such as new technology methods for antibody detection, and automated and microplate cell grouping procedures. These preparations and an agreed method for their use are now available from listed centres as ICSH/ISBT and Food and Drug Administration reference materials.

Detection of anti-Fya, anti-S and anti-Jka in relation to the genotypes of the panel red cells: report of a U.K. NEQAS survey. U.K. National External Quality Assessment Scheme.

Three antibody-containing samples (anti-Fya, anti-S and anti-Jka), each at two dilutions, were distributed to U.K. hospitals and transfusion centres together with an antibody screening panel comprising red cells homozygous for the corresponding antigens. Participants in the study subjected the samples to their routine antibody screening procedures using both their own antibody screening panels and the screening panel provided. A within-group comparison of those participants using their own screening panels having a heterozygous expression of the antigens, with the same participants when using the screening panel provided, showed for five of the samples a greater detection rate in routine antibody screening procedures when using the panel provided, having homozygous expression of the corresponding antigens. The sixth sample, the most potent, was detected equally using both panels. The difference in overall detection rate is statistically significant (chi-square test, 2P < 0.001). The study shows that the use of red cells presumptively homozygous for Fya, S and Jka improved the detection of the corresponding antibodies.

BCSH-NIBSC anti-D reference reagent for antiglobulin tests: the in-house assessment of red cell washing centrifuges and of operator variability in the detection of weak, macroscopic agglutination. British Committee for Standards in Haematology. National Institute for Biological Standards and Control.

A batch of an anti-D preparation, reference 91/608, has been prepared for the preparation of red cells weakly sensitized with IgG that can reveal inhibition of the antiglobulin test by one volume of human serum, diluted 1:1000. The preparation provides an objective assessment of red cell washer efficacy and the confidential, in-house assessment of operator variability in detecting weak but definite macroscopic agglutination by blind, replicate tests. Red cell washer efficacy and poor operator reading procedures causing disruption of weak agglutination are two major causes of false-negative antiglobulin tests; neither are adequately detected by the common quality-control procedure of adding strongly IgG-sensitized red cells ('Coombs control cells') to apparently negative antiglobulin tests. However, weakly IgG-sensitized red cells do offer a valuable control function that can detect some degree of cell washer inefficiency and reading errors although such cells are not a substitute for the more sensitive replicate testing. Test protocols are provided to assess the efficacy of cell washing machines and operator skills in the detection of weak but definite macroscopic agglutination.

The nasolabial fold donor site for full-thickness skin grafts of nasal tip defects.

BACKGROUND: The nasal tip has unique skin texture, geographic, and topographic qualities that frequently make repair of defects in this area difficult from the standpoint of function and cosmesis. OBJECTIVE: To assess seven outcome variables of function and cosmesis in 41 patients who underwent nasolabial graft repair for nasal tip defects. METHODS: A retrospective review of photographic and written records as well as person to person and phone interviews with 41 patients who underwent nasolabial graft repair of nasal tip defects after Mohs micrographic surgery was performed. Seven outcome variables were assessed. Follow-up periods ranged from 3 to 28 months. RESULTS: Patient and doctor evaluators rated overall outcome as good or excellent in 95% and 89% of cases respectively. CONCLUSION: We consider the nasolabial graft to be an important reconstructive option for nasal tip defects when the underlying cartilage is not involved.

The use of the antiglobulin 'gel-test' for antibody detection.

Four antibodies used routinely in-house for the assessment of antiglobulin reagents (anti-Fyb, anti-Jka, anti-S) were tested in parallel using tube and antiglobulin 'gel-test' low ionic strength antiglobulin techniques. In the latter the red cells are centrifuged following incubation through a dextran matrix incorporating an anti-human globulin reagent. The results show that the antiglobulin 'gel-test' was less sensitive than the tube technique in the detection of these difficult antibodies.

Heat exchange by the pinna of the African elephant (Loxodonta africana).

