Color Doppler twinkling artifact related to chronic pancreatitis with parenchymal calcification

Color Doppler twinkling artifact is known as a rapidly changing mixture of red and blue behind certain strongly reflecting structures. This artifact has been described behind calcifications in various tissues. We describe a case of twinkling artifact related to chronic pancreatitis with parenchymal calcification.

Feasibility of ovarian preservation in patients with early stage endometrial carcinoma: A retrospective study

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Background: The treatment of endometrial cancer involves surgical removal of the ovary; this elimination induces an abrupt menopause and may deteriorate the qualities of life. Therefore, ovarian preservation may be a consideration for premenopausal women. Our main objectives are to examine the occurrence of ovarian metastasis or synchronous malignancy and to evaluate the feasibility of ovarian preservation in patients with early stage endometrial carcinoma. Methods: We reviewed the medical records of 259 patients undergoing surgical treatment for endometrial cancer at a single institute from 1992 to 2004. Results: Among the 224 patients with endometrial adenocarcinoma who had undergone ovarian removal, cancer in ovarian tissue was detected in 21 cases (9.4%, 14 ovarian metastasis, 7 synchronous cancer). Synchronous ovarian cancer showed abnormal gross finding in all 7 cases. Thirteen cases of ovarian metastasis were high grade lesion in preoperative evaluation, or showed intraoperative peritoneal seeding or abnormal gross lesion around adnexa. In 35 patients, grossly normal ovary was saved selectively in compliance with patients’ need (19 bilateral, 16 unilateral). Thirty-one of 35 (89%) were under 45 years and mostly showed early stage (Ia, 24; Ib, 7; Ic, 1; IIa, 1; IIb, 2). Pre-operative MRI was available in 30 cases, and none of them showed findings suggesting tumor extension outside of uterus. In 2 cases of IIb, postoperative radiation therapy was done. There was no recurrence or death in all cases of ovarian preservation except one in which a patient died of sepsis caused by postoperative bowel perforation (median duration of follow-up, 76 mon.; range 3∼121). Conclusions: Ovarian preservation can be cautiously performed, preceded by a thorough preoperative and intraoperative assessment of the adnexa in young women with endometrial carcinoma. The patients who desire ovarian preservation should be counseled regarding the rate of ovarian metastasis or synchronous malignancy.

No significant financial relationships to disclose.

Measurement of two- and three-nucleon short-range correlation probabilities in nuclei

The ratios of inclusive electron scattering cross sections of 4He, 12C, and 56Fe to 3He have been measured at 1 < xB <. At Q2 > 1.4 GeV2, the ratios exhibit two separate plateaus, at 1.5 < xB < 2 and at xB > 2.25. This pattern is predicted by models that include 2- and 3-nucleon short-range correlations (SRC). Relative to A = 3, the per-nucleon probabilities of 3-nucleon SRC are 2.3, 3.1, and 4.4 times larger for A = 4, 12, and 56. This is the first measurement of 3-nucleon SRC probabilities in nuclei.

Eta' photoproduction on the proton for photon energies from 1.527 to 2.227 GeV

Differential cross sections for the reaction gamma p --> eta' p have been measured with the CLAS spectrometer and a tagged photon beam with energies from 1.527 to 2.227 GeV. The results reported here possess much greater accuracy than previous measurements. Analyses of these data suggest for the first time the coupling of the eta'N channel to both the S11(1535) and P11(1710) resonances, known to couple strongly to the etaN channel in photoproduction on the proton, and the importance of J = 3/2 resonances in the process.

Search for Theta+ (1540) Pentaquark in High-Statistics Measurement of gammap-->K0K+n at CLAS

The exclusive reaction gammap-->K0K+n was studied in the photon energy range between 1.6 and 3.8 GeV searching for evidence of the exotic baryon Theta+ (1540)-->nK+. The decay to nK+requires the assignment of strangeness S=+1 to any observed resonance. Data were collected with the CLAS detector at the Thomas Jefferson National Accelerator Facility corresponding to an integrated luminosity of 70 pb-1. No evidence for the Theta+ pentaquark was found. Upper limits were set on the production cross section as function of center-of-mass angle and nK+ mass. The 95% C.L. upper limit on the total cross section for a narrow resonance at 1540 MeV was found to be 0.8 nb.

