Proton dynamics in a spark-plasma sintered BaZr0.7Ce0.2Y0.1O3-δ proton conductor investigated by quasi-elastic neutron scattering

The thermally activated proton dynamics in the perovskite lattice of spark-plasma sintered BaZr_0.7Ce_0.2Y_0.1O_3-δ was investigated by quasi-elastic neutron scattering (QENS) and electrochemical impedance spectroscopy (EIS) in the temperature range from 200-600 °C. The quasi-elastic signal could be resolved into two components corresponding to a translational and rotational motion. From a description of the diffusive movements with the Chudley-Elliot jump diffusion model a jump distance of 3.12 Å and residence time of 13.6 ps were found for the translational protonic diffusion at 600 °C. The diffusion coefficients for QENS and EIS follow an Arrhenius law with activation energies of 0.16 eV, 0.58 eV and 0.88 eV for the microscopic proton self-diffusion, the bulk and grain boundaries, respectively. The rotational motion was analyzed using a two-site jump and a spherical rotation model which resulted in O-H distances of 0.89 Å and 0.71 Å, respectively. The data provided by the two-site jump model evidences the Grotthuss-type mechanism behind the translational proton dynamics.

Expert range maps of global mammal distributions harmonised to three taxonomic authorities

AIM

Comprehensive, global information on species' occurrences is an essential biodiversity variable and central to a range of applications in ecology, evolution, biogeography and conservation. Expert range maps often represent a species' only available distributional information and play an increasing role in conservation assessments and macroecology. We provide global range maps for the native ranges of all extant mammal species harmonised to the taxonomy of the Mammal Diversity Database (MDD) mobilised from two sources, the Handbook of the Mammals of the World (HMW) and the Illustrated Checklist of the Mammals of the World (CMW).

LOCATION

Global.

TAXON

All extant mammal species.

METHODS

Range maps were digitally interpreted, georeferenced, error-checked and subsequently taxonomically aligned between the HMW (6253 species), the CMW (6431 species) and the MDD taxonomies (6362 species).

RESULTS

Range maps can be evaluated and visualised in an online map browser at Map of Life (mol.org) and accessed for individual or batch download for non-commercial use.

MAIN CONCLUSION

Expert maps of species' global distributions are limited in their spatial detail and temporal specificity, but form a useful basis for broad-scale characterizations and model-based integration with other data. We provide georeferenced range maps for the native ranges of all extant mammal species as shapefiles, with species-level metadata and source information packaged together in geodatabase format. Across the three taxonomic sources our maps entail, there are 1784 taxonomic name differences compared to the maps currently available on the IUCN Red List website. The expert maps provided here are harmonised to the MDD taxonomic authority and linked to a community of online tools that will enable transparent future updates and version control.

A Severe Lack of Evidence Limits Effective Conservation of the World's Primates

Threats to biodiversity are well documented. However, to effectively conserve species and their habitats, we need to know which conservation interventions do (or do not) work. Evidence-based conservation evaluates interventions within a scientific framework. The Conservation Evidence project has summarized thousands of studies testing conservation interventions and compiled these as synopses for various habitats and taxa. In the present article, we analyzed the interventions assessed in the primate synopsis and compared these with other taxa. We found that despite intensive efforts to study primates and the extensive threats they face, less than 1% of primate studies evaluated conservation effectiveness. The studies often lacked quantitative data, failed to undertake postimplementation monitoring of populations or individuals, or implemented several interventions at once. Furthermore, the studies were biased toward specific taxa, geographic regions, and interventions. We describe barriers for testing primate conservation interventions and propose actions to improve the conservation evidence base to protect this endangered and globally important taxon.

