Prehospital tracheal intubation in severe facial trauma: a short window of opportunity.

A case of severe facial injury is described. The pre-hospital management including pre-hospital anaesthesia and intubation and the importance of advanced anaesthetic skills in rare trauma cases is discussed. In addition the rare situation where large bone fragments are retrieved from the scene and potentially used in reconstruction is mentioned.

Precision measurement of the weak mixing angle in Møller scattering.

We report on a precision measurement of the parity-violating asymmetry in fixed target electron-electron (Møller) scattering: A(PV) = [-131 +/- 14(stat) +/- 10(syst)] x 10(-9), leading to the determination of the weak mixing angle sin2(thetaW(eff) = 0.2397 +/- 0.0010(stat) +/- 0.0008(syst), evaluated at Q2 = 0.026 GeV2. Combining this result with the measurements of sin2(thetaW(eff) at the Z0 pole, the running of the weak mixing angle is observed with over 6sigma significance. The measurement sets constraints on new physics effects at the TeV scale.

Observation of parity nonconservation in møller scattering.

We report a measurement of the parity-violating asymmetry in fixed target electron-electron (Møller) scattering: A(PV)=[-175+/-30(stat)+/-20(syst)] x 10(-9). This first direct observation of parity nonconservation in Møller scattering leads to a measurement of the electron's weak charge at low energy Q(e)(W)=-0.053+/-0.011. This is consistent with the standard model expectation at the current level of precision: sin((2)theta(W)(M(Z))((-)MS)=0.2293+/-0.0024(stat)+/-0.0016(syst)+/-0.0006(theory).

Specificity of FGF signaling in cell migration in Drosophila.

We wanted to investigate the relationship between receptor tyrosine kinase (RTK) activated signaling pathways and the induction of cell migration. Using Drosophila tracheal and mesodermal cell migration as model systems, we find that the intracellular domain of the fibroblast growth factor receptors (FGFRs) Breathless (Btl) and Heartless (Htl) can be functionally replaced by the intracellular domains of Torso (Tor) and epidermal growth factor receptor (EGFR). These hybrid receptors can also rescue cell migration in the absence of Downstream of FGFR (Dof), a cytoplasmic protein essential for FGF signaling. These results demonstrate that tracheal and mesodermal cells respond during a specific time window to a receptor tyrosine kinase (RTK) signal with directed migration, independent of the presence or absence of Dof. We discuss our findings in the light of the recent findings that RTKs generate a generic signal that is interpreted in responding cells according to their developmental history.

Measurement of the elastic magnetic form factor of (3)He at high momentum transfer.

New electron scattering measurements have been made that extend data on the (3)He elastic magnetic form factor up to Q(2) = 42.6 fm(-2). These new data test theoretical conjectures regarding non-nucleonic effects in the three-body system. The very small cross sections, as low as 10(-40) cm(2)/sr, required the use of a high-pressure cryogenic gas target and a detector system with excellent background rejection capability. No existing theoretical calculation satisfactorily accounts for all the available data.

GABA(A) receptors containing (alpha)5 subunits in the CA1 and CA3 hippocampal fields regulate ethanol-motivated behaviors: an extended ethanol reward circuitry.

GABA receptors within the mesolimbic circuitry have been proposed to play a role in regulating alcohol-seeking behaviors in the alcohol-preferring (P) rat. However, the precise GABA(A) receptor subunit(s) mediating the reinforcing properties of EtOH remains unknown. We examined the capacity of intrahippocampal infusions of an alpha5 subunit-selective ( approximately 75-fold) benzodiazepine (BDZ) inverse agonist [i.e., RY 023 (RY) (tert-butyl 8-(trimethylsilyl) acetylene-5,6-dihydro-5-methyl-6-oxo-4H-imidazo [1,5a] [1,4] benzodiazepine-3-carboxylate)] to alter lever pressing maintained by concurrent presentation of EtOH (10% v/v) and a saccharin solution (0.05% w/v). Bilateral (1.5-20 microgram) and unilateral (0.01-40 microgram) RY dose-dependently reduced EtOH-maintained responding, with saccharin-maintained responding being reduced only with the highest doses (e.g., 20 and 40 microgram). The competitive BDZ antagonist ZK 93426 (ZK) (7 microgram) reversed the RY-induced suppression on EtOH-maintained responding, confirming that the effect was mediated via the BDZ site on the GABA(A) receptor complex. Intrahippocampal modulation of the EtOH-maintained responding was site-specific; no antagonism by RY after intra-accumbens [nucleus accumbens (NACC)] and intraventral tegmental [ventral tegmental area (VTA)] infusions was observed. Because the VTA and NACC contain very high densities of alpha1 and alpha2 subunits, respectively, we determined whether RY exhibited a "negative" or "neutral" pharmacological profile at recombinant alpha1beta3gamma2, alpha2beta3gamma2, and alpha5beta3gamma2 receptors expressed in Xenopus oocytes. RY produced "classic" inverse agonism at all alpha receptor subtypes; thus, a neutral efficacy was not sufficient to explain the failure of RY to alter EtOH responding in the NACC or VTA. The results provide the first demonstration that the alpha5-containing GABA(A) receptors in the hippocampus play an important role in regulating EtOH-seeking behaviors.

