Efficient femtosecond optical parametric generation in group-velocity-matched MgO:PPLN at 10†MHz.

We report on efficient single-pass optical parametric generation (OPG) of broadband femtosecond pulses in the mid-infrared at 10 MHz by exploiting group-velocity-matched interaction in a 42-mm-long MgO:PPLN crystal. Using a microchip-started femtosecond amplified Mamyshev oscillator at 1064 nm as the pump, the OPG source can provide tunable femtosecond pulses across 1516-1566 nm in the signal and 3318-3568 nm in the idler, with slope efficiencies of ∼93% and ∼41%, respectively. For 650 mW of average input pump power, signal powers of up to 283 mW at 1524 nm are generated, with more than 200 mW over the entire tuning range. Idler average powers of up to 104 mW at 3450 nm, with more than 80 mW across the full range, are also obtained. For input pump pulses of ∼182 fs, the generated signal pulses have a duration of ∼460 fs at 1516 nm. The idler pulses have a typical bandwidth of ≥100 nm over the entire tuning range, and as wide as 181 nm at 3457 nm. The OPG source exhibits excellent passive power stability, better than 0.5% rms in the signal and 0.6% rms in the idler, over 1 h, both in Gaussian TEM00 spatial profile with M2 < 1.5.

Development and Implementation of a Perioperative Blood Glucose Monitoring Protocol for Patients Undergoing Spinal Surgery.

PURPOSE: Stress-induced hyperglycemia during the perioperative period is associated with adverse outcomes after spinal surgery, which increases both patient-related burden and hospital costs. This quality improvement project describes the development and implementation of a perioperative blood glucose monitoring protocol for patients undergoing spinal surgery. DESIGN: An evidence-based perioperative blood glucose monitoring protocol was developed by a multidisciplinary committee of specialists in endocrinology and anesthesiology with utilization of the American Diabetes Association diabetes screening criteria. METHODS: The protocol was implemented in the perioperative areas of a regional hospital in the Southeastern United States. The project sample included patients with and without a prior diagnosis of diabetes who met protocol inclusion criteria during a 3-month implementation period. FINDINGS: Preoperative glycated hemoglobin (HbA1c) testing identified more than 54% of previously undiagnosed patients with levels consistent with either prediabetes or diabetes according to the American Diabetes Association criteria for diagnosis. Patients with diabetes and those without diabetes experienced a perioperative increase in blood glucose with levels remaining elevated above preoperative baseline through postoperative day 1. CONCLUSIONS: A perioperative blood glucose monitoring protocol enables preoperative identification of patients with undiagnosed prediabetes and diabetes, allowing for optimization before elective surgery and establishment of appropriate postoperative follow-up care. In addition, a blood glucose monitoring protocol increases the detection of perioperative hyperglycemia and may lead to a reduction in postoperative complications after spinal surgery.

50-mJ macro-pulses at 1064 nm from a diode-pumped picosecond laser system.

Pulse-picking from a 100-mW cw mode-locked seeder, a hybrid master-oscillator power-amplifier (MOPA) system, based on Nd:YVO4 and Nd:YAG amplifier modules, has been developed, delivering single-pulses of 8.6 ps at 455-MHz repetition-rate, bunched into ~1-µs trains of 50 mJ ("macro-pulses"). The output beam is linearly polarized and nearly diffraction limited up to the maximum macro-pulse repetition-rate of 50 Hz. The single-pulse peak power and the macro-pulse duration and energy are quite suitable for high-energy nonlinear optical applications such as low-threshold synchronously-pumped parametric converters in the mid infrared. The impact on the overall efficiency of saturation distortion of the macro-pulse envelope as well as of amplified spontaneous emission (ASE) is considered. The managing of the envelope distortion compensation and of the ASE suppression by means of fast saturable absorbers is reported.

Abdominal mass as the first sign of follicular lymphoma B of mesentery: Case report.

Primary mesenteric lymphoma is a disease of the mesenteric lymph nodes that may represent a localized process or a component of a more disseminated pattern of disease.The case refers to a woman of 78 years, that was studied by ultrasound examination after accidental finding of abdominal mass. The examination confirmed the presence of the lesion; it defined the place (peritoneum) and the features (neoplastic lesion). Computer tomography (CT) confirmed the ultrasound diagnosis and showed an additional smaller lesion. The cytology exam from the CT biopsy showed to be a follicular lymphoma B. This case confirms the ultrasound examination role in the study of peritoneal lesions and underlines how a proper diagnostic process is essential for therapy.