Novel approaches for the design, delivery and administration of vaccine technologies

It is easy to argue that vaccine development represents humankind's most important and successful endeavour, such is the impact that vaccination has had on human morbidity and mortality over the last 200 years. During this time the original method of Jenner and Pasteur, i.e. that of injecting live-attenuated or inactivated pathogens, has been developed and supplemented with a wide range of alternative approaches which are now in clinical use or under development. These next-generation technologies have been designed to produce a vaccine that has the effectiveness of the original live-attenuated and inactivated vaccines, but without the associated risks and limitations. Indeed, the method of development has undoubtedly moved away from Pasteur's three Is paradigm (isolate, inactivate, inject) towards an approach of rational design, made possible by improved knowledge of the pathogen-host interaction and the mechanisms of the immune system. These novel vaccines have explored methods for targeted delivery of antigenic material, as well as for the control of release profiles, so that dosing regimens can be matched to the time-lines of immune system stimulation and the realities of health-care delivery in dispersed populations. The methods by which vaccines are administered are also the subject of intense research in the hope that needle and syringe dosing, with all its associated issues regarding risk of injury, cross-infection and patient compliance, can be replaced. This review provides a detailed overview of new vaccine vectors as well as information pertaining to the novel delivery platforms under development.

Composite Piezoelectric Sensors and Actuators

Composite materials have found a number of structural applications, but their use in the electronics industry has been relatively limited. As the function of electroceramic composites are better understood, we can expect this picture to change. In this paper some of the piezoelectric composite sensor and actuator studies carried out in our laboratory during the past decade will be reviewed. The ideas that provide a basic understanding of functional composites have previously been discussed [1]. This paper describes recent advances in the processing and properties of composites possessing 0-3, 1-3, and 2-2 connectivity made of polymers, metals and ferroelectric ceramics. The introduction of open spaces in the previous connectivity patterns allows the development of new designs of several piezoelectric composites with connectivity patterns of 0(0)-3, 1(0)-3, 2(0)-2-2, and 2-0-2. As in most electronic systems that are developed with improved properties a push toward lower cost and smaller sizes of the piezoelectric ceramics, together with improved reliability and performance occurs. The piezocomposites with open spaces in their structures clearly demonstrate the growth of the functional ceramics into the field of the smart ceramics as the materials for the beginning of the next century.

Abstract ES7-1: Next Generation Sequencing for the Clinician: A Breast Cancer Study

The ability to study genome-wide sequence alterations in cancer genomes has transformed our understanding of the intricacies of this disease. We have applied whole genome sequencing and analysis to tease apart the genomic predictors of aromatase inhibitor (AI) response, by selecting luminal breast cancer cases obtained within a clinical trial of aromatase inhibitor treatment (ACOSOG Z1031). Our study compared the constitutional genome to the cancer genome for patients that exhibit either a response or a resistance phenotype, based on their Ki67 IHC score following 4 month AI treatment and resection. My talk will highlight the process by which these genomes are sequenced and analyzed, and will provide our most recent insights into how the combination of the constitutional and somatic genomes determine whether a patient will respond to AI treatment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr ES7-1.

British Society of Haematology, Slide Session presented at the Annual Scientific Meeting, Brighton 2009

Seven cases were discussed by an expert panel at the 2009 Annual Scientific Meeting of the British Society of Haematology. These cases are presented in a similar format to that adopted for the meeting. There was an initial discussion of the presenting morphology, generation of differential diagnoses and then, following display of further presenting and diagnostic information, each case was concluded with provision of a final diagnosis.

Effects of exenatide on circulating glucose, insulin, glucagon, cortisol and catecholamines in healthy volunteers during exercise

AIMS/HYPOTHESIS

Exenatide, a glucagon like peptide-1 agonist, is a treatment for type 2 diabetes mellitus that stimulates insulin and suppresses glucagon secretion in a glucose-dependent manner. By contrast, during aerobic exercise, the serum insulin concentration normally falls, with a rise in plasma glucagon. We therefore assessed whether exenatide might predispose to hypoglycaemia during exercise.

