Exploring pulmonary distribution of intratracheally instilled liquid foams in excised porcine lungs

The applicability of inhalation therapy to some severe pulmonary conditions is often compromised by limited delivery rates (i.e. total dose) and low deposition efficiencies in the respiratory tract, most notably in the deep pulmonary acinar airways. To circumvent such limitations, alternative therapeutic techniques have relied for instance on intratracheal liquid instillations for the delivery of high-dose therapies. Yet, a longstanding mechanistic challenge with such latter methods lies in delivering solutions homogeneously across the whole lungs, despite an inherent tendency of non-uniform spreading driven mainly by gravitational effects. Here, we hypothesize that the pulmonary distribution of instilled liquid solutions can be meaningfully improved by foaming the solution prior to its instillation, owing to the increased volume and the reduced gravitational bias of foams. As a proof-of-concept, we show in excised adult porcine lungs that liquid foams can lead to significant improvement in homogenous pulmonary distributions compared with traditional liquid instillations. Our ex-vivo results suggest that liquid foams can potentially offer an attractive novel pulmonary delivery modality with applications for high-dose regimens of respiratory therapeutics.

Functional Communication as a Means of Decreasing Self-injurious Behavior: A Case Study

This case study examines the effects of a systematic functional communication training program on the self-injurious behaviors of a girl who is blind and has severe disabilities. The two-level program, in which the girl was offered choices among preferred activities and learned to use a communication board, resulted in a decrease in the episodes of these behaviors.

Targeted Drug Delivery to Upper Airways Using a Pulsed Aerosol Bolus and Inhaled Volume Tracking Method

The pulmonary route presents an attractive delivery pathway for topical treatment of lung diseases. While significant progress has been achieved in understanding the physical underpinnings of aerosol deposition in the lungs, our ability to target or confine the deposition of inhalation aerosols to specific lung regions remains meagre. Here, we present a novel inhalation proof-of-concept in silico for regional targeting in the upper airways, quantitatively supported by computational fluid dynamics (CFD) simulations of inhaled micron-sized particles (i.e. 1-10 μm) using an intubated, anatomically-realistic, multi-generation airway tree model. Our targeting strategy relies on selecting the particle release time, whereby a short-pulsed bolus of aerosols is injected into the airways and the inhaled volume of clean air behind the bolus is tracked to reach a desired inhalation depth (i.e. airway generations). A breath hold maneuver then follows to facilitate deposition, via sedimentation, before exhalation resumes and remaining airborne particles are expelled. Our numerical findings showcase how particles in the range 5-10 μm combined with such inhalation methodology are best suited to deposit in the upper airways, with deposition fractions between 0.68 and unity. In contrast, smaller (< 2 μm) particles are less than optimal due to their slow sedimentation rates. We illustrate further how modulating the volume inhaled behind the pulsed bolus, prior to breath hold, may be leveraged to vary the targeted airway sites. We discuss the feasibility of the proposed inhalation framework and how it may help pave the way for specialized topical lung treatments.

Penile cancer associated with so-called low-risk human papilloma virus. Report of five cases from rural Venezuela

Penile cancer is uncommon in western countries. It has been related to human papilloma virus (HPV) types 16 and 18. We describe five cases of carcinoma of the penis in men from a rural Venezuelan town that were related to HPV types 6, 11, 53, which represent a rather low risk for cancer.

Observation of an Alfvén Wave Parametric Instability in a Laboratory Plasma

A shear Alfvén wave parametric instability is observed for the first time in the laboratory. When a single finite ω/Ω_{i} kinetic Alfvén wave (KAW) is launched in the Large Plasma Device above a threshold amplitude, three daughter modes are produced. These daughter modes have frequencies and parallel wave numbers that are consistent with copropagating KAW sidebands and a low frequency nonresonant mode. The observed process is parametric in nature, with the frequency of the daughter modes varying as a function of pump wave amplitude. The daughter modes are spatially localized on a gradient of the pump wave magnetic field amplitude in the plane perpendicular to the background field, suggesting that perpendicular nonlinear forces (and therefore k_{⊥} of the pump wave) play an important role in the instability process. Despite this, modulational instability theory with k_{⊥}=0 has several features in common with the observed nonresonant mode and Alfvén wave sidebands.

Nonlinear excitation of acoustic modes by large-amplitude Alfvén waves in a laboratory plasma

The nonlinear three-wave interaction process at the heart of the parametric decay process is studied by launching counterpropagating Alfvén waves from antennas placed at either end of the Large Plasma Device. A resonance in the beat wave response produced by the two launched Alfvén waves is observed and is identified as a damped ion acoustic mode based on the measured dispersion relation. Other properties of the interaction including the spatial profile of the beat mode and response amplitude are also consistent with theoretical predictions for a three-wave interaction driven by a nonlinear ponderomotive force.