1. Surface temperatures of the pinnae of four female African elephants were measured at ambient temperatures between 14 and 32 degrees C using infrared thermography. Instantaneous heat losses calculated using those values ranged from 10.67 to 76.2 W under the observed conditions. 2. Using a value of 17 kcal/kg/day, those heat losses account for 0.65-4.64% of the animals' standard metabolic rates, considering one side of one ear only. 3. A model of heat flow across a flat vertical plate was constructed and compared to the actual values. Up to 100% of an African elephant's heat loss needs can be met by movement of its pinnae and by vasodilation. 4. Thermography indicates that the temperature distribution pattern across the pinna changes with ambient temperature and that areas of specialized motor control exist.

The pH, conductivity and osmolality of low ionic strength solutions used within the U.K. for the antiglobulin test.

Low ionic strength solutions (LISS) for use in the antiglobulin test were obtained from 356 U.K. laboratories. Of the 324 laboratories using LISS to suspend the test red cells and who returned details of their LISS technique, 15 used unequal proportions of red cell suspension and serum despite the LISS being formulated for use with equal proportions. Of the 22 laboratories mixing LISS with serum and red cells suspended in a normal ionic strength medium, four used a LISS preparation formulated for a LISS-suspension technique and three used a commercially available LISS-addition preparation using proportions of red cells, serum and LISS not recommended by the manufacturer. The mean (standard deviation) pH, conductivity and osmolality of the 334 LISS preparations for LISS-suspension was 6.9 (0.2), 4.1 (0.4) mS/cm and 298 (15) mmole/kg, respectively. It is suggested that attention should be paid to the osmolality and, particularly, conductivity during the preparation of LISS because values were observed that were clearly outside the acceptable range cited in the Guidelines for the Blood Transfusion Services in the United Kingdom, i.e. pH 6.7 +/- 0.2, conductivity 3.7 +/- 0.3 mS/cm and osmolality 295 +/- 5 mmole/kg.

The use of DIN glass ampoules to freeze-dry biological materials with a low residual moisture and oxygen content.

A capillary device has been developed to enable biological materials to be freeze-dried from aqueous and non-aqueous solution in ampoules conforming to DIN 58377-B5-fl. This device reduced the absorption of atmospheric moisture by the material and the diffusion of oxygen into the ampoules awaiting sealing, by a factor of 13 and 7, respectively, over a 30 min period, respectively, compared to unprotected ampoules. The device has the advantage of being able to be assembled and fitted to the ampoules mechanically.

Sensitive two-stage papain technique without cell washing.

A two-stage papain technique is described in which cell washing after papain treatment is replaced by the addition of a specific papain inhibitor. This technique permits optimal enzyme treatment of red cells while digestion of immunoglobulin following the addition of serum is avoided. The technique therefore combines the design and consequent sensitivity advantage of two-stage tests with the convenience of one-stage tests, rendering it suitable for use in compatibility testing.

The pH optima for papain and bromelain treatment of red cells.

The action of papain and bromelain, prepared over a pH range from 4.6 to 8.6, was evaluated for the ability to render red cells agglutinable by five incomplete antibodies of differing blood group specificities using a two-stage technique. The optimal pH for treatment of red cells by activated papain or bromelain was between 5.4 and 5.8. Above this pH range, a fall in serological sensitivity was apparent which was much more pronounced with papain than with bromelain. The optimal pH for enzyme treatment of red cells can be achieved in two-stage techniques, but not in one-stage techniques due to the buffering effect of serum proteins.

A preparation for calibrating the assay of the blood group antibody anti-c.

A freeze-dried, working calibration preparation (84/628) has been assayed against the International Incomplete anti-c Reference Serum (67/160) in a multi-centre study. The use of 84/628 will avoid the between-laboratory variation, inherent in the use of local preparations, in the reporting of assays of anti-c using the AutoAnalyzer. A value of 13 IU/ampoule has been assigned to the anti-c content of preparation 84/628 which is available from the Blood Group Reference Laboratory, Oxford.