[End-stage heart failure: quantity or quality of life?]. / Insuffisance cardiaque terminale: quantité ou qualité de vie ?

Several clinical trials testing the safety and efficacy of different positive inotropic agents in patients suffering form end-stage heart failure have confirmed that these drugs increase mortality. We nevertheless, use these agents regularly because of the presumption that they improve quality of life. However, this presumption, sound a priori, is not firmly anchored. When we prescribe these drugs, do we inform our patients? Do the patients ultimately decide whether to be treated with inotropic agents? What is the role of palliative care in the end-stage heart failure patient? We review the literature and reflect on these issues, long completely ignored, though beginning to elicit specific articles.

A study of the pharmacokinetics and tolerability of ritipenem acoxil in healthy volunteers following multiple oral dosing.

The pharmacokinetics of ritipenem acoxil, the oral prodrug of the antibiotic ritipenem, were studied in volunteers after single and repeated dosing (500 mg, three times daily for 10 days). Concentrations of ritipenem and open beta-lactam ring metabolites were measured using HPLC/UV. Ritipenem did not accumulate significantly in plasma, owing to its half-life of about 0.7 h; the area under the curve for 0-8 h was on average about 10 mg x h/L. Plasma pharmacokinetics of ritipenem and metabolites were time-independent. A decrease of ritipenem renal clearance (87 versus 132 mL/min) and a slight increase in the amount of metabolites excreted in urine were observed following repeated dosing.

Characterisation of poxviruses from sporadic human infections.

An orthopoxvirus was isolated from the vesicular rash of a man in Natal who died in coma and who had not been vaccinated. Analysis of the viral DNA showed that it was a vaccinia virus, more closely related to the virus of South African smallpox vaccine than to other vaccinia viruses. DNA analysis also showed that an orthopoxvirus isolated from a sporadic case of severe pustular rash in Nigeria was a vaccinia virus closely related to the smallpox vaccine virus used there. Minor biological differences between the viruses isolated and the corresponding vaccine strains suggested that some natural transmission of the virus had occurred, but the results of DNA analysis implied that they originated from the use of smallpox vaccine. No similar cases have been detected since smallpox vaccination was discontinued.

Episomal DNA of a BK virus variant in a human insulinoma.

BK virus (BKV) DNA was detected by blot hybridization in a human adenoma of pancreatic islets from patient I.R. BKV DNA was free, and no evidence was found of viral sequences integrated into cellular DNA. Virus was rescued by transfection of human embryonic fibroblasts with tumor DNA. The DNA from rescued virus (BKV-IR) was different from wild-type BKV DNA by restriction endonuclease mapping. The genome of BKV-IR is 235 base pairs (bp) shorter than the genome of wild-type BKV. This alteration originates from a deletion of approximately 300 bp involving HindIII fragments B and D, and an insertion of 70 bp in the region of HindIII fragment C. Transformation of hamster kidney cells was induced by total tumor DNA as well as by BKV-IR and BKV-IR DNA. No antibodies to BKV tumor (T) antigen were detected in the patient's serum by immunofluorescence. The significance of episomal BKV DNA in a human tumor is discussed.

BK virus-induced tumors in hamsters: a morphological, histochemical and ultrastructural study.

Macroscopic morphology, histology and ultrastructure of BK virus (BKV)-induced hamster and mouse tumors were investigated. Groups of animals were immunosuppressed to study the relationship between immune system and BKV oncogenesis. Ependymomas had the highest incidence, followed by tumors of pancreatic islets, osteosarcomas, lymphomas and sarcomas, sometimes associated in the same animal. All the tumors were found to be BKV specific. Ependymomas showed the shortest latency, infiltrated surrounding tissues but did not metastasize. Pseudo-rosettes were common and basal bodies were observed. Atypia and necrosis were more often present in immunosuppressed animals both for the ependymomas and for the other oncotypes. Pancreatic insulomas were frequently multinodular, possibly because of multifocal origin and metastasized to the liver. Hormone secretory granules were often found on electron microscopy. Osteosarcomas metastasized to lungs and peritoneum and showed the presence of osteoid, chondroblastoid and mixoid areas. Characteristic giant cells were present. Immunosuppression did not enhance tumor incidence and did not influence the latency period. However, neoplastic growth appeared to be more rapid and with more aggressive behavior in immunodepressed animals. These findings suggest an influence of the immune system in tumor development, whereas the virus oncogenic process seems unaffected.