Quantitative study of guide-field effects on Hall reconnection in a laboratory plasma

The effect of guide field on magnetic reconnection is quantitatively studied by systematically varying an applied guide field in the Magnetic Reconnection Experiment (MRX). The quadrupole field, a signature of two-fluid reconnection at zero guide field, is altered by a finite guide field. It is shown that the reconnection rate is significantly reduced with increasing guide field, and this dependence is explained by a combination of local and global physics: locally, the in-plane Hall currents are reduced, while globally guide field compression produces an increased pressure both within and downstream of the reconnection region.

Theoretical analysis of the growth mode for thin metallic films on oxide substrates

We show how the growth mode of a thin metallic film on an insulating substrate can be predicted theoretically by combining thermodynamic considerations with ab initio calculations for ordered metal/insulator interfaces at low coverage. Our approach is illustrated by calculations for Ag film deposited on an MgO substrate. Ab initio calculations predict high mobility of adsorbed Ag atoms on MgO, even at low temperatures, which greatly aids their aggregation.

Cholecystectomy via Kocher incision without peritoneal closure

This investigation was carried out to evaluate the surgical wound outcome of patients who underwent cholecystectomy via Kocher incision, without peritoneal closure. Consecutive patients (n = 129) were randomized either to have the peritoneal closure (n = 66) or to have this step omitted (n = 63). Demographic data of the patients were similar in both groups. There were no significant differences in overall wound complication (p = 0.44), wound infection (p = 0.71), wound dehiscense (p = 0.96) and incisional hernia (p = 0.95). This study provides strong evidence that the avoidance of the peritoneal closure represents no adverse effect to the postoperative course of the patients.

[Surgical treatment of congenital cysts of the liver]

We report 9 patients who were surgically treated for symptomatic congenital liver cysts. Median age at presentation was 51 years and all the cases were females. Symptoms and clinical findings included a painful mass in the upper right quadrant of the abdomen. Ultrasonography was used most frequently and was an accurate technique for diagnosing these lesions. The cysts were often located in the right hepatic lobe. Surgical technique included total excision (n = 6) and partial excision via fenestration (n = 3). Based in our limited experience we believe that fenestration constitutes the least aggressive approach with a high rate of symptom relief and should be considered as an alternative in the treatment of these lesions.

Comparison of hemp and cotton fiber implants in muscle rat tissue. Study of the inflammatory response

Hemp fiber is obtained from the plant Musa textilis. The cost of preparation of its raw fibers is low. The purpose of this paper was to compare the inflammatory response in the rat muscle tissue originated by both hemp and cotton fibers. Both types of fibers, were implanted in gluteal muscles of Sprague Dawley rats. The rats were sacrificed at 15, 30 and 60 postoperative days. Muscle tissue sections were stained with hematoxilyneosin. The inflammatory response was measured by subtracting the suture surface area from the total granulomatous area. At 15 days, the inflammatory response was more conspicuous for hemp than for cotton fiber (P < 0.05). At 30 and 60 days, responses were similar (P > 0.05). We cannot conclude that the hemp fiber is superior to cotton, nevertheless, they behave the same. Therefore, hemp constitutes an alternative as suture material.

[A leiomyosarcoma of vascular origin. A case report]

Leiomyosarcomas arising from the wall of the blood vessels, are highly malignant tumours. Although 75% of the cases have been reported in the inferior vena cava, nevertheless scanty mention is made in the literature of an analogous tumor originating from smaller blood vessels. This paper deals with a 53-year-old man with a tumor in the right axilla. Surgery consisted in wide local excision. Histopathology revealed a mesenchymal tumor in an axillary blood vessel. Electron microscopy revealed tumor cell with all the characteristics of a leiomyosarcoma. The patient refused adjuvant therapy and died 10 months later with local recurrence and lung metastases.

Self Diffusion Parameters from Non-empirical Pair Potentials

A scheme for construction of the pair potential from non-empirical calculations of electronic structure of solids is suggested. As an example, parameters of Lennard-Jones potential are obtained for fccCs, based on LMTO calculations of energy parameters. Vacancy formation and migration energies for fccCs are calculated from this first-principles pair potential. In addition, the frequency of vibration and the jump probability of an atom are calculated and it is shown that they are direction dependent.

