ABSTRACT
Protons with energies up to approximately 10(15) eV are the main component of cosmic rays, but evidence for the specific locations where they could have been accelerated to these energies has been lacking. Electrons are known to be accelerated to cosmic-ray energies in supernova remnants, and the shock waves associated with such remnants, when they hit the surrounding interstellar medium, could also provide the energy to accelerate protons. The signature of such a process would be the decay of pions (pi(0)), which are generated when the protons collide with atoms and molecules in an interstellar cloud: pion decay results in gamma-rays with a particular spectral-energy distribution. Here we report the observation of cascade showers of optical photons resulting from gamma-rays at energies of approximately 10(12) eV hitting Earth's upper atmosphere, in the direction of the supernova remnant RX J1713.7-3946. The spectrum is a good match to that predicted by pion decay, and cannot be explained by other mechanisms.
Subject(s)
Antiphospholipid Syndrome/complications , Scleritis/etiology , Adult , Female , Follow-Up Studies , Humans , RecurrenceABSTRACT
Retinopathy has been described in dermatomyositis but visual loss is rare. We describe an unusual case of dermatomyositis where retinal complications resulted in permanent and profound central visual loss. Pulsed intravenous and oral methylprednisolone and cyclophosphamide therapy controlled the systemic disease but the macular and optic disc damage was irreversible. Early diagnosis and aggressive immunosuppressive therapy may help to prevent and control severe and potentially blinding intraocular inflammation. We emphasize the need for close co-operation between ophthalmologist and physician in the management of this condition.
Subject(s)
Dermatomyositis/complications , Vision Disorders/etiology , Adult , Dermatomyositis/drug therapy , Drug Therapy, Combination , Endophthalmitis/etiology , Endophthalmitis/prevention & control , Female , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Methotrexate/therapeutic use , Methylprednisolone/therapeutic use , Retinal Diseases/etiology , Retinal Diseases/prevention & control , Vision Disorders/prevention & controlABSTRACT
PIP: Oral rehydration solutions (ORS) with low and high sodium or potassium contents were compared in 84 infants aged 3-15 months with dehydration caused by acute watery diarrhea. In randomized, double-blind trials, the ORS contained (in mmol/liter): glucose, 110; HCO3, 30; K, 10; Na, 60 (low) or 90 (high), or, in a second trial, the high Na formula plus 20 vs. 35 mEq/liter of K and extra oral water, given in the ratio of 2 bottles (240 ml) of ORS followed by 1 bottle of plain water (the 2:1 regimen). The balance technique was used to measure net absorption. Of the 84 infants, only 1 required intravenous therapy. During the first 6 hours of therapy, mean sodium absorption was significantly lower in the low Na group, and hyponatremia was more common. A few high Na group infants receiving no extra oral water had transient mild asymptomatic hypernatremia. Mean K absorption from 0-6 hours was significantly higher in the high K group, and they had no hypokalemia after oral rehydration; in contrast, 33% of the low K infants had hypokalemia. High Na ORS in the 2:1 regimen caused no electrolyte abnormalites, yielded better sodium absorption, and was usable in all age groups and for all diarrheas. High K ORS corrected K deficits better than the low K ORS. An increase in potassium concentration above that in the currently recommended ORS formula should be considered.^ieng