METHODS

We studied eight non-diabetic men, who were 35.3 +/- 6.3 years of age with BMI of 24.7 +/- 1.7 kg/m(2) (mean +/- SD), using a randomised, crossover, double-blind design investigation. After an overnight fast, participants received 5 microg of subcutaneous exenatide or placebo and rested for 105 min before cycling at 60% of their maximal oxygen uptake (VO(2max)) for 75 min and then recovering for a further 60 min.

RESULTS

The insulin/glucagon molar ratio rose with exenatide at rest (p < 0.01), then fell during exercise with placebo and with exenatide. At rest, fasting blood glucose fell by approximately 1 mmol/l with exenatide to a nadir of 3.4 +/- 0.1 mmol/l (p < 0.01). During exercise, blood glucose fell with placebo but, unexpectedly, rose with exenatide. Plasma adrenaline (epinephrine) and noradrenaline (norepinephrine), but not cortisol concentrations increased to a greater extent during exercise after exenatide. No participant developed symptomatic hypoglycaemia and the lowest individual blood glucose recorded was 2.8 mmol/l with exenatide at 50 min in the pre-exercise period.

CONCLUSIONS/INTERPRETATION

In non-diabetic participants given exenatide, blood glucose concentrations rise rather than fall during aerobic exercise with an associated greater catecholamine response.

Multicenter experience of ABO-incompatible pediatric cardiac transplantation

Although ABO blood group incompatible cardiac transplantation in neonates and infants reduces waiting list mortality without compromising outcome, the technique has not been adopted by all centers, and to date Toronto remains the only center to have published results from a large case series. We present a review of ABO-incompatible heart transplantation in the United Kingdom (UK) where current recipient selection criteria differ somewhat from those used in the United States (US) and Canada. Between February 2000 and November 2006, 21 ABO-incompatible cardiac transplants were performed in children aged 2-40 months (median 10.0). Immunosuppression followed standard regimens. Pretransplant donor-specific isohemagglutinins of >1:4, (the UNOS cutoff), were present in five patients and reduced by plasma exchange. After transplantation, 19/21 recipients demonstrated persisting deficiency of donor-specific isohemagglutinins. Significant donor-specific isohemagglutinins levels were detected repeatedly in 2/21 recipients who have shown no clinical or biopsy evidence of rejection. All recipients survive without retransplantation and there have been no episodes of humoral rejection. We conclude it is possible for other centers to replicate the excellent results achieved in Toronto and that ABO-incompatible transplantation may be performed successfully in some patients beyond infancy with established isohemagglutinin production providing preoperative antibody removing strategies are used.

The importance of local tree resources around Gombe National Park, Western Tanzania: implications for humans and chimpanzees

Miombo woodlands and associated habitats provide a vital resource for both humans and chimpanzees in western Tanzania. A baseline survey was conducted to determine the perceived relative value of different woody species to local people in the six villages adjacent to Gombe National Park. This area also provides direct comparison of tree utilization by humans and chimpanzees since it has been the site of a long-term behavioral study on chimpanzees. Four hundred and fifty-two people, all over 30 years old, were interviewed and asked to select the 10 trees that they considered to be the most important in their everyday lives: 77% of the 4520 responses (represented by 260 species) were native and 23% (represented by 35 species) were exotic trees. In this study, particular focus was paid to the 25 tree species most frequently listed. Of these trees, 19 (representing 50% of all responses) were native, and 6 were exotic. There was a marked difference in the choices, especially with respect to native trees, by men and women. Many of the trees highly prized by humans are also of great importance in the diet of chimpanzees. It is recommended that a major effort be made to maintain the usage and availability of native trees outside the park boundary, which, in conjunction with the balanced planting of exotics for meeting local needs, should contribute to protecting the biodiversity of Gombe and the local ethnobotanical heritage.

Influence of perineal swellings on behavior and stress reaction in levonorgestrel implanted Macaca sylvanus females

OBJECTIVES

Contraceptives are common tools in controlling the reproductive physiology in primates. Levonorgestrel, a synthetic gestagen, can usually enable contraception and does not suppress the extension of perineal swellings.

