Never to be missed again - an analysis of 55 consecutive cases of traumatic diaphragmatic hernia.

BACKGROUND: This report reviews our clinical experience with 55 cases of traumatic diaphragmatic hernia at a Brazilian university hospital. Traumatic diaphragmatic hernia is an uncommon injury and presents diagnostic and therapeutic challenges. Occasionally, it is missed in trauma patients and is usually associated with significant morbidity and mortality. This analysis aimed to improve the diagnostic outcomes of trauma patient care. METHODS: Retrospective design analysis of database records of trauma patients at HC-Unicamp were performed to investigate incidence, trauma mechanism, diagnosis, herniated organs, associated injuries, trauma score, morbidity and mortality. RESULTS: Fifty-five patients were analysed. Blunt trauma was two-fold more frequent than penetrating trauma and was associated with high-grade injury; motor vehicle collision was the most common mechanism. Left-sided hernia was four-fold more frequent than that on the right side, although critical injuries were more frequently associated with the right side. The stomach was the most herniated organ in both trauma mechanisms. Preoperative diagnosis was mostly performed using chest radiography (55%). Postoperative diagnosis was mostly performed via laparotomy rather than laparoscopy. Associated injuries were observed in 43 patients (78%) and the mortality rate was 20% for both the sides. CONCLUSION: Isolated injuries are rare, and the presence of associated injuries increases morbidity and mortality. Chest radiography in the trauma bay is useful as an initial examination, although it is not suitable for use as a definitive method. Despite the use of laparoscopy in a few cases, laparotomy is the most common approach.

Avaliação do risco de potencial ecotoxicológico de resíduos de 17? estradiol obtidos pós-processo oxidativo a base de peróxido de hidrogênio destinados a remoção deste hormônio / Assessment of potential ecotoxicological risk from products of estradiol 17? after process of oxidation with hydrogen peroxide for environmental removal of this hormone

The increasing disposal of medicines into the environment has increased concern about the possible environmental impact of such actions, in both the medium and long term. Estrogens have been found in soil, surface water and groundwater. The aim of this study was to assess the ecotoxicity of chemical residues originating from in situ oxidation of 17β estradiol with hydrogen peroxide, a process of chemical remediation which is used to remove these hormones in acetone solution, at various pHs. Analyses were carried out by high resolution gas chromatography and a bioassay in which the single-cell species Euglena gracilis was the test organism. The results were obtained by comparing analyses done before and after the AOP (advanced oxidation process). It was observed that at pH 5.0, with a treatment time of 20 minutes, there was a good yield, but with some change in the behavior of the test organism. With a pH of 7.0, with 20 minutes time, the yield was low but there was no demonstration of ecotoxicological activity...

Com o crescente descarte de medicamentos no meio ambiente, observa-se o aumento da preocupação com o impacto ambiental que tal ação pode acarretar, tanto a médio como em longo prazo. Os estrogênios vêm sendo encontrados no solo, em águas superficiais e subterrâneas. O objetivo deste estudo foi avaliar a ecotoxicidade dos resíduos químicos originados a partir da oxidação do 17? estradiol, via peróxido de hidrogênio, em um processo destinado à remoção química destes hormônios em solução de acetona, e em diferentes pHs. As análises foram feitas utilizando cromatografia gasosa de alta resolução e bioteste com algas do gênero Euglenas gracillis. Os resultados foram baseados nas comparações de análises pré-processo oxidativo avançado (POA) e pós POA. Observou-se que os resultados obtidos na condição de pH 5,0, com tempo de 20 minutos, apresentou um bom rendimento, porém com mudança de comportamento dos bioindicadores. Em pH 7,0, com tempo de 20 minutos, o rendimento foi menor, porém não houve demonstração de atividade ecotoxicológica...

[Knife injury to the thoracic aorta and spinal cord. Report on an"almost-mistake"]. / Messerstichverletzung von thorakaler Aorta und Myelon. Bericht über einen "Beinahe-Fehler".

We report the surgical treatment of a thoracic knife injury with lesions of the aorta and the myelon. An initially incomplete revision of the wound nearly resulted in a critical situation. Complete revision of a wound is obligatory in a penetrating injury, when a relevant structure is possibly injured.

In-situ optical analysis of the gas phase during the formation of carbon nanotubes.

