Angle-dependent evolution of the Fulde-Ferrell-Larkin-Ovchinnikov state in an organic superconductor

We report magnetic-field and angular-dependent high-resolution specific-heat measurements of the organic superconductor β''-(BEDT-TTF)2SF5CH2CF2SO3. When the magnetic field is aligned precisely within the conducting BEDT-TTF layer, at low temperatures a clear upturn of the upper critical field beyond the Pauli limit of 9.73 T is observed, hinting at the emergence of a Fulde-Ferrell-Larkin-Ovchinnikov state. This upturn disappears when the field is oriented out of plane by more than ∼0.5  deg. For smaller out-of-plane angles, the specific-heat anomaly at T(c) sharpens and a second peaky phase transition appears within the superconducting state.

Magnetic frustration in a quantum spin chain: the case of linarite PbCuSO4(OH)2

We present a combined neutron diffraction and bulk thermodynamic study of the natural mineral linarite PbCuSO4(OH)2, this way establishing the nature of the ground-state magnetic order. An incommensurate magnetic ordering with a propagation vector k=(0,0.186,1/2) was found below T(N)=2.8 K in a zero magnetic field. The analysis of the neutron diffraction data yields an elliptical helical structure, where one component (0.638μ(B)) is in the monoclinic ac plane forming an angle with the a axis of 27(2)°, while the other component (0.833μ(B)) points along the b axis. From a detailed thermodynamic study of bulk linarite in magnetic fields up to 12 T, applied along the chain direction, a very rich magnetic phase diagram is established, with multiple field-induced phases, and possibly short-range-order effects occurring in high fields. Our data establish linarite as a model compound of the frustrated one-dimensional spin chain, with ferromagnetic nearest-neighbor and antiferromagnetic next-nearest-neighbor interactions. Long-range magnetic order is brought about by interchain coupling 1 order of magnitude smaller than the intrachain coupling.

Relationship between the heparin management test and the HemoTec activated clotting time in patients undergoing percutaneous coronary intervention

Point-of-care whole blood coagulation tests are critical in the management of patients who undergo percutaneous coronary intervention. The Hemochron and HemoTec devices have been traditionally used to measure the activated clotting time (ACT) in the cardiac catheterization laboratory. The heparin management test (HMT) was recently introduced into clinical practice as an alternative method to current ACT measurements that uses a different sample volume, contact activators and detection system to measure whole blood coagulation. We compared the HMT to the HemoTec ACT in 68 prospectively enrolled patients (127 blood samples) undergoing percutaneous coronary intervention. Measurements were performed 10 minutes after the initial heparin bolus and thereafter at the discretion of the attending physician. The mean HMT was 41 seconds higher (approximately 15%) than the HemoTec ACT (HMT 304+/-59 vs. ACT 263+/-52, P< 0.0001), but there was a significant correlation between the methods (r=0.77, P<0.0001). However, there was increasing disagreement between the two methods as the level of anticoagulation increased. The relationship between HMT and ACT was similar in patients in whom glycoprotein IIb/IIIa inhibitors were used. The HMT, therefore, appears to be more sensitive to heparin anticoagulation that the HemoTec ACT and correlates well with it in the range required for percutaneous coronary intervention.

The expression of substance P and its neurokinin-1 receptor mRNA in the bovine corpus luteum of early developmental stage

Related to all leukocytes, 90% of eosinophils are recruited into the bovine corpus luteum of early developmental stage. We here describe a simultaneous appearance of substance P (SP)-positive fibre-like structures and the neurokinin-1 (NK-1) receptor mRNA for SP. Substance P was depicted by using indirect immunohistology and immunofluorescence localization. The dot blot analysis confirmed the presence of SP at the protein level. Using nested reverse transcribed-polymerase chain reaction (RT-PCR) analysis, a 358 bp long partial bovine receptor mRNA for SP (NK-1) was sequenced in the spinal cord. The mRNA for SP and for the NK-1 receptor were then detected in the corpus luteum of early developmental stage with RT-PCR and nested RT-PCR. We conclude: The production of SP and the expression of NK-1 receptor mRNA may be involved in the selective recruitment of eosinophils into the bovine corpus luteum of early developmental stage.

[The practicability, patient comfort and efficiency of the pre-oxygenation device NasOral]

OBJECTIVE

We examined the new NasOral-System (NOS; Logomed, Germany), which is designed for a fasten and more complete denitrogenization when compared to the use of a contemporary face-mask. The patient inhales oxygen via a nose mask and exhales via mouthpiece. Nose mask and mouthpiece have built-in one-way valves, resulting in an unidirectional gas flow (nasal-oral).