SETTING

This study investigated the effects on intra-sexual behavior and fecal cortisol excretion rates in different swollen Barbary macaque females (N =24) during the non-reproductive phase of the year. The study was conducted on a semi-free population at Affenberg Salem (Germany).

RESULTS

The results showed that females with reduced swellings received more aggressive encounters than females with enlarged perinea; whereas, at the same time the latter individuals have increased their active grooming interactions paralleled with decreased fecal cortisol excretion rates. No correlations were found between the perineal swelling size and the dominance rank, age, or implantation time of the females.

MAIN FINDINGS

This report shows that the rate of perineal swelling expression can modulate intra-sexual behavior and stress reactivity in levonorgestrel implanted Barbary macaque females.

CONCLUSION

We conclude that large perineal swellings represent an influencing key factor in Barbary macaque females' social interactions, irrespective of whether these signals are shown naturally or induced biochemically.

How we do it: adjunctive intravenous midazolam: diagnosis and treatment of therapy-resistant muscle tension dysphonia

Dysphonic patients with muscle tension are common at voice clinics. The majority respond to intensive vocal therapy. A small number of cases remain resistant to intensive vocal therapy. We have used intravenous midazolam to enhance therapy-resistant dysphonic patients' self-monitoring, their self-awareness and to change fixed patterns. Six of seven patients were discharged with restoration of normal voice 1 month after treatment.

Can causes of false-normal D-dimer test [SimpliRED] results be identified?

BACKGROUND

To simplify the diagnostic strategy of patients suspected for venous thromboembolism, the use of D-dimer tests has been advocated. Very important for the safety of such diagnostic strategies would be the capacity to recognise false-normal D-dimer results, in order to prevent inadequately withholding anticoagulant treatment in patients who actually have the disease. Insight in the causes of false-normal D-dimer results would therefore be necessary. We hypothesised that certain patient characteristics are associated with relatively low plasma D-dimer levels and, therefore, could increase the risk of false-normal results.

METHODS

Consecutive patients with an objectively confirmed venous thromboembolic event and an independently obtained false-normal SimpliRED D-dimer test result were included in the study. For each patient, two controls with objectively confirmed venous thromboembolism and an adequate abnormal D-dimer result were selected. Baseline patient characteristics, obtained by standardised questionnaires, were compared between the two groups of patients.

RESULTS

In total, 686 patients had a venous thromboembolic event and 47 of these patients had a false-normal SimpliRED result. Therefore, the overall sensitivity of the SimpliRED test for venous thromboembolism was 94% (95% CI: 92-95%). Although the prevalence of certain clinical characteristics was significantly higher in patients with a false-normal D-dimer result than in the controls [odds ratios for (LMW)heparin treatment and symptoms lasting more than 10 days: 5.1 (95% CI: 1.5-18.7) and 3.2 (95% CI:1.4-7.4), respectively], the prevalence of these characteristics was also high in the control group with an adequate abnormal D-dimer. Combining two or more of these characteristics had a low prevalence and did not further improve the ability to identify those patients with a false-normal D-dimer test at presentation.

CONCLUSIONS

Although these findings clearly indicate an association between certain baseline clinical characteristics and the occurrence of a false-normal SimpliRED test, the clinical utility for these characteristics is limited.

Coagulation factor activity during neonatal extra-corporeal membrane oxygenation

OBJECTIVE

To ascertain the activity of major coagulation factors during the first 24 h of extra-corporeal membrane oxygenation (ECMO) used to support hypoxaemic neonates.

DESIGN AND SETTING

A prospective observational study in a regional centre for ECMO and paediatric cardiac surgery, placing 15-20 neonates on ECMO per year.

PATIENTS

Ten neonates receiving ECMO for severe hypoxaemia.

