[The educational program for modern military surgeons]. / Weiterbildung zum modernen Militärchirurgen.

Casualties in military conflict produce patterns of injuries that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialization the deployed surgeon needs to acquire and maintain a wide range of skills from a variety of surgical specialties. Improvised explosive devices (IEDs) have become the modus operandi for terrorists and in the current global security situation these tactics can be equally employed against civilian targets. Therefore, knowledge and training in the management of these injuries are relevant to both military and civilian surgeons. To create this kind of military surgeon the so-called "DUO-plus" model for the training of surgical officers (specialization general surgery plus a second specialization either in visceral surgery or orthopedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery and emergency gynecology, are integrated into this concept and will be taught in courses. Log books will be kept in accordance with the training curricula. On successful completion of the program medical officers will be officially appointed as Medical Officer "Einsatzchirurg" by their commanding officers for a maximum of 5 years and it will be necessary to renew it after this period. These refresher programs will require participation in visiting physicians programs in the complementary surgical disciplines in order to retain the essential specific skills.

Cultural, social, and intrapersonal factors associated with substance use among alternative high school students.

The purpose of this study was to identify cultural, social, and intrapersonal factors associated with tobacco, alcohol, and illicit drug use among students attending dropout prevention/recovery high schools. Four mutually exclusive categories of substance use were used as outcome measures, and religiosity, educational achievement, educational aspiration, family caring, others caring, self-esteem, optimism, coping, depression, loneliness, and self-efficacy were used as predictor variables. In the final multivariate model more family caring and loneliness were inversely associated with marijuana use; young age, more family caring, less coping ability, church attendance, and low educational aspirations were significantly associated with cocaine use. This study demonstrates the importance of health education and health promotion programs for students attending alternative high schools which include prevention of initiation, as well as treatment.

Health risk behaviors of Texas students attending dropout prevention/recovery schools in 1997.

This study determined prevalence of health risk behaviors of 9th through 12th grade students attending dropout prevention/recovery alternative schools in Texas in 1997. Participants were 470 youth whose health risk behaviors were assessed using the Youth Risk Behavior Survey in an anonymous, self-administered format. Behaviors measured included frequency of weapon-carrying and fighting, suicide-related behaviors, substance use, and sexual behaviors. A substantial percentage of alternative school students reported participating in behaviors that placed them at acute or chronic health risk. Differences in the prevalence of risk behaviors were noted by gender, racial/ethnic, and age subgroups. In addition, alternative school students frequently engaged in multiple risk behaviors. These findings suggest a need for comprehensive school-based health education/intervention programs to reduce the prevalence of risk behaviors in populations of alternative school students.

Identification of a 185 kd Maclura pomifera agglutinin binding glycoprotein as a candidate for a differentiation marker for alveolar type II cells in adult rat lung.

In adult rat lung the lectin Maclura pomifera agglutinin (MPA) binds apically to alveolar type II (ATII) cells but not to alveolar type I (ATI) cells. This suggests that the presence of MPA binding glycoproteins might be a criterion by which to distinguish the differentiated state of these two adult alveolar epithelial cells. The authors therefore studied MPA binding glycoproteins of ATII cells, comparing, biochemically and cytochemically, MPA binding glycoproteins in freshly isolated ATII cells with those in cultures of ATII cells that are "dedifferentiating" or have "dedifferentiated" as a result of growth on tissue culture plasticware. A MPA binding glycoprotein (185 kd) that is present in freshly isolated "differentiated" ATII cells and then is subsequently lost as isolated ATII cells "dedifferentiate" in tissue culture has been identified. This 185 kd MPA binding glycoprotein alone, or expressed in conjunction with other proteins, is a candidate for a differentiation marker for ATII cells. Preliminary data suggests that this 185 kd MPA binding glycoprotein is not found in ATI cells.

A 70 kDa microtubule-associated protein in NIL8 cells comigrates with the 70 kDa heat shock protein.

When eukaryotic cells are exposed to environmental stress such as elevated temperature, the synthesis of heat shock proteins (HSP) is stimulated. We have raised a monoclonal antibody to a 70 kDa cytoskeleton-associated protein; this antibody also appears to recognize HSPs 68, 70 and 90, as well as an additional 40 kDa non-heat shock protein. We have used this monoclonal antibody to study the localization of the 70 kDa protein in the cytoskeletons of NIL8 hamster fibroblasts. By selective sequential solubilization of the components of NIL8 cells and analysis of the resulting cytoskeletal preparations by Western blot technique and indirect immunofluorescence, we have shown that the 70 kDa protein is associated with microtubules in mitotic and interphase cells and comigrates with HSP70 on 2-dimensional gel electrophoretigrams.

Isolation of pulmonary alveolar type I cells from adult rats.

The authors have developed a procedure for the isolation of alveolar Type I (ATI) cells from adult rat lung. After an initial selective enzymatic digestion of the lungs by lavage with 0.2% collagenase, 0.05% trypsin, 0.008% elastase, and 0.005% DNAse Type I, the cells which are released are separated by density gradient centrifugation, and a fraction which includes all ATI cells (density, 1.0177-1.0411) is harvested. Contaminating leukocytes are excluded by specific surface adsorption, exploiting the fact that these cells have leukocyte common antigen on their surfaces, whereas ATI cells do not. Similarly, contaminating alveolar Type II (ATII) cells are removed by specific surface adsorption with the use of the lectin Maclura pomifera agglutinin, which binds to freshly isolated ATII cells and not to ATI cells. Our procedure yields 5 X 10(6) ATI cells per rat in a fraction that is at least 85-88% pure; the cells are immediately available for biochemical or pharmacologic analysis and represent a 98% recovery of the ATI cells loaded onto the density gradient. The ATI cells retain their essential in vivo morphologic characteristics, including their polarity.

Improved isolation of rat lung alveolar type II cells. More representative recovery and retention of cell polarity.

We have developed an improved isolation procedure for rat lung alveolar Type II (ATII) cells which yields a more representative sample of ATII cells with respect to their densities. This procedure includes an initial selection on a density gradient of approximately the complete density range of rat lung ATII cells. Subsequently, to exclude contaminating macrophages and lymphocytes from this fraction, the authors have exploited the fact that the contaminating cells have leukocyte common antigen (LC) on their surfaces, whereas the ATII cells do not. Our procedure yields 2 X 10(7) ATII cells per rat in a fraction which is 90% pure; the cells are immediately available for biochemical or pharmacologic analysis and represent a 90-95% recovery of the ATII cells loaded onto the density gradient. The cells retain their in vivo morphologic characteristics, including their polarity.