Relationship between indoor and outdoor bio-aerosols collected with a button inhalable aerosol sampler in urban homes

This field study investigated the relationship between indoor and outdoor concentrations of airborne actinomycetes, fungal spores, and pollen. Air samples were collected for 24 h with a button inhalable aerosol sampler inside and outside of six single-family homes located in the Cincinnati area (overall, 15 pairs of samples were taken in each home). The measurements were conducted during three seasons - spring and fall 2004, and winter 2005. The concentration of culturable actinomycetes was mostly below the detection limit. The median indoor/outdoor ratio (I/O) for actinomycetes was the highest: 2.857. The indoor of fungal and pollen concentrations followed the outdoor concentrations while indoor levels were mostly lower than the outdoor ones. The I/O ratio of total fungal spores (median=0.345) in six homes was greater than that of pollen grains (median=0.025). The low I/O ratios obtained for pollen during the peak ambient pollination season (spring) suggest that only a small fraction penetrated from outdoor to indoor environment. This is attributed to the larger size of pollen grains. Higher indoor concentration levels and variability in the I/O ratio observed for airborne fungi may be associated with indoor sources and/or higher outdoor-to-indoor penetration of fungal spores compared to pollen grains. Practical Implication This study addresses the relationship between indoor and outdoor concentrations of three different types of bio-aerosols, namely actinomycetes, fungal spores, and pollen grains. The results show that actinomycetes are rare in indoor and outdoor air in Midwest, USA. Exposure to pollen occurs mainly in the outdoor air even during peak pollen season. Unexpectedly high fungal spore concentrations were measured outdoors during winter. The presented pilot database on the inhalable levels of indoor and outdoor bio-aerosols can help apportion and better characterize the inhalation exposure to these bio-aerosols. Furthermore, the data can be incorporated into existing models to quantify the penetration of biological particles into indoor environments from outdoors.

Psychological therapies for people with borderline personality disorder

BACKGROUND

Borderline personality disorder (BPD) is a relatively common personality disorder with a major impact on health services as those affected often present in crisis, often self-harming.

OBJECTIVES

To evaluate the effects of psychological interventions for people with borderline personality disorder.

SEARCH STRATEGY

We conducted a systematic search of 26 specialist and general bibliographic databases (December 2002) and searched relevant reference lists for further trials.

SELECTION CRITERIA

All relevant clinical randomised controlled trials involving psychological treatments for people with BPD. The definition of psychological treatments included behavioural, cognitive-behavioural, psychodynamic and psychoanalytic.

DATA COLLECTION AND ANALYSIS

We independently selected, quality assessed and data extracted studies. For binary outcomes we calculated a standard estimation of the risk ratio (RR), its 95% confidence interval (CI), and where possible the number need to help/harm (NNT/H). For continuous outcomes, endpoint data were preferred to change data. Non-skewed data from valid scales were summated using a weighted mean difference (WMD).

MAIN RESULTS

We identified seven studies involving 262 people, and five separate comparisons. Comparing dialectical behaviour therapy (DBT) with treatment as usual studies found no difference for the outcome of still meeting SCID-II criteria for the diagnosis of BPD by six months (n=28, 1 RCT, RR 0.69 CI 0.35 to 1.38) or admission to hospital in previous three months (n=28, 1 RCT, RR 0.77 CI 0.28 to 2.14). Self harm or parasuicide may decrease at 6 to 12 months (n=63, 1 RCT, RR 0.81 CI 0.66 to 0.98, NNT 12 CI 7 to 108). One study detected statistical difference in favour of people receiving DBT compared with those allocated to treatment as usual for average scores of suicidal ideation at 6 months (n=20, MD -15.30 CI -25.46 to -5.14). There was no difference for the outcome of leaving the study early (n=155, 3 RCTs, RR 0.74 CI 0.52 to 1.04). For the outcome of interviewer-assessed alcohol free days, skewed data are reported and tend to favour DBT. When a substance abuse focused DBT was compared with comprehensive validation therapy plus 12-step substance misuse programme no clear differences were found for service outcomes (n=23, 1 RCT, RR imprisoned 1.09 CI 0.64 to 1.87) or leaving the study early (n=23, 1 RCT, RR 7.58 CI 0.44 to 132.08). When dialectical behaviour therapy-oriented treatment is compared with client centred therapy no differences were found for service outcomes (n=24, 1 RCT, RR admitted 0.33 CI 0.08 to 1.33). However, fewer people in the DBT group displayed indicators of parasuicidal behaviour (n=24, RR 0.13 CI 0.02 to 0.85, NNT 2 CI 2 to 11). There were no differences for outcomes of anxiety and depression (n=24, 1 RCT, RR anxiety BAI >/=10 0.60 CI 0.32 to 1.12; RR depression HDRS >/=10 0.43 CI 0.14 to 1.28) but people who received DBT had less general psychiatric severity than those in the control (MD BPRS at 6 months -7.41 CI -13.72 to -1.10). Finally this one relevant study reports skewed data for suicidal ideation with considerably lower scores for people allocated to DBT. When psychoanalytically oriented partial hospitalization was compared with general psychiatric care the former tended to come off best. People who received treatment in a psychoanalytic orientated day hospital were less likely to be admitted into inpatient care when measured at different time points (e.g. n=44, RR admitted to inpatient 24 hour care >18 to 24 months 0.05 CI 0.00 to 0.77, NNT 3 CI 3 to 10) Fewer people in psychoanalytically oriented partial hospitalization needed day hospital intervention in the 18 months after discharge (n=44, 1 RCT, RR 0.04 CI 0.00 to 0.59, NNT 2 CI 2 to 8). More people in the control group took psychotropic medication by the 30 to 36 month follow-up, than those receiving psychoanalytic treatment (n=44, 1 RCT, RR 0.44 CI 0.25 to 0.80, NNT 3 CI 2 to 7). Anxiety and depression scores were generally lower in the psychoanalytically oriented partial hospitalization group (n=44, 1 RCT, RR >/=14 on BDI 0.52 CI 0.34 to 0.80, NNT 3 CI 3 to 6), as are global severity scores. People receiving psychoanalytic care in a day hospital had better social improvement in social adjustment using the SAS-SR at 6 to 12 months compared with people in general psychiatric care (MD -0.70 CI -1.08 to -0.32). Rates of attrition were the same (n=44, 1 RCT, RR leaving the study early 1.00 CI 0.23 to 4.42).