Preweaning treatment with methamphetamine induces increases in both corticosterone and ACTH in rats.

Treatment with methamphetamine (MA) on postnatal days P11-20 induces adult spatial learning and memory deficits without affecting monoamine levels in various brain regions. In this study, we examined the pituitary and adrenal response of animals administered MA four times daily on P11, P11-15, or from P11 to P20. Corticosterone (CORT) and adrenocorticotropin hormone (ACTH) levels were assessed over a 1-hour period following MA exposure. On P11, MA produced marked elevations of both CORT and ACTH; this is during the stress hyporesponsive period (SHRP). On P15 and P20, the maximal effect of MA on CORT titers was observed at 30 min, with lower, but still significantly increased, levels at 60 min compared to controls. Males receiving MA on P15 had higher levels of ACTH than did control males, while no differences were noted among females. On P20, MA treatment resulted in higher levels of ACTH relative to vehicle-injected controls, but levels were not different from controls that were only weighed at each drug administration. MA treatment inhibited body, but not brain weight gain, resulting in hippocampal weights that were heavier in the MA-treated animals when expressed as a percent of body weight. The elevations of adrenal steroids by MA, during late phases of hippocampal neurogenesis, may contribute to neuronal alterations that are later manifested in deficits of learning and memory.

Radiation-induced apoptosis of human prostate cancer cells is independent of mutant p53 overexpression.

BACKGROUND: Previous studies have demonstrated that androgen-independent prostate cancer cancer cells undergo apoptosis in response to ionizing irradiation. The p53 protein controls cell cycle arrest and apoptosis by acting as a checkpoint control that halts the cell cycle in G1, while DNA damage is present. In this study the effect of overexpression of mutant p53 protein, on radiation-induced apoptotic cell death of human prostate cancer cells PC-3 was investigated. MATERIALS AND METHODS: PC-3 cells were transfected with the plasmid encoding the mutant p53 sequence, and the neomycin resistance gene. Selected transfectant clones, were characterized at the molecular level (gene integration, and level of mRNA and protein expression) and cloned transfectants expressing high levels of p53 protein were treated with increasing doses of ionizing irradiation. The cellular response to radiation was determined on the basis of: a) clonogenic survival (colony forming ability of irradiated cells); b) induction of apoptosis as determined by the terminal transferase assay; c) apoptotic DNA fragmentation; and d) induction of expression of genes associated with prostate-apoptosis. RESULTS: Both mutant p53 transfectant and parental PC-3 cells underwent apoptosis in response to ionizing irradiation following similar kinetics of induction of DNA fragmentation. In addition, the magnitude of induction of expression of prostate apoptosis associated genes, SGP-2 and TGF-beta, was similar in the mutant p53 overexpressing and parental PC-3 cells and coincidental with DNA fragmentation. CONCLUSIONS: These findings seriously challenge the involvement of p53 in radiation-induced apoptosis in human prostate cancer cells and suggest that p53 mutations provide no selective advantage in the development of radioresistance of prostate tumor cells within the context of p53 independent apoptotic pathway.

Impact from changes in Illinois drivers license renewal requirements for older drivers.

In late 1989, Illinois revised the length of license term and renewal requirements for older drivers. The term was shortened from 4 to 2 years for those ages 81-86 and 1 year for those ages 87 and up. A mandatory road test which had been required at renewal for all drivers ages 69 and over, was eliminated for those ages 69 to 74. Data are available to explore the impact of these changes on crashes, fatal crashes, crash rates, and licensure rates of senior drivers. Comparisons are made between 1987-1989 averages and 1995 for three age groups: 70-74, 75-80 (the control group that had no changes in requirements), and 81 and up. It does not appear that eliminating the road test for those ages 69 to 74 had any negative impact. On the contrary, it does not appear that the more frequent renewal period for those ages 81 and up produced any benefit compared to the control group. As the number of older drivers continue to increase into the future, the analysis of licensing requirements and their impact is important.

Impact of the Illinois child passenger protection act: a retrospective look.

This paper considers the Illinois child restraint use law which took effect in July 1983. This law requires parents to use safety seats for children under age 4, and seat belts or safety seats for those aged 4 or 5. ARIMA time series models and a monthly data set of fatalities and injuries from 1980 through 1986 were utilized. The law reduced the total number of children under 5 killed or injured in traffic crashes by 10% along with a 17% decline in the number of child injuries per crash. No spillover effect was found for older children.

Impact of the 65 mph speed limit on accidents, deaths, and injuries in Illinois.