MEASUREMENT AND RESULTS

The activity of major clotting factors, of the inhibitor anti-thrombin III and of markers of blood activation were measured during the first 24 h of neonatal extra-corporeal membrane oxygenation (ECMO) and prior to initiation of ECMO. There was laboratory evidence of factor deficiency and of activation of coagulation at all stages. The initiation of ECMO leads to an initial worsening of coagulopathy, but factor deficiency and abnormal activation of coagulation is also seen prior to ECMO in these very sick neonates.

CONCLUSION

If factor deficiency is to be avoided a pro-active approach is required to rapidly correct factor activity. This would include the use of fresh frozen plasma. The effect of such an approach on outcome is at yet uncertain.

Soluble N-cadherin stimulates fibroblast growth factor receptor dependent neurite outgrowth and N-cadherin and the fibroblast growth factor receptor co-cluster in cells

A chimeric molecule consisting of the extracellular domain of the adhesion molecule, N-cadherin, fused to the Fc region of human IgG (NCAD-Fc) supports calcium-dependent cell adhesion and promotes neurite outgrowth following affinity-capture to a tissue culture substrate. When presented to cerebellar neurons as a soluble molecule, the NCAD-Fc stimulated neurite outgrowth in a manner equivalent to that seen for N-cadherin expressed as a cell surface glycoprotein. Neurons expressing a dominant-negative version of the fibroblast growth factor (FGF) receptor did not respond to soluble NCAD-Fc. In cells transfected with full-length N-cadherin and the FGF receptor, antibody-clustering of N-cadherin resulted in a co-clustering of the FGF receptor to discrete patches in the cell membrane. The data demonstrate that the ability of N-cadherin to stimulate neurite outgrowth can be dissociated from its ability to function as a substrate associated adhesion molecule. The N-cadherin and the FGF receptor co-clustering in cells provides a basis for the neurite outgrowth response stimulated by N-cadherin being dependent on FGF receptor function.

Initial sequencing and analysis of the human genome

The human genome holds an extraordinary trove of information about human development, physiology, medicine and evolution. Here we report the results of an international collaboration to produce and make freely available a draft sequence of the human genome. We also present an initial analysis of the data, describing some of the insights that can be gleaned from the sequence.

A physical map of the human genome

The human genome is by far the largest genome to be sequenced, and its size and complexity present many challenges for sequence assembly. The International Human Genome Sequencing Consortium constructed a map of the whole genome to enable the selection of clones for sequencing and for the accurate assembly of the genome sequence. Here we report the construction of the whole-genome bacterial artificial chromosome (BAC) map and its integration with previous landmark maps and information from mapping efforts focused on specific chromosomal regions. We also describe the integration of sequence data with the map.

The timing of norplant insertion and postpartum depression in teenagers

BACKGROUND

This study tested the hypothesis that teenagers who have Norplant inserted during the puerperium report more depressive symptoms during the first postpartum year than their peers who do not receive Norplant.

METHODS

We studied the prevalence of depressive symptoms in a group of 212 mothers aged 19 years less, in relation to the timing of Norplant insertion. The participants were divided into 3 groups: 100 (47%) had Norplant inserted during the puerperium (early Norplant users); 72 (34%) had Norplant inserted during the next 10 months (late Norplant users); and 40 (19%) used other contraceptives (40% oral contraceptives; 17% condoms; 43% nothing). Depressive symptoms were measured with the Center for Epidemiologic Studies - Depression Scale. Postpartum depression was defined as a scale score >/=16, 6-12 months after Norplant insertion or delivery. Variables examined as potential confounders were identified a priori from a review of the literature and controlled for in analysis of variance.

RESULTS

At delivery, members of the 3 contraceptive groups did not differ significantly with regard to age, race, parity, educational, marital, or socioeconomic status. Late Norplant users were, however, more apt to have new boyfriends (p =. 03), to rate the support they received from the baby's father as poor (p =.004), and experience depression prior to Norplant insertion (p =.02). Contrary to the study hypothesis, late rather than early Norplant insertion was associated with postpartum depression. Multivariate analyses identified 3 independent predictors of the severity of depressive symptoms at follow-up (depression prior to Norplant insertion, a new boyfriend at delivery, and late Norplant insertion); R(2) = 41.3%.

