Publisher Correction: Measuring the ionisation fraction in a jet from a massive protostar.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Measuring the ionisation fraction in a jet from a massive protostar.

It is important to determine if massive stars form via disc accretion, like their low-mass counterparts. Theory and observation indicate that protostellar jets are a natural consequence of accretion discs and are likely to be crucial for removing angular momentum during the collapse. However, massive protostars are typically rarer, more distant and more dust enshrouded, making observational studies of their jets more challenging. A fundamental question is whether the degree of ionisation in jets is similar across the mass spectrum. Here we determine an ionisation fraction of ~5-12% in the jet from the massive protostar G35.20-0.74N, based on spatially coincident infrared and radio emission. This is similar to the values found in jets from lower-mass young stars, implying a unified mechanism of shock ionisation applies in jets across most of the protostellar mass spectrum, up to at least ~10 solar masses.

Recovery after nasal surgery vs. tonsillectomy: discriminant validation of the Postoperative Quality of Recovery Scale.

BACKGROUND: Initial validation and feasibility of the Post-Operative Quality of Recovery Scale (PQRS) was published in 2010. Ongoing validation includes studies to determine whether this scale can discriminate differences in recovery in similar patients having different surgery. METHODS: A prospective observational study included 89 patients undergoing nasal surgery and 46 patients undergoing tonsillectomy as the primary surgical procedure. Patients were assessed using the PQRS. Assessments were performed pre-surgery, at 15 and 40 min, 1 and 3 days, and 3 months after surgery. RESULTS: Tonsillectomy patients were younger [25.0 standard deviation (SD) 17.8 vs. 32.1 SD 18.0 years, P = 0.031] and had shorter anaesthesia duration (29.5 SD 12.6 vs. 42.7 SD 15.8 min, P < 0.01). Tonsillectomy patients had worse recovery in the nociceptive (pain and nausea; P < 0.001), activities of daily living (P < 0.001) and overall recovery (P = 0.025) domains, but were not different in the cognitive, emotive (depression and anxiety) or physiological recovery domains. Complete satisfaction was lower for tonsillectomy (P < 0.001). At 3 months, there was equivalence between groups in all assessments. CONCLUSION: The study shows the ability of the PQRS to discriminate recovery in different domains. Tonsillectomy has a worse recovery profile over the first 3 days in nociceptive, activities of daily living and overall recovery, which is associated with poorer satisfaction than nasal surgery.

Human T-cell-porcine endothelial cell interactions induce human Th1 cytokines and porcine activation markers.

BACKGROUND: Since the future of clinical transplantation will undoubtedly include xenotransplantation, there is a need to examine human anti-pig cellular reactions. The objective of this study is to use human anti-porcine mixed lymphocyte endothelial cell culture (MLEC) to investigate cell interactions, cross-species molecular compatibilities, and the induction of human cytokines and porcine activation markers. METHODS: Human peripheral blood mononuclear cells or enriched CD4+ T cells depleted of professional antigen-presenting cells were cultured with resting pig aortic endothelial cells in the absence of exogenous cytokines. T-cell proliferative responses were measured and PAEC were monitored for cell surface markers by flow cytometry. Culture supernatants were assayed for human TNF-alpha and IFN-gamma by ELISA. RESULTS: Human T cells proliferated strongly in response to PAEC (median stimulation index = 75), even in serum-free cultures. High levels of the human Th1 cytokines TNF-alpha (20-350 pg/ml) and IFN-gamma (200-3800 pg/ml) were detected only in cultures containing PAEC, with levels peaking on Day 4. CD4+ T-cell-enriched, APC-depleted responders maintained proliferative anti-PAEC responses and cytokine release. By Day 3, MHC Class II and VCAM expression was induced in 92-96% PAEC: mean fluorescence intensity (MFI) increased from 5 to 83 +/- 12 and 166 +/- 74, respectively, and MHC Class I was increased from MFI 31 to 965 +/- 269. CONCLUSIONS: These results indicate that MLEC is an excellent in vitro model in which to study human anti-porcine cellular responses. Human T cells are activated in response to direct antigen presentation by PAEC, which are also activated in this system. Specific cytokines, receptors, and adhesion molecules appear to cross the xenograft barrier and play a critical role in T-cell - PAEC interactions. Such interactions are likely to affect VEC activation and immune responses to porcine xenografts in vivo.

Topical application of ethanol to the tonsillar bed immediately following tonsillectomy does not improve post-operative analgesia.

