Effect of vermicomposting on calcium, sulphur and some heavy metal content of different biodegradable organic wastes under liming and microbial inoculation.

A study was conducted to evaluate the changes in total calcium and sulphur and some heavy metal (Zn, Cu, and Pb) concentration of different organic wastes affected by liming and microorganism inoculation. Vermicomposting was an effective technology for disposal of organic substrates like municipal solid wastes (MSW), possessing comparatively higher concentration of heavy metals. The addition of lime in initial organic substrates significantly (P ≤ 0.05) increased total calcium and total sulphur content of vermicomposts. Inoculation of microorganisms significantly (P ≤ 0.05) reduced the heavy metal content of final products as compared to control. Fungal strains were comparatively more effective in detoxification of heavy metals than B. polymyxa.

Emotion recognition in progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) is an atypical parkinsonian syndrome characterised by akinesis, rigidity, falls, supranuclear gaze palsy and cognitive, particularly executive, dysfunction. This study examined the extent to which emotion recognition is affected by PSP. Although deficits in the recognition of emotion have been reported in several diseases which share clinicopathological characteristics with PSP, it has never been studied systematically in PSP. Twenty-four patients with probable or definite PSP and matched healthy controls were studied using tests of facial identity and facial emotion recognition. Patients were not impaired in recognising famous faces, but they showed significant deficits in the recognition of emotions, particularly negative emotions. Moreover, emotion recognition was strongly correlated with the severity of other cognitive deficits in PSP, but not disease duration. Deficits in emotion recognition form an integral part of the cognitive spectrum of the disease. The findings point to the pathological involvement of key regions necessary for the processing of emotions and to a subtype of PSP with cognitive and emotion recognition impairments. The acknowledgement of deficits in emotion recognition is important for management of both patients and their carers.

Parkinson's disease and dopaminergic therapy--differential effects on movement, reward and cognition.

Cognitive deficits are very common in Parkinson's disease particularly for 'executive functions' associated with frontal cortico-striatal networks. Previous work has identified deficits in tasks that require attentional control like task-switching, and reward-based tasks like gambling or reversal learning. However, there is a complex relationship between the specific cognitive problems faced by an individual patient, their stage of disease and dopaminergic treatment. We used a bimodality continuous performance task during fMRI to examine how patients with Parkinson's disease represent the prospect of reward and switch between competing task rules accordingly. The task-switch was not separately cued but was based on the implicit reward relevance of spatial and verbal dimensions of successive compound stimuli. Nineteen patients were studied in relative 'on' and 'off' states, induced by dopaminergic medication withdrawal (Hoehn and Yahr stages 1-4). Patients were able to successfully complete the task and establish a bias to one or other dimension in order to gain reward. However the lateral prefrontal cortex and caudate nucleus showed a non-linear U-shape relationship between motor disease severity and regional brain activation. Dopaminergic treatment led to a shift in this U-shape function, supporting the hypothesis of differential neurodegeneration in separate motor and cognitive cortico-striato-thalamo-cortical circuits. In addition, anterior cingulate activation associated with reward expectation declined with more severe disease, whereas activation following actual rewards increased with more severe disease. This may facilitate a change in goal-directed behaviours from deferred predicted rewards to immediate actual rewards, particularly when on dopaminergic treatment. We discuss the implications for investigation and optimal treatment of this common condition at different stages of disease.

Effect of fly ash, organic wastes and chemical fertilizers on yield, nutrient uptake, heavy metal content and residual fertility in a rice-mustard cropping sequence under acid lateritic soils.

A field experiment was conducted for two years in sandy loam acid lateritic soil to study the direct effect of fly ash, organic wastes and chemical fertilizers on rice (Oryza sativa) and their residual effect on mustard (Brassica napus var glauca) grown in sequence. Rice yields were higher when fly ash, organic wastes and chemical fertilizers were used in an integrated manner as compared to sole application of chemical fertilizers. Yields of mustard were also higher under the residual effect of the former rather than the latter. However, this beneficial residual effect under integrated nutrient sources was inadequate for the mustard crop in the low fertility test soil. Hence, direct application of fertilizers was needed, in addition to residual fertility. The effect of fly ash on mean rice equivalent yield of the rice-mustard cropping sequence was highest (up to 14%) when it was used in combination with organic wastes and chemical fertilizers. While the yield increase was 10% when it was used in combination with only chemical fertilizers. The minimum yield advantage, 3%, occurred when fly ash was applied alone. The equivalent yield of the rice-mustard cropping sequence was equally influenced by either of the organic wastes. Cadmium and Ni content in rice grain and straw were less under the direct effect of fly ash. The residual effect on mustard was similar for Ni content in seed and stover; however, Cd content was increased. Beneficial residual soil chemical properties in terms of pH, organic carbon and available N, P and K were noted for integrated nutrient treatments involved fly ash, organic wastes and chemical fertilizers as compared to continuous use of only chemical fertilizers. Application of fly ash alone was effective in raising soil available P. Thus, integrated use of fly ash, organic wastes and chemical fertilizers was beneficial in improving crop yield, soil pH, organic carbon and available N, P and K in sandy loam acid lateritic soil.

Using computer graphics to preserve function in resection of malignant melanoma of the foot.