AUTHORS' CONCLUSIONS

This review suggests that some of the problems frequently encountered by people with borderline personality disorder may be amenable to talking/behavioural treatments but all therapies remain experimental and the studies are too few and small to inspire full confidence in their results. These findings require replication in larger 'real-world' studies.

Pharmacological interventions for people with borderline personality disorder

BACKGROUND

Borderline Personality Disorder (BPD) is prevalent (2% in the general population, 20% among psychiatry in-patients) and has a major impact on health facilities as those affected often present in crisis but then make poor use of further attempts to help them.

OBJECTIVES

To evaluate the effects of pharmacological interventions for people with borderline personality disorder.

SEARCH STRATEGY

We conducted a systematic search of 26 specialist and general bibliographic databases (October 2002) and searched relevant reference lists for further trials.

SELECTION CRITERIA

We included all randomised clinical trials comparing any psychoactive drugs with any other treatment for people with borderline personality disorder.

DATA COLLECTION AND ANALYSIS

We independently selected, quality assessed and data extracted studies. For binary outcomes we calculated a standard estimation of the risk ratio (RR), its 95% confidence interval (CI), and where possible the number need to help/harm (NNT/H). For continuous outcomes, endpoint data were preferred to change data. Non-skewed data from valid scales were synthesised using a weighted mean difference (WMD).

MAIN RESULTS

We found ten small (total n=554), short, randomised studies involving eight comparisons from which we could extract usable data. Studies comparing antidepressants with placebo were small (total n=79, 2 RCTs) but for ratings of anger fluoxetine may offer some improvement for those on antidepressant therapy over placebo (n=22, 1 RCT, RR anger not improved 0.30 CI 0.10 to 0.85, NNT 2 CI 2 to 9). The one small study investigating the important outcome of attempted suicide found no difference between mianserin and placebo (n=38, 1 RCT, RR 0.82 CI 0.44 to 1.54). Haloperidol may be better than antidepressants for symptoms of hostility and psychotism. There were few differences between MAOIs and placebo except that people given MAOIs were less hostile (n=62, 1 RCT, MD -9.19 CI -16.12 to -2.26). Although some ratings were statistically significant the comparison of MAOIs with antipsychotics did not show convincing differences. Antipsychotics may effect some mental state symptoms more effectively than placebo but results are difficult to interpret clinically and there is little evidence of advantage of one antipsychotic over another. Finally mood stabilisers such as divalporex may help mental state (n=16, 1 RCT, RR no improvement in mental state 0.58 CI 0.36 to 0.94, NNT 3 CI 2 to 17) but data are far from conclusive.

AUTHORS' CONCLUSIONS

Pharmacological treatment of people with BPD is not based on good evidence from trials and it is arguable that future use of medication should be from within randomised trials. Current trials suggest that the positive effect of antidepressants, in particular, could be considerable. Well designed, conducted and reported clinically meaningful trials are possible and needed with, perhaps, the question of antidepressant versus placebo being addressed first.