A reactor has been developed at ONERA to investigate the gas phase during carbon nanotube formation by laser-induced fluorescence (LIF), Laser-induced incandescence (LII), coherent anti-Stokes Raman Scattering (CARS), and emission spectroscopy. Continuous vaporization is achieved with a continuous wave CO2 laser. Optimized conditions are used for single-walled nanotube growth, that is, a graphite target doped with 2 atom % Ni and 2 atom % Co, helium as buffer gas at a flow rate of 50 ml/s, and a pressure of 300 hPa. Temperature profiles are measured by CARS on H2, and soot images are obtained by LII in the hot carbonaceous flow. LIF and spontaneous emission of the C2 radical and Ni and Co atoms are presented. Spectral investigations are conducted at 3100 and 3200 K to have an optimized pair of excitation/detection wavelengths. Spatial investigations of the relative concentrations in the hot carbonaceous flow are performed up to 3500 K. The concentrations are measured as a function of target temperature. Two regimes of vaporization are observed. Vaporization is slow up to 3350 K and becomes much faster above this temperature. The fast regime in the 3350-3500 K range corresponds to the observed spatial extent of the metal vapors region. At 3500 K, the C2 profiles obtained with and without catalysts are very different as a result of carbon coalescence as well as carbon dissolution into the metal nanoparticles when these are present in the gas phase. The shape of the C2 profile can be related to nanotube formation and growth at a target temperature of 3500 K.

Wavelet networks for face processing.

Wavelet networks (WNs) were introduced in 1992 as a combination of artificial neural radial basis function (RBF) networks and wavelet decomposition. Since then, however, WNs have received only a little attention. We believe that the potential of WNs has been generally underestimated. WNs have the advantage that the wavelet coefficients are directly related to the image data through the wavelet transform. In addition, the parameters of the wavelets in the WNs are subject to optimization, which results in a direct relation between the represented function and the optimized wavelets, leading to considerable data reduction (thus making subsequent algorithms much more efficient) as well as to wavelets that can be used as an optimized filter bank. In our study we analyze some WN properties and highlight their advantages for object representation purposes. We then present a series of results of experiments in which we used WNs for face tracking. We exploit the efficiency that is due to data reduction for face recognition and face-pose estimation by applying the optimized-filter-bank principle of the WNs.

A novel and highly efficient synthesis of gem-difluorocyclopropanes

[reaction: see text] A new and highly versatile source of difluorocarbene is reported. Trimethylsilyl fluorosulfonyldifluoroacetate (TFDA) undergoes decomposition in the presence of catalytic fluoride to form difluorocarbene under conditions that allow its addition to relatively electron deficient alkenes in high yield. For example, unprecedented CF2: addition to n-butyl acrylate proceeded in 73% yield.

Heterogeneity in rabbit liver cytochrome P-450 LM2 observed by cation exchange HPLC: partial biochemical characterization of the two major LM2 subfractions.

Cytochrome P450 LM2 (CYPIIB4) from phenobarbital-induced rabbit liver microsomes, purified to only one band in SDS-PAGE, was further resolved in five peaks by cation exchange HPLC. The two major peaks were partially characterized. Both of them have the amino terminal sequence Met-Glu and the same Cys content. They exhibited the same spectral absorption maximum and similar binding constants for 1-benzylimidazole and imidazole. However, binding of benzphetamine was different. One subfraction presented a Michaelis-Menten type binding curve, but the other presents a non-typical one with an additional high affinity binding site. These subfractions of cytochrome P450 LM2 slightly differed in their catalytic activities with benzyloxy- and pentoxyresorufin substrates. On the contrary, no heterogeneity was observed for P450 LM4.

Direct visualization of a cardiolipin-dependent cytochrome P450scc-induced vesicle aggregation.

Cytochrome P450scc can be reconstituted successfully into large unilamellar phospholipid vesicles by a combined octylglucoside dialysis/adsorption method. Freeze-fracture electron microscopy was used to analyze the morphology, distribution, and protein topology of the cytochrome P450scc vesicles in dependence on lipid composition. Particles were observed only in close contact to the vesicle surface, probably representing tightly associated cytochrome P450scc at the outer vesicle surface. In cytochrome P450scc vesicles similar in lipid composition to the inner membrane of bovine mitochondria direct evidence by freeze-fracturing was found for a specific cytochrome P450scc-induced aggregation of the vesicles. The vesicle aggregation critically depends on the content of the specific mitochondrial membrane constituent cardiolipin. The aggregation and thus the intervesicular contacts were observed to be inhibited by both addition of anti-cytochrome P450scc IgG and adrenodoxin. Enzymatic reduction of cytochrome P450scc in the liposomal membrane by its electron transfer partners completely indicates an asymmetrical localization in/at the outer side of the bilayer membrane. It is suggested that vesiculation of the inner mitochondrial membrane may be a consequence of the characteristic cardiolipin-dependent cytochrome P450scc membrane topology: the cardiolipin binding, peripheral, non-bilayer-spanning integration as an oligomer in the outer leaflet of the membrane may play a role in the dynamics of formation and dissociation of intramitochondrial vesicles with a functional importance for steroidogenesis.