[Granular cell tumor of the vulva]

Granular cell tumor is a relatively uncommon entity of unknown etiology and uncertain histogenesis. A case of granular cell tumor of the vulva is presented with a discussion of the clinical features, pathological characteristics and the histogenic theories of its origin.

[Single diverticulum of perforated cecum. Report of 5 cases]

Cecal diverticulitis is a relatively rare disease, which closely mimics the picture of acute appendicitis. At times it is difficult to differentiate from carcinoma. Five cases of cecal diverticulitis are reported, with a discussion of some salient features of this condition. Although two cases were treated with a right hemicolectomy, a plea for conservatism in the treatment of this disease is made.

Smoking cessation with young women in public family planning clinics: the impact of physician messages and waiting room media

This study evaluated the impact of a media program and a physician-delivered message in encouraging smoking cessation among young black women in public family planning clinics. Incorporated into the clinic visit, the 3- to 5-min physician message was intended to elicit a commitment from participants to take steps toward quitting, namely, to think about quitting, set a target date, enlist the help of family and friends, throw away matches and cigarettes, and to then quit "cold turkey." The media program consisted of specially designed posters in waiting rooms showing models of people in the process of quitting and a continuously run movie dealing with women and smoking. A total of 1,179 female smokers were recruited into the study when they came to three separate clinics in Baltimore, Maryland, to receive gynecological examinations and/or contraceptive services. Four separate interventions were tested: (I) a baseline questionnaire about smoking habits and related information; (II) baseline questionnaire plus media program; (III) baseline questionnaire plus physician message; and (IV) baseline questionnaire plus media program plus physician message. Conditions I and II were administered in Clinic A on alternating weeks, Condition III was administered in Clinic B, and Condition IV was administered in Clinic C. Follow-up was conducted at 3 and 12 months. Follow-up rates were 88.1% at 3 months, 79.9% at 12 months, and 84.1% for both 3 and 12 months. Among women receiving the physician message (Conditions III and IV), 9.9% reported not smoking at 12 months; the lowest selfreported cessation rate was 3.1% in Condition I. When verified through analyzing cotinine in saliva, quit rates were 0.09% in Condition I, 2.4% in Condition II, 3.7% in Condition III, and 2.1% in Condition IV. The fact that participants receiving the physician message quit smoking at a significantly greater rate than those who did not indicates the need for further study of the impact of physician-delivered smoking cessation messages and ways to increase their effectiveness.

Balantidiasis: report of a fatal case with appendicular and pulmonary involvement

A case of fatal balantidial infection with appendicular and pulmonary involvement in a Venezuelan farmer is reported. The clinical, post-mortem and histological features are described.

Tomographic diagnosis of pituitary microadenomas in Forbes-Albright syndrome (amenorrhea-galactorrhea)

The present study documents a characteristic tomographic sellar abnormality in five patients with Forbes-Albright syndrome (ammenorrhea-galactorrhea) and surgically proved pituitary microadenomas. This abnormality, noted in patients with normal-sized sellae, consists of asymmetric erosion of the anterior inferior wall of the sella turcica. Utilizing the twin criteria of an elevated serum prolactin and characteristic sella abnormality, herein described, previously unrecognized patients with pituitary microadenomas can be diagnosed and treated effectively.

Brain cell surface antigens detected by anti-corpus callosum antiserum

When rabbits are injected with tissue homogenates of white matter from bovine corpus callosum, an antiserum is produced which reacts with the surface membrane of 20-30% of all cells obtained by trypsin-dissociation of cerebellum from 10-day-old mice. The antigen or set of antigens recognized by this antiserum is detectable on embryonic, early postnatal, and adult mouse brain, but not on liver, spleen, kidney, thymus and sperm. The antigen is expressed in different regions of the brain and also, in decreased amounts, on retina. In histological sections of cerebellum from 21-day-old mice the antigen is predominantly localized in white matter tracts. Whereas nervous tissue from chicken and rabbit does not carry detectable levels of the antigen, rat, bovine and human brains are antigen-positive.

The effect of dietary fiber supplementation in man. II. Alteration in fecal physiology and bacterial flora

Fecal weight and water content and fecal quantitative and qualitative bacterial studies were compared on six volunteer subjects during regular diet periods and when on 5.4 g of diet fiber supplementation. There was a statistical mean stool weight increase for the group from 103 +/- 40 g to 226 +/- 90 g. The water content of the stool remained constant under the diet conditions of this study. The total anaerobic counts increased significantly while the subjects were on the high fiber diet. Trends in bacterial genus changes appeared but were not significant and total aerobic counts were stable.