Highly engineered mesoporous structures for optical processing

Arranging periodic, or quasi-periodic, regions of differing refractive index in one, two, or three dimensions can form a unique class of mesoporous structures. These structures are generally known as photonic crystals, or photonic quasicrystals, and they are the optical analogue of semiconducting materials. Whereas a semiconductor's band structure arises from the interaction of electron or hole waves with an arrangement of ion cores, the photonic crystal band structure results from the interaction of light waves with an arrangement of regions of differing refractive index. What makes photonic crystals highly attractive to the optical engineer is that we can actually place the regions of differing refractive index in a pattern specifically tailored to produce a given optical function, such as an extremely high dispersion, for example. That is, we can define the geometrical arrangement of the dielectric foam to provide us with the form of band structure we require for our optical functionality. In this paper, the optical properties and applications of these highly engineered mesoporous dielectrics will be discussed.

A case of tetramine poisoning: a lethal rodenticide

We report a fatal case of suicide presenting with convulsions and subsequently multi-organ failure. Rodenticide poisoning was not suspected until the next day when tetramine was detected in the patient's blood, urine, and food residues. Tetramine is a potent rodenticide with a rapid action and high mortality. The poison has been banned worldwide but is still readily available in Mainland China. Outbreaks of poisoning are reported frequently and doctors should be alert for this lethal toxin.

Efficient dechlorination of tetrachloroethylene in soil slurry by combined use of an anaerobic Desulfitobacterium sp. strain Y-51 and zero-valent iron

A laboratory test was conducted to examine the combined effect of bioaugmentation of an anaerobic bacterial Desulfitobacterium sp. strain Y-51 and addition of zero-valent iron (Fe0) on the reductive dechlorination of tetrachloroethylene (PCE) in a non-sterile soil slurry. Introduction of a strain Y-51 culture in soil (3 mg vss (volatile suspended solids)/kg soil) containing PCE (at 60 micromol/kg soil) led to complete conversion of PCE to cis-1,2-dichloroethylene (cis-DCE) within 40 d. Treatments of the same soil slurry with Fe0 (0.1-1.0%) resulted in extended PCE dechlorination to ethylene (ETH) and ethane (ETA). The combined use of a strain Y-51 culture and Fe0 showed effective dechlorination of PCE than did the individual use. The cis-DCE produced from biological PCE dechlorination by strain Y-51 was totally converted to non-chlorinated end products by the following chemical reduction by Fe0. Furthermore, anaerobic corrosion of Fe0 was found to stimulate the biological reductive dechlorination of PCE by keeping proper levels of pH and oxidation-reduction potential (ORP) and by producing cathodic hydrogen, which might be used as an electron donor for respiratory PCE dechlorination. These findings suggest that the combined use of bacterial strain Y-51 and Fe0 is effective for practical treatment of PCE and other chlorinated ethylenes in contaminated sites.

Beam-helicity asymmetries in double-charged-pion photoproduction on the proton

Beam-helicity asymmetries for the two-pion-photoproduction reaction gammap-->ppi(+)pi(-) have been studied for the first time in the resonance region for center-of-mass energies between 1.35 and 2.30 GeV. The experiment was performed at Jefferson Lab with the CEBAF Large Acceptance Spectrometer using circularly polarized tagged photons incident on an unpolarized hydrogen target. Beam-helicity-dependent angular distributions of the final-state particles were measured. The large cross-section asymmetries exhibit strong sensitivity to the kinematics and dynamics of the reaction. The data are compared with the results of various phenomenological model calculations, and show that these models currently do not provide an adequate description for the behavior of this new observable.

Systems analysis of a quorum sensing network: design constraints imposed by the functional requirements, network topology and kinetic constants

Understanding the relationship between the structural organization of intracellular decision networks and the observable phenotypes they control is one of the exigent problems of modern systems biology. Here we perform a systems analysis of a prototypic quorum sensing network whose operation allows bacterial populations to activate certain patterns of gene expression cooperatively. We apply structural perturbations to the model and analyze the resulting changes in the network behavior with the aim to identify the contribution of individual network elements to the functional fitness of the whole network. Specifically, we demonstrate the importance of the dimerization of the transcription factor and the presence of the auxiliary positive feedback loop on the switch-like behavior of the network and the stability of its "on" and "off" states under the influence of molecular noise.

Black shale as a sorbent for trichloroethylene and Cr(VI)

Black shale was examined as a natural sorbent for organic and inorganic contaminants. Trichloroethylene (TCE) could be removed well from the water by sorption onto the locally available black shale because of the high organic carbon content (5.2%) of the black shale in this study. Hexavalent chromium Cr(VI) was mainly removed by ionic sorption and reduction in batch and column experiments. Amphiphilic humic acid was also sorbed onto the black shale and could facilitate the sorption of TCE at the same time. Humic acid also enhanced the removal of Cr(VI) by reduction and sorption, but the amount of Cr(VI) adsorbed (mg kg(-1)) was smaller than that of TCE. Considering that the black shale in this study was used without any modifications and has a small surface area, black shale can be a cost-effective natural geosorbent and additive to remove organic contaminants and heavy metals.