At the end of April 1987, Illinois raised the speed limit from 55 to 65 mph on rural interstates and limited-access highways. This paper examines the effects of this change. It applies ARIMA techniques to a monthly time series of accidents, injuries, and fatalities dating from five years before the limit increase to four years after. Two types of rural highways are examined: those where the speed limit was raised and those where it remained at 55 mph. The impact of higher limits on mean speeds, speed variance, traffic diversion, traffic generation, speed spillover, and issues of benefits and costs are considered. The findings suggest the higher limit led to 300 additional accidents per month in rural Illinois, with associated increases in deaths and injuries. This impact was apparent on both 65 and 55 mph roads. There is some evidence of traffic diversion from 55 to 65 mph highways plus traffic generation and speed spillover.

Birth outcomes to rural Illinois residents: is there a crisis?

In recent years, the supply of obstetric services in rural areas has been a concern. At the same time, the demand for such services has been affected by the reduction in population and economic base. This article explores the extent of these trends in Illinois and whether they have led to a deterioration in amount of prenatal care and birth outcomes. Using birth certificate and infant death data for residents of rural Illinois counties in 1983 and 1988, prenatal care and birth outcomes for each year are compared within rural areas and to the rest of the state, as well as between the two time periods. Although rural residents began prenatal care later, they obtained similar qualities of care as their urban counterparts. The data revealed no adverse impact on birth outcomes of residing in increasingly rural areas, nor was there a deterioration during the time period. An attempt was made to identify rural counties that lost providers and/or facilities and those that gained them. Although such a classification scheme is subjective, similar results ensued. While indirect costs such as time and effort to obtain care may have increased, at 1988 levels of care availability there was no crisis in Illinois.

Risk compensation and the Illinois seat belt use law.

The question of whether drivers alter their behavior due to vehicle safety improvements or public policy changes (laws, enforcement) has been debated for some years. The possibility of risk compensation (offsetting behavior) has been offered: drivers may go faster or operate in a less safe manner in response to such a change. Three 1991 publications purportedly find risk compensation due to mandatory seat belt use laws. However, these conclusions are questionable due to the weaknesses in statistical methods that were used (before/after comparisons, regression). This paper examines whether risk compensation occurred due to the 1985 use law in Illinois. It also compares the results of the before/after method to a preferred technique (ARIMA, developed by Box and others). These approaches are applied to monthly totals and rates of fatalities, injuries classified by level of severity, and total accidents from 1980-1991. Three types of accident are analyzed: vehicle/pedestrian, vehicle/bicycle, and all others. If nonoccupants have suffered adverse consequences, risk compensation could provide the explanation. Much less evidence of offsetting behavior was found. No statistically significant increase in accidents occurred. While other types of safety changes may alter driver behavior, this did not seem to occur in Illinois due to the belt use law.

Variability and consistency of rates of primary and repeat cesarean sections among hospitals in two states.

Hospitals in New York and Illinois have wide variations in their primary and repeat cesarean section rates. A number of factors account for these differences. To investigate whether hospitals with higher or lower rates tend to continue these patterns over time, their rates in 1988 were compared with those in 1983. It was found that a hospital's cesarean section rate was consistent, but some regression to the mean process did occur. By 1988, teaching hospitals had lower rates than nonteaching hospitals; this difference is likely due to the greater response to calls for increasing trials of vaginal birth after a previous cesarean section by teaching hospitals. Over time this should contribute to further moderating of the rates. Data were from the Illinois and New York State Departments of Health.

The HOME inventory: a new scale for families of pre- and early adolescent children with disabilities.

A preliminary form of a new version of the Home Observation for Measurement of the Environment (HOME) is presented. It is designed for use with families of children aged 10-15. The 80-item preliminary version of the Preadolescent HOME (PA-HOME) was field tested on 117 children with varying disabilities. The 80 items were selected from a pool of over 250 items by means of several field tests and accompanying item analyses. Both factor analyses and item analyses were used to help pare down items and produce a scale with acceptable psychometric properties. The psychometric properties of the PA-HOME are quite similar to those reported for the other three versions of the HOME Inventory. It appears to be a reasonably reliable scale with moderate correlations with other measures of the family environment, such as SES, social support, and marital stability. It has low to moderate correlations with measures of child competence in this sample of children with disabilities. The correlations are of the same general magnitude of correlations between the Infant-Toddler, Early Childhood, and Middle Childhood versions of HOME in samples of younger children with disabilities.

Right ventricular myocardial infarction.

Right ventricular myocardial infarction (RVMI) is recognized as an important clinical entity. The clinical course of patients with RVMI may be benign, or it may progress to profound hypotension and cardiogenic shock. The medical and nursing management of these patients differs significantly from that of patients with left ventricular infarction. The nurse must be familiar with the clinical signs and medical treatment of RVMI to facilitate early diagnosis and to plan appropriate acute and long-term nursing management of these patients.

A sophisticated electromechanical ventricular simulator for ventricular assist system testing.

With the advent of chronically implanted left ventricular assist systems, new adaptive control algorithms are being developed to allow automatic device control under a variety of hemodynamic conditions. An electromechanical pump is described that accurately mimics ventricular function. A pusher-plate sac pump with tri-leaflet valves is coupled to a high-speed linear motor. Pump chamber volume and pressure are constrained to follow the time-varying elastance model of ventricular function by use of a microprocessor feedback loop.