The increasing incidence of malignant melanoma challenges physicians to find innovative ways to preserve function and appearance in affected areas that require partial resection. We carefully planned the resection of a malignant lesion between the third and fourth toes of a 77-year-old man with the aid of computer technology. The subsequent excision of the third, fourth, and fifth digits was executed such that the new metatarsal arc formed would approximate the dimensions of the optimal hyperbola, thereby minimizing gait disturbance.

Parathyroid carcinoma: report of three cases and review of the literature.

Parathyroid carcinoma is a rare endocrine malignancy characterized by the exaggerated metabolic effects of the parathyroid glands. The preoperative differential diagnosis between parathyroid carcinoma and primary hyperparathyroidism is often difficult because many of the signs and symptoms are very similar. Intraoperative differentiation is obscured by the strict anatomic and histologic criteria required for diagnosis of parathyroid carcinoma. We have encountered three patients with parathyroid carcinoma during the last 10 years and managed them successfully. Two of them presented with recurrence of hypercalcemia, one 11 years after and the other 3 years after the primary operation for hyperparathyroidism; both patients were eventually diagnosed with parathyroid carcinoma. The third case was suspected as primary hyperparathyroidism preoperatively but confirmed as carcinoma subsequent to histologic examination.

Stereotactic breast biopsy as an alternative to excisional biopsy.

The current widespread use of modern mammography has increased the detection of suspicious mammographic lesions, which has led to a greater number of diagnostic surgical biopsies. Most of these lesions referred for surgical biopsy have been benign. The reduction in the number of benign surgical biopsies can reduce medical costs and unnecessary invasive breast surgery. Stereotactic large-core needle biopsies in patients with suspicious mammographic lesions can preselect the breast lesions that need further evaluation with surgical excisional biopsy. Our results with stereotactic large-core needle biopsies support this alternative approach to the workup of suspicious mammographic lesions.

Management of ductal carcinoma in situ of the breast--experiences from National Naval Medical Center during last 10 years.

Seventy-one ductal carcinoma in situ (DCIS) patients were reported to the tumor registry at the National Naval Medical Center between 1986 and 1995. This number represents 6.5% of all breast cancer patients. We did not include the patients with microinvasion or infiltrating ductal carcinoma with extensive DCIS in this study. After excluding 16 cases because of inaccessable clinical records, 55 cases of pure DCIS were analyzed. The mean age at presentation was 52.0 years (32 year-old to 74 year-old) and the most common clinical feature was an abnormal mammographic finding (40 cases, 73%). Family history of breast cancer was positive in 14 cases among the 39 cases with DCIS (35.9%) according to the medical records. Total mastectomy was the most common form of treatment for DCIS (19 cases, 34.5%) during this period, followed by modified radical mastectomy, lumpectomy only, lumpectomy with radiation therapy. Three hundred and two axillary lymph nodes were examined but revealed no nodal metastasis. Comedo type DCIS was the most common subtype (21 cases, 38.2%). There were no local recurrences or DCIS related deaths reported to the tumor registry during this period (mean follow-up interval of 51 months).

Germ cell testis cancer: 15-year review.

Testis cancer affects 2-3 men per every 100,000 in the United States, making it the most common solid tumor of men in the 20-35-year-old age range. Since the average age of active duty military personnel is included in the age range of those at greatest risk for germ cell testis cancer, it is of pertinent clinical importance to physicians who treat these young patients. The National Naval Medical Center has been using cisplatin-based protocols since the time of their introduction. This study reviews the success of treating these patients and examines the treatment failures.

Laparoscopic knot security.

The security of several types of laparoscopic and open knots and varying suture materials was tested in an attempt to improve suture and knot selection for advanced laparoscopic procedures. Six different types of knots and five suture materials were tested. All sutures were of 2-0 size, and laparoscopic knots were tied using a pelvic trainer. A typical number of square throws was used for each suture. Stress was gradually applied by withdrawing the ends of a manual digital tensiometer until either the knot slipped or the suture parted. The maximum stress withstood by the knot-suture complex was recorded, as was whether the knot was secure (i.e., whether the knot held until the suture broke). The data were analyzed using analysis of variance to compare the knot security of the various knot types and the different sutures using a given knot. No significant difference was found in security or stress resistance between laparoscopic square and open square knots or in the Dacron, polypropylene, and expand polytetrafluoroethylene (ePTFE) extracorporeal and intracorporeal knots, with the exception of ePTFE intracorporeal knots, which were significantly less secure (p = 0.028). Silk suture was significantly less secure than all the other sutures tested for all knots tested (p < 0.0001). The Roeder's and Fisherman's knots were the least secure of all laparoscopic knots in all sutures tested (p < 0.0001), with the exception of polyglactin tied with a fisherman's knot, which was as secure as the extracorporeal and intracorporeal polyglactin knots. These experiments showed laparoscopic square knots to be as secure as open square knots; removing the operating finger from the knot does not seem to affect the security of a well-tied square knot. Furthermore, of the permanent sutures tested, there was no substantive difference in the security of laparoscopic intracorporeally and extracorporeally tied knots, except that ePTFE was more secure when tied with extracorporeal throws. Our data also suggest that silk is not as secure as other permanent suture materials.