CONCLUSIONS

Contrary to the study hypothesis, puerperal Norplant insertion did not exacerbate postpartum depression. Delaying Norplant insertion may increase the risk of depression during the first postpartum year, particularly in teenagers with other psychosocial risk factors.

Northern region asplenia register--analysis of first two years

OBJECTIVES

To assess the feasibility of setting up a register of patients with asplenia within a defined geographical area; to ensure that guidelines on best practice were implemented; to obtain information on antibody levels to pneumococcal capsular polysaccharides and Haemophilus influenzae type b capsular polysaccharide, before and after immunisation and annually thereafter; to raise awareness of risks among clinicians and to offer advice on management.

DESIGN

Prospective recruitment using multiple sources of recruitment. Annual follow up reminders sent from Registration Centre.

SUBJECTS

Population of (old, pre-1995) Northern Health Region: approximately 3.1 million.

MAIN OUTCOME MEASURES

Data were obtained on reasons for asplenia, duration of asplenia, use of prophylactic antibiotics, Medic-Alert bracelets, immunisations, antibody levels, death.

RESULTS

The register was initiated at the beginning of April 1995 and ran to the end of March 1997. After two years of operation, 1111 cases had been registered but the response from some health districts was poor. Major primary causes of asplenia were trauma (264), other surgical (198), lymphoproliferative disease (154), and idiopathic thrombocytopenic purpura (147). There were 664 patients on prophylactic antibiotics, of whom 498 were on continuous antibiotics. Only 18 had any type of warning bracelet. Antibody measurements were carried out at least once on 75% of patients; 306 patients had satisfactory antibody levels on first blood sample in year 1, rising to 405 in year 2; 43 patients failed to make any antibody response to Pneumovax despite multiple immunisations, and three patients failed to respond to Hib vaccine. Sixteen patients with satisfactory antibody levels in year 1 had low levels in year 2 requiring vaccine boosters. Sixteen deaths were reported, two of which were directly attributable to overwhelming sepsis.

CONCLUSIONS

Registration has been successful and has raised awareness of the management of asplenia. Compliance with antibiotic prophylaxis and immunisation was initially poor. A potential high risk group of vaccine non-responders has been identified and poor persistence of pneumococcal antibodies has been identified which is likely to alter approaches to immunisation in asplenic patients.

Evaluation of routine postoperative chest X-rays in the management of the cardiac surgical patient

OBJECTIVES

To evaluate the role of routine chest X-rays in the management of patients post cardiac surgery.

METHODS

340 adult patients undergoing cardiac surgery were studied in three consecutive groups (A, B, C) of 100 patients each. Forty patients were excluded due to the intensive care stay greater than 36 h (n = 35), or early mortality within 36 h (n = 5). Routine chest X-rays were performed according to different protocols in Groups A and B. In group C there were no routine chest X-rays during the entire postoperative period [corrected]. In all three groups chest X-rays were performed where clinically indicated. Group A had three routine chest X-rays post-operation. Group B had one routine chest X-ray on day 4 post-operation. Group C had chest X-rays only when indicated. The X-rays were evaluated in terms of their assistance value and the resultant number of interventions.

RESULTS

The three groups were similar preoperatively for age, sex, preoperative left ventricular function, presence of chronic obstructive airway disease and type of operation performed. The total number of chest X-rays in groups A, B and C were 304, 133 and 36, respectively. The number of chest X-rays leading to interventions were five, four and four in groups A, B and C, respectively. Chest X-rays that helped in management were 36, 28, and 28, respectively, in the same groups. There was no mortality or morbidity attributable to non-performance of routine chest X-ray.

CONCLUSIONS

Routine chest X-rays post-cardiac surgery are of very little value and patients are adequately managed by performing chest X-rays only when clinically indicated. There was no increased mortality or morbidity attributed to lack of routine chest X-rays in any of these groups. We recommend performing chest X-rays only when clinically indicated in satisfactorily recovering adult cardiac surgical patients.