METHODS

With approval of the local ethic committee, pre-oxygenation with both the NOS and a face mask (Laerdal) was studied in 50 adult patients. Midazolam 3.75-7.5 mg p.os was given for premedication. The NOS was studied in two different ways: the nose mask fastened by rubberband and with the nose mask held by hand. Prior to induction every patient received every system in a randomised manner. Semi-closed-anaesthetic circle-systems with a fresh-gas-flow of 10 litres/min were used. The FEO2 over 5 min of pre-oxygenation were recorded (AS-3, Datex). Speed and degree of the denitrogenization was documented by an external digital data-acquisition system. Practicability of the systems regarding the anaesthesists (n = 27) and patient comfort were evaluated by means of a standardized postoperative questionnaire.

RESULTS

The hand-held NOS is definitely more effective and reliable than both the NOS fastened by rubber-band and the classical face mask: 80% of the hand-held NOS were able to achieve a FEO2 of > or = 0.8 compared to only 36% of the NOS fixed by rubber-band, face mask: 48%. FEO2 of > or = 0.8 was achieved with 52% of the hand-held NOS in 90 s, a time we consider practical for daily routine, whereas only 10% of the NOS fixed by rubberband and 14% of the face masks accomplished this threshold. A cooperative patient is an important condition when using the NOS: a strong premedication effect, absence of dentures, and patients who can not inspire via nose and expire via mouth involve impairment of the positive effects of the NOS. 21% of the anaesthesists felt disturbed by the NOS. 72% do not believe, that induction of anaesthesia will become more safe with the NOS. For 8 patients, breathing with the NOS was disagreeable (face-mask: 3 patients), 15 were disturbed by the nose part/mouth piece (face-mask: no patient).

CONCLUSION

An acceptable FEO2 of > or = 0.8 can be achieved only without leakage of both the NOS and the face-mask. Therefore, routine FEO2-monitoring seems highly desirable. Efficiency of the hand-held NOS is much better than with the NOS fastened by rubberband or the face mask. However, even the hand-held NOS cannot guarantee for optimal denitrogenization. Practicability in daily use was poor, because a test of airway patency by manual ventilation prior to relaxation/intubation is not possible with the NOS. Using the device as a help in apnoic oxygenation seems useful.

Prenatal diagnosis of a partial trisomy 19q

Phenotypic anomalies due to a genetic imbalance of chromosome 19 have been reported in very rare postnatal cases. Here a case of partial trisomy 19 diagnosed prenatally by ultrasonography and cytogenetic analysis is presented. Detailed evaluation by sonography showed major anomalies which could be correlated to the typical appearance of this chromosomal anomaly. Termination of pregnancy at 21 weeks of gestation was performed, and the prenatal diagnosis was confirmed postnatally by autopsy. The syndrome in this case was caused by a duplication of the long arm of chromosome 19 (46,XY, dup(19) (q13.1-->qter).

A convenient assay for estimating the possible involvement of efflux of fluoroquinolones by Streptococcus pneumoniae and Staphylococcus aureus: evidence for diminished moxifloxacin, sparfloxacin, and trovafloxacin efflux

We developed a simplified assay for estimating efflux by measuring the effect of reserpine on the growth of Streptococcus pneumoniae and Staphylococcus aureus over 7 h. Reserpine enhanced ciprofloxacin and levofloxacin 17 to 68%. The hydrophobic drug trovafloxacin and the drug moxifloxacin, with a bulky C-7 substituent but hydrophilicity similar to that of levofloxacin, showed little (0 to 11%) reserpine-enhancing effect. The ease of resistant mutant strain selection correlated with efflux susceptibility.

Contribution of topoisomerase IV and DNA gyrase mutations in Streptococcus pneumoniae to resistance to novel fluoroquinolones

In this study, we assessed the activity of ciprofloxacin, levofloxacin, sparfloxacin, and trovafloxacin against clinical isolates of Streptococcus pneumoniae that were resistant to the less-recently developed fluoroquinolones by using defined amino acid substitutions in DNA gyrase and topoisomerase IV. The molecular basis for resistance was assessed by using mutants selected with trovafloxacin, ciprofloxacin, and levofloxacin in vitro. This demonstrated that the primary target of trovafloxacin in S. pneumoniae is the ParC subunit of DNA topoisomerase IV, similar to most other fluoroquinolones. However, first-step mutants bearing the Ser79-->Phe/Tyr substitution in topoisomerase IV subunit ParC were susceptible to trovafloxacin with a minimum inhibitory concentration of 0.25 microg/ml, and mutations in the structural genes for both topoisomerase IV subunit ParC (parC) and the DNA gyrase subunit (gyrA) were required to achieve levels of resistance above the breakpoint. The data also suggest that enhanced activity of trovafloxacin against pneumococci is due to a combination of factors that may include reduced efflux of this agent and an enhanced activity against both DNA gyrase and topoisomerase IV.