Formation of oligomeric free BK virus DNA is required for tandem integration of viral genomes into cellular DNA.

Mouse kidney cells have been transformed by linear BK virus (BKV) DNA with cohesive ends. These BKV genomes can circularize and subsequently replicate or physically join end to end yielding oligomeric viral DNA molecules. Blot hybridization analysis of transformed cells showed the presence of BKV DNA both in free circular forms and integrated into cellular DNA in a tandem head-to-tail array of full-length viral genomes. Formation of oligomers either by replication via previous circularization or by end to end joining is hindered after elimination of cohesive termini by digestion with the single-strand-specific nuclease S1. After treatment of linear BKV DNA with nuclease S1 only integrations of single viral genomes were observed in transformed cells; tandem insertions and free viral DNA were absent. These results support the hypothesis that formation of tandems of free viral DNA is a necessary prerequisite for tandem integration of viral genomes.

Transformation of human embryonic fibroblasts by BK virus, BK virus DNA and a subgenomic BK virus DNA fragment.

Human embryonic fibroblasts (HEF) have been transformed by BK virus (BKV) DNA and by u.v.-inactivated or live BKV alone or in association with methyl-cholanthrene (MTC). The transformed cells produced BKV large T and small t antigens as well as the cellular 53 kdal protein, detected by immunofluorescence and immunoprecipitation. After an initial phase of lysis and virus shedding, virus or its coat protein antigen could not be detected in transformed cells. All human transformed cell lines could be superinfected by BKV or BKV DNA, but their susceptibility to superinfection was 20- to 500-fold lower than normal HEF. BKV could be rescued by fusion of transformed cells with normal HEF or Vero cells and by transfection of normal HEF with total DNA and DNA extracted from the Hirt supernatant of transformed cells. Blot hybridization analysis of DNA from transformed cells showed a considerable amount of free BKV DNA in monomeric and polymeric forms. Integrated BKV DNA was absent in most cell lines but present in only small amounts in BKV-transformed cells treated with MTC. Analysis of free BKV DNA with various restriction endonucleases and by blot hybridization showed that monomeric forms were complete BKV genomes, whereas polymers contained both complete and defective or rearranged BKV DNA. Transformation of HEF was also obtained with a 3.7 kilobase (kb) fragment of the BKV genome, produced by sequential digestion of BKV with the restriction endonucleases HhaI and EcoRI. This fragment extends clockwise on the virus genome from 0 to 72.2 map units and contains the entire early region. Blot hybridization analysis of cells transformed by the HhaI/EcoRI 3.7 kb fragment showed two separate integrations of BKV sequences without free virus DNA.

Oncogenity of BK virus for immunosuppressed hamsters.

Tumors were induced by BK virus (BKV) inoculated intravenously in 3-week-old Syrian golden hamsters immunosuppressed with anti-lymphocyte serum or methylprednisolone acetate alone or in association with gamma-radiation (60Co). The induced neoplasms were ependymoma, carcinoma of pancreatic islets, lymphoma, osteosarcoma, undifferentiated sarcoma, kidney and renal pelvis carcinoma, pheochromocytoma and hemangiosarcoma. High levels of insulin and glucagon and altered concentrations of glucose were detected in blood of animals with tumors of pancreatic islets. No antibodies to BKV tumor antigen (TAg) and low levels of hemagglutination-inhibition antibodies to BKV viral coat protein Ag were detected in hamster sera. BKV TAg was found in tumors by complement fixation. Blot hybridization analysis of tumor DNA showed the presence of both free and integrated BKV genomes in tumor cells. BKV DNA inoculated intravenously and subcutaneously in immunosuppressed or immunocompetent hamsters was not oncogenic, whereas it was weakly oncogenic when inoculated intracerebrally.