Tonsillectomy is a painful procedure with discomfort continuing for days after the operation. We investigated whether topical application of a neurolytic agent (ethanol) to the tonsillar bed following dissection could provide long-term analgesia. Sixty-four patients undergoing tonsillectomy were randomized using matched pairs, to receive topical ethanol applied to the operative site, or saline for three min, in a double-blind study. Endpoints included self-reported pain using a pictorial pain scale, analgesia consumption adjusted for body mass, and weight loss. Follow-up continued until day 7 post-operatively. Both groups received the same analgesic protocol including infiltration of the operative site with ropivacaine. There were no significant differences in pain scores, analgesia requirements or weight loss between groups for any time period. The incidence of severe pain was significantly greater on the third post-operative day compared with day 1 and 2 (p = 0.0096). Topical application of ethanol does not reduce post-operative pain.

Differential cytotoxicity of trace metals in cisplatin-sensitive and -resistant human ovarian cancer cells.

Cellular resistance of cisplatin is related to various factors such as membrane transformations, changes in cellular transport systems, and an increased efflux of cisplatin by the tumor cells. Deficiencies of one or more trace metals can affect normal physiological functions, leading to altered enzymatic activities and a reduction in immune responses. This in vitro investigation was undertaken to study and determine the differential cytotoxicity of certain trace metals in human ovarian cancer cells that were sensitive and resistant to cisplatin. Standard cytotoxicity assays were performed using the neutral red assay. In general, the cisplatin-resistant cells exhibited an increased resistance to the externally supplied trace metals. For both cell lines the rank order of cytotoxicity from greatest to least with the non-essential metals was Cd2+ > Bi3+, and for the macrometals, Ca2+ > K+ > Mg2+. The transition metals and selenium exhibited a slight difference between the two cell lines with respect to the order of cytotoxicity. The cisplatin-sensitive cells had a rank order of V5+ > Se6+ > Cu2+ > Zn2+ > Fe3+, from greatest to least toxicity. The cisplatin-resistant cells had a rank order of Cu2+ > V5+ > Se6+ > Zn2+ > Fe3+. Since trace metals have various functions in maintaining normal health, these results provide key baseline cytotoxicity data and show that, in general, cytotoxic resistance to the trace metals tested followed a pattern similar to cellular cisplatin resistance.

The cytotoxic interaction of inorganic trace elements with EDTA and cisplatin in sensitive and resistant human ovarian cancer cells.

Cisplatin (CDDP)-sensitive and -resistant human ovarian cells were studied in vitro with the objective of enhancing CDDP cytotoxicity by the addition of a metal and the chelate ethylenediaminetetraacetic acid (EDTA), to the CDDP. Chelateable elements, such as bismuth, calcium, cadmium, copper, iron, magnesium, selenium, vanadium, and zinc, when added to CDDP and in the presence of EDTA increased the cytotoxicity of the CDDP as compared to CDDP treatment alone.

Maneuver to assist examination of the hypopharynx.

BACKGROUND: The lower hypopharynx, lying posterior to the larynx, is not usually assessable during outpatient examination. A maneuver was developed to assist flexible endoscopic examination of this region. The discomfort experienced by fifty consecutive patients undergoing the maneuver was assessed together with the view obtained. METHOD: Fifty patients assigned scores from 0 to 10 to the discomfort experienced during manual anterosuperior traction applied to the prelaryngeal skin, together with two other commonly performed procedures. The view obtained in the last 30 patients was assessed. RESULTS: The mean discomfort score for the maneuver was 3.77, compared with 3.84 and 5.94 for the other two procedures. A view to the cricoarytenoid joint or below was obtained in 60% of the patients assessed. CONCLUSIONS: We conclude that the maneuver is well tolerated and results in a useful view of the hypopharynx in the majority of patients. No prior report of this maneuver has been found in the literature.

Limy 'milky' bile: without apparent gall-bladder obstruction by a gallstone.

Limy bile, characterized by excessive precipitation of calcium carbonate, is an uncommon complication of gallstone disease, and is a condition that seems to follow gall-bladder obstruction. Limy bile was observed at cholecystectomy in a 57 year old woman who presented with biliary colic. At operation a mass of precipitated cohesive crystals, that had coalesced into a whitish paste of calcium carbonate, was observed obstructing the outlet of the gall-bladder. This case report is unique in that calcium carbonate precipitation appears to have preceded gall-bladder obstruction.