Compact sources as the origin of the soft gamma-ray emission of the Milky Way.

The Milky Way is known to be an abundant source of gamma-ray photons, now determined to be mainly diffuse in nature and resulting from interstellar processes. In the soft gamma-ray domain, point sources are expected to dominate, but the lack of sensitive high-resolution observations did not allow for a clear estimate of the contribution from such sources. Even the best imaging experiment revealed only a few point sources, accounting for about 50% of the total Galactic flux. Theoretical studies were unable to explain the remaining intense diffuse emission. Investigating the origin of the soft gamma-rays is therefore necessary to determine the dominant particle acceleration processes and to gain insights into the physical and chemical equilibrium of the interstellar medium. Here we report observations in the soft gamma-ray domain that reveal numerous compact sources. We show that these sources account for the entirety of the Milky Way's emission in soft gamma-rays, leaving at most a minor role for diffuse processes.

Treatment of juvenile idiopathic arthritis with intra-articular triamcinolone hexacetonide: evaluation of clinical effectiveness correlated with circulating ANA and T gamma/delta + and B CD5+ lymphocyte populations of synovial fluid.

OBJECTIVE: The aims of the study were to assess the effect of intra-articular treatment with triamcinolone hexacetonide (TH) in juvenile idiopathic arthritis (JIA) and to investigate whether treatment response correlates with the presence of antinuclear antibodies (ANA) in the serum and/or B CD5+ and T gamma/delta + lymphocytes in the synovial fluid. METHODS: A total of 37 patients (81% females, 56% ANA+) with oligoarticular JIA involving knees were treated with intra-articular injections of TH after failing to respond to NSAIDs for two months. Eighteen patients were treated within 6 months of onset, 19 were treated more than 6 months after onset. RESULT: Mean duration of remission was 13.9 months. Twelve patients (7 ANA+) had stable remission after a single injection; 13 patients (3 ANA+) experienced more than 6 months' remission but subsequently had a relapse; 12 patients (11 ANA+) had a relapse within six months of injection. Of 20 patients treated within 6 months of onset, 17 had stable remission whereas only 8 out of 17 who were treated during relapse attained stable remission (p = 0.03). The mean percentage of T gamma/delta + and of B CD5+ lymphocytes in synovial fluid was the same as in peripheral blood of normal subjects. CONCLUSION: Our data indicate that local treatment with slow-release steroids is very effective in oligoarticular JIA. Prolonged remission was less likely in the presence of ANA positivity, probably because the disease is immunologically more active. Finally, our data suggest that the earlier the treatment, the easier it is to obtain a protracted, and possibly permanent, response.

Effects of cervical headgear and edgewise appliances on growing patients.

Maxillary basal bone, dentoalveolar, and dental changes in Class II Division 1 patients treated to normal occlusion by using cervical headgear and edgewise appliances were retrospectively evaluated. A sample of 45 treated patients was compared with a group of 30 untreated patients. Subjects were drawn from the Department of Orthodontics, Araraquara School of Dentistry, Brazil, and ranged in age from 7.5 to 13.5 years. The groups were matched based on age, gender, and malocclusion. Roughly 87% of the treated group had a mesocephalic or brachicephalic pattern, and 13% had a dolicocephalic pattern. Cervical headgear was used until a Class I dental relationship was achieved. Our results demonstrated that the malocclusions were probably corrected by maintaining the maxillary first molars in position during maxillary growth. Maxillary basal bone changes (excluding dentoalveolar changes) did not differ significantly between the treated and the untreated groups. Molar extrusion after the use of cervical headgear was not supported by our data, and this must be considered in the treatment plan of patients who present similar facial types.

Long-term skeletal and dental effects of mandibular symphyseal distraction osteogenesis.

The purpose of this study was to evaluate the effects of mandibular symphyseal distraction osteogenesis using a tooth-borne expansion device. The sample included 20 Hispanic nonsyndromic patients (11 males and 9 females) between 13.5 years and 37.3 years of age. Predistraction (1.5 months before surgery), postdistraction (1 month after surgery), and long-term follow-up (1.3 year after surgery) records included posteroanterior, lateral, and panoramic radiographs and models. Postdistraction radiographic evaluation showed that symphyseal distraction osteogenesis produced insignificant increases in the bicondylar, bigonion, and biantegonion widths; intermolar and, especially, intercanine widths increased significantly and a distraction gap was observed in the symphyseal region. Follow-up model analysis showed the largest width increases between the first molars and second premolars and the smallest width increases between canines and first premolars. The difference between the postdistraction and long-term follow-up width changes was explained by the postdistraction orthodontic effect, which modified the shape of the dental arch. A disproportionate pattern of distraction, characterized by significantly greater dental than skeletal widening, was observed in the second molar and antegonion region. Distraction osteogenesis without presurgical orthodontic treatment produced significant proclination of the mandibular incisors; no proclination was observed in cases with predistraction orthodontic treatment. Dental crowding was resolved by the movement of teeth into the distraction regenerate and concomitant orthodontic treatment. Follow-up radiographs showed transverse skeletal stability of the distraction procedure. We conclude that mandibular symphyseal distraction osteogenesis increased mandibular arch width and partially corrected dental crowding, with a potential for disproportionate distraction patterns and proclination of the mandibular incisors.

Age-associated changes in decorin in rat mandibular condylar cartilage.

The small proteoglycan decorin strongly binds the fibrils of collagen types I and II; this interaction is thought to play a part in the maintenance of tissue integrity and biomechanical properties. In limb articular cartilage, there is evidence that decorin synthesis increases with age and that it is elevated in response to increased loading or in osteoarthritic cartilage. The aim here was to characterize the presence and relative amount of decorin in the condylar cartilage of the temporomandibular joint (TMJ) with maturation by Western blotting, and to assess its tissue localization by immunohistochemistry. Comparative data were obtained from tibial articular cartilage, which has been extensively studied. Cartilage from the mandibular condyle and tibial plateau was harvested from 24-day-old (growing) and 161-day-old (young adult) female Sprague-Dawley rats. In growing animals, decorin appeared slightly more abundant in the mandibular condylar cartilage than in articular cartilage, whereas in young adult animals the decorin content in the TMJ cartilage was noticeably less than in limb articular cartilage. Although there was an increase in decorin abundance with age at the TMJ, the increase in decorin with age in limb articular cartilage was considerably more pronounced. These data indicate that, although decorin is present in mandibular condylar cartilage, its abundance in adults is less than in limb articular cartilage; thus, maturation-associated changes may be dissimilar in magnitude from those documented for limb articular cartilage.

[Communication in the neonatal intensive therapy unit: the opinions of parents and of medical personnel compared]. / La comunicazione in terapia intensiva neonatale: opinioni dei genitori e del personale sanitario a confronto.

Within the framework of an European international project, the issue of parents-staff communication in Neonatal Intensive Care Units was explored. 5 Italian unit participated in the project. 80 mothers and 62 fathers of singleton, not malformed, very low birthweight babies were interviewed during the fourth week of their baby's life, while the views of the health personnel (60 doctors and 106 nurses) were collected through an anonymous, self-administered questionnaire. Most of the staff feels that parents should be informed completely about their baby's conditions and prognosis, while the actual practices about transmission of information are reported differently according to professional status: more nurses than doctors feel that the information is not as complete as it should be. Uncertainty of prognosis is the most commonly quoted reason for restricting the information. Parents, on the other hand, are generally satisfied about the information received, although some of them complain about the style of communication, and especially the need to ask repeatedly in order to be informed. These results show some of the gaps existing in communication both within the staff and with parents, and suggest possible ways of improvement.