Conformational analysis of mitochondrial and microsomal cytochrome P-450 by resonance Raman spectroscopy.

Mitochondrial and microsomal cytochromes P-450SCC and P-450LM2 in the ferric substrate-free and substrate-bound states were studied by resonance Raman spectroscopy. In the spectra of cytochrome P-450SCC two conformational states (A and B) were detected, each of them constituting an equilibrium between a six-coordinated low-spin and a high-spin form. Both the conformational and the spin equilibria are pH- and temperature-dependent, which is in line with previously published results [Lange, R., Larroque, C., & Anzenbacher, P. (1992) Eur. J. Biochem. 207, 69-73)]. On the basis of well-resolved resonance Raman spectra, measured at different pH and temperatures, these equilibria were analyzed quantitatively. Both low-spin configurations of A and B exhibit different band patterns in the spin state marker band region, indicating differences in the active-site structures. While in the high-spin configuration of state A the heme iron remains weakly bound by a sixth ligand, the high-spin form of state B is five-coordinated. Binding of cholesterol to cytochrome P-450SCC causes a significant population of the high-spin forms, particularly of state A (62%). On the other hand, binding of 22R-hydroxycholesterol to the substrate-free enzyme leaves the overall spin equilibrium largely unchanged, i.e., six-coordinated low spin (76% A and 24% B). In both substrate-bound complexes, interactions between the substrate and the heme lead to small but distinct differences in the resonance Raman spectra of the low-spin form of state A. In contrast to cytochrome P-450SCC, the resonance Raman spectra of microsomal cytochrome P-450LM2 provide no indications for multiple conformers at 22 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Rotation of cytochrome P450SCC (CYP11A1) in proteoliposomes studied by delayed fluorescence depolarization.

The rotational diffusion of cytochrome P450SCC (CYP45011A1) was investigated in proteoliposomes measuring the time-resolved delayed fluorescence anisotropy of diiodofluorescein iodoacetamide covalently and specifically attached to Cys264 of P450SCC. Rotation strongly depends on the lipid composition of the membrane, especially on the cardiolipin content. In proteoliposomes having a lipid composition similar to the inner membrane of bovine adrenal mitochondria P450SCC is rotating uniaxially with a relaxation time phi rot about 53 microseconds and almost no immobile P450 is present. Addition of high KCl concentration has no effect. The results and the absence of any intramembrane particles observed by freeze-fracturing indicate that P450SCC probably exists in the liposomal membrane as oligomer not penetrating the bilayer. It is suggested to bind tightly within the outer monolayer with large parts exposed to the aqueous solution surrounding the membrane.

Carpal tunnel syndrome: objective measures and splint use.

One hundred five adults with carpal tunnel syndrome (CTS) were studied to assess the efficacy of a neutral-angle wrist splint, and to identify criteria for splint referral. Ten observations before and after treatment were analyzed with descriptive and inferential statistics. After splint use, 67% of the subjects reported symptom relief. T-test comparison of sensory latency of values before and after treatment indicated improvement for the total group. Chi-square and t-tests failed to reveal significant differences between relief and no-relief groups for gender, affected hand, presence of concomitant conditions, duration of symptoms before treatment, age, length of time between pretreatment and posttreatment nerve conduction testing, initial nerve latency of motor and sensory fibers, or the difference between pretreatment and posttreatment sensory latencies. A significant difference was found for motor latency; the relief group improved and the no-relief group deteriorated. Data suggest that splinting is most effective if applied within three months of symptom onset. Those with damage to the wrist structures or median nerve were least responsive to splinting.

Principles of blood separation and component extraction in a disposable continuous-flow single-stage channel.

A single-stage disposable channel and seal that provides for leukocyte and granulocyte collection by continuous-flow cell separation (CFCS) has been designed by the IBM Corporation. This paper describes (1) the separation characteristics of whole blood as it responds to varying gravitational (G) forces and flow rates through the channel; (2) the mechanism by which the buffy coat accumulates and is extracted; (3) the efficiency of extraction; (4) those donor and procedural variables that contribute to the final yield; (5) posttransfusion increment response in patients; and (6) the functional integrity of the cells collected.