[Coronary emergency--the best pathway for rapid diagnosis]

Acute coronary syndrome includes instable angina pectoris, non-Q-wave infarction and, in current publications, usually also Q-wave infarction. The common pathological substrate is intracoronary plaque rupture with the formation of a thrombus. A careful work-up of the symptoms and their classification permits a presumptive diagnosis. This must then be confirmed by ECG without delay. On the basis of the clinical picture and the ECG, an acute myocardial infarction can be diagnosed unequivocally, and treatment initiated immediately. In these cases, laboratory findings merely confirm the diagnosis, and provide information on the size of the infarction and the success of reperfusion. In the event of an unclear ECG, rapid troponin tests may help to establish the diagnosis and monitoring of treatment, as well as providing prognostic information. While, formerly, a strict differentiation was made between instable angina pectoris, non-transmural and transmural infarctions, current pathophysiological knowledge makes the overarching term of acute coronary syndrome appear to be a more suitable term.

Use of modified fluid gelatin and hydroxyethyl starch for colloidal volume replacement in major orthopaedic surgery

We have compared 6% hydroxyethyl starch (HES 200/0.5) with 3% modified fluid gelatin (MFG) for volume replacement in major orthopaedic surgery and studied the effects on haemodynamic state, colloid osmotic pressure, blood clotting and plasma homeostasis. Using a controlled, randomized, single-blind clinical design, we studied 46 consecutive patients undergoing major elective orthopaedic hip surgery. The two groups were comparable in age, body weight and duration of surgery. Patients were maintained haemodynamically stable using both HES and MFG over the entire study. Fluid balance and colloidal replacement volumes were comparable in both groups (median perioperative infusion volume: HES 2500 ml, MFG 2400 ml). Laboratory variables were not clinically different. We conclude that both colloidal solutions were comparable in volume efficacy and effects on plasma oncotic pressure, clotting and plasma homeostasis. In the small number of patients studied, 6% HES 200/0.5 was found to be safe when administered in amounts corresponding to the currently accepted maximum daily dose in Germany and France of 33 ml/kg body weight and 2.0 g/kg body weight, respectively.

Growth and pubertal development in patients with meningomyelocele: a retrospective analysis

Our retrospective analysis of growth and pubertal development includes 109 children and adults with meningomyelocele (MMC) (52 M, 57 F) aged 3.2-21.0 years (median 8.9 years). Anthropometric data, growth-retarding factors and data on pubertal development were analysed in comparison to the normal population using standards from Prader et al. (1). The results (mean +/- SD) were as follows. Fifty patients (46.8%) had short stature (height SDS for chronological age (SDS CA) < -2). The supine length was influenced by the level of the lesion (height SDS CA: > or = L2 -3.13 +/- 1.62, < or = S2 -0.46 +/- 1.27), ambulatory status, skeletal deformities and pubertal stage. The mean adult height (n = 15, age 16.1-21.0 years) measured 141.3 cm for women (height SDS CA -3.83 +/- 1.79) and 159.2 cm for men (height SDS CA -2.27 +/- 1.81). In 82.6% of the subjects (n = 90), arm spans were within the normal range. Reduced arm spans (SDS < -2) as found in 19 patients (17.4%) with short stature (mean height SDS CA -3.29 +/- 1.29) may be caused by factors other than neurological lesions and skeletal deformities, and require further endocrinological studies. Out of 27 pubertal patients, central precocious puberty was diagnosed in five girls. The stages of puberty in MMC girls developed earlier than expected for the age-related group.

[Dwarfism in pericentric inversion of the X-chromosome]

We report on a 9 2/12 year old girl with pericentric inversion of the X-chromosome. It was diagnosed accidentally by a chromosome-analysis led through because of small stature. She bears a strong phenotypic resemblance to her mother (normal chromosomes), carrier of the pericentric inversion however is the phenotypically normal father. The breakpoint of the X-chromosome not lying within the critical region suggests that the patient will neither suffer a gonadal dysfunction. Both short stature and phenotypic dysmorphic features have familial cause.

[Roentgen findings in spontaneous esophageal perforation (Boerhaave syndrome)]

Having experienced two cases of Boerhaave's syndrome (spontaneous rupture of the oesophagus), one a 42-year-old man, the other a 76-year-old woman, who both died of complications failing operative repair, the authors undertook a survey of the literature in order to evaluate the role of radiology in the detection of this life-threatening condition. An analysis of 118 clinically and 67 radiologically well-documented cases yielded pathologic findings in chest X-rays in 90% of the cases. Hydropneumothorax was found in 51%, pneumomediastinum in 30%, isolated pleural effusion in 25%, and infiltration of the parenchyma in 14% of the patients. In all cases it was possible to demonstrate by contrast medium-filling of the oesophagus with an aqueous medium.