A survey of reproductive parameters in the free-ranging chimpanzees of Gombe National Park

This study is a review of reproductive records for chimpanzees (Pan troglodytes schweinfurthii) living in Gombe National Park, Tanzania, between 1964 and 1994. Females exhibited their first full anogenital swelling at approximately 10.8 years of age. Duration of adolescent infertility averaged 2.37 years, with first conception occurring at 12.7 years and first parturition at 13.3 years. The menstrual cycles of young nulliparous females were significantly longer than those of older multiparous females (average 39.8 days versus 33.8 days). Analysis of anogenital swelling patterns indicated an average duration of 12-13 days for maximal swelling in all classes of cycle. Nulliparous and postpartum females exhibited a similar pattern of shortened detumescent phase, indicative of anovulation. Duration of gestation averaged 225.3 days (range = 208-235) with no significant fetal gender effect. When an infant lived to weaning age, the postpartum amenorrhoea of the mother averaged 3.86 years, whereas if the offspring died as an infant the mother resumed menstrual cycles an average of 35 days later. Once postpartum cycles resumed, the next conception averaged 142.5 days later if the previous infant had survived, but sooner (92.9 days later) if the previous offspring died in infancy. Interbirth interval averaged 5.15 years. Analysis of behavioural records indicated that a lower percentage of conceptions occurred during consort matings than was previously thought, suggesting additional research is needed on this topic. Detailed discussion focuses on the environmental influence on reproductive parameters described here. Future work in this area will probably identify the importance of diet-via basic nutrition and phytochemical content-in effecting the seasonal and individual differences seen in this study.

Comparison of stretching with ice, stretching with heat, or stretching alone on hamstring flexibility

OBJECTIVE

To investigate the efficacy of stretching with ice for increasing hamstring flexibility.

DESIGN AND SETTING

Supine hamstring flexibility was measured before and after subjects accomplished a 20-minute hamstring stretching routine. Two groups of eight subjects accomplished the routine using one of two modalities. A control group (n = 8) accomplished the routine without a modality. The measurements were compared.

SUBJECTS

Twenty-four male collegiate baseball players.

MEASUREMENTS

Heat or ice applied to the hamstring.

RESULTS

We found differences in the responses among subject groups. Supine hamstring flexibility after stretching with ice was greater than both stretching with heat and stretching alone. Scores after stretching with heat and stretching alone were not different.

CONCLUSIONS

The results of our investigation suggest that the application of ice may provide enhanced short-term improvements in hamstring flexibility over heat or stretching alone. Further research is necessary to investigate the possible mechanisms for these improvements and to determine whether similar results can be obtained with other muscle groups.

Cryoglobulinaemia and septal perforation: a rare but logical cause

A case of nasal septal perforation secondary to cryoglobulinaemia is reported. In this instance the cryoglobulinaemia was due to Waldenstrom's macroglobulinaemia (lymphoplasmocytic lymphoma with IgM paraprotein) in which the paraprotein was a potent cryoglobulin.

Non-Hodgkin's lymphoma and hepatitis C virus infection

The hepatitis C virus (HCV) is a recently described and important cause of acute and chronic liver disease. A hallmark of HCV is its propensity to become chronic, some patients with chronic HCV progressing to cirrhosis and hepatocellular carcinoma (HCC). HCV is also lymphotrophic and we report 2 patients with HCV cirrhosis who developed non-Hodgkins lymphoma (NHL). These cases raise the possibility that chronic HCV infection of lymphocytes plays an aetiological role in this malignancy. However screening of a further 63 consecutive patients over the age of 50 years with NHL for HCV antibody by second generation enzyme linked immunoassay (ELISA) failed to identify any patients with evidence of HCV infection. This suggests that HCV is an uncommon contributory factor for the development of non-Hodgkins lymphoma in the United Kingdom.