Spontaneous colonic perforation and abdominal wall extrusion of an orally ingested fork handle

Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but a small number of cases lead to complications and necessitate surgical intervention. We present a rare case of an ingested fork handle that perforated silently through the colon and fistulated through the abdominal wall. This case highlights the importance of balancing the risks and benefits of surgical intervention and the multidisciplinary approach to complex situations.

Gradual Decline of Japanese Beetle (Coleoptera: Scarabaeidae) Populations in Michigan Follows Establishment of Ovavesicula popilliae (Microsporidia)

The purpose of this research was to document the incidence of Japanese beetle, Popillia japonica Newman (Coleoptera: Scarabaeidae), infection by the microsporidian pathogen, Ovavesicula popilliae Andreadis & Hanula (Microsporida: Pleistophoridae) while monitoring Japanese beetle populations at nine golf courses in Michigan from 1999 to 2018. We also compared the current distribution of the pathogen in Michigan to the known distribution in 1999. Beetles were sampled a total of seven different years, in three time periods: 1999-2000, 2005-2007, and 2015-2018. At these nine golf courses, O. popilliae infection rates of adults increased from 0.39% in 2000 to 29.5% in 2018, while Japanese beetle adult populations declined 73.2%, and Japanese beetle larval density declined 78.6% (from 1999 to 2018). In previous research, larval infection rates averaged at least twice the infection rates of adults, because all infections originate in the larval stage, and at least 75% of infected larvae die before pupation. This means that an adult infection rate of 29.5%, combined with previously observed 50% reductions in egg production by infected females, are consistent with the observed population declines. The current distribution of O. popilliae in southern Michigan was determined by sampling Japanese beetle larvae and adults at 38 sites in 2017 and 2018. Ovavesicula popilliae was found at 21 of 38 sites and in 16 of 21 counties, compared with two sites in one of 16 counties when it was first detected in Michigan in 1999 and 2000.

Germline variants and phenotypic spectrum in a Canadian cohort of individuals with diffuse gastric cancer

Background

CDH1 pathogenic variants (pvs) cause most cases of inherited diffuse gastric cancer (dgc), but have low detection rates and vary geographically. In the present study, we examined hereditary causes of dgc in patients in Ontario.

Methods

CDH1 testing through single-site or multi-gene panels was conducted for patients with dgc meeting the 2015 International Gastric Cancer Linkage Consortium (igclc) criteria, or with isolated dgc at less than 50 years of age, or with a strong family history of cancer identified at the Zane Cohen Centre (zcc). All CDH1-positive patients at zcc, regardless of cancer history, were summarized.

Results

In 15 of 85 patients with dgc (17.6%), a pv or likely pv was identified through CDH1 single-site (n = 43) or multi-gene panel (n = 42) testing. The detection rate was 9.4% overall (8 of 85) and 11% using igclc criteria (7 of 65). No CDH1 pvs were identified in patients with isolated dgc at less than 40 years of age, but 1 pv was identified in a patient with isolated dgc at less than 50 years of age. Multi-gene panels identified 9 pvs (21.4%), including CDH1, STK11, ATM, BRCA2, MLH1, and MSH2. Review of 81 CDH1 carriers identified 10% with dgc (median age: 48 years; range: 38-59 years); 41% were unaffected (median age: 53 years; range: 26-89 years). Observed malignancies other than dgc or lobular breast cancer (lbc) included colorectal, gynecologic, kidney or bladder, prostate, testicular, and ductal breast cancers. Lobular-breast cancer was seen only in 3 families.

Conclusions

In Ontario, the detection rate of CDH1 pvs in patients with dgc was low: no pvs were identified in patients with isolated dgc at less than 40 years of age, and 1 was identified in a patient with isolated dgc at less than 50 years of age. Isolated lbc with no dgc was observed in CDH1-positive families, as were pathology-confirmed nondgc or non-lbc malignancies, which had not previously been reported. Given a phenotype that overlaps with other hereditary conditions, multi-gene panels are recommended for all patients with dgc at less than 50 years of age and for those meeting igclc criteria.

Analysis of radioactive waste generated during the cyclotron production of 99mTc

Past and prospective shortages of medical radioisotopes have driven recent developments in the direct production of ^99mTc via the ¹⁰⁰Mo(p,2n)^99mTc reaction. The cyclotron-based production method has been shown to successfully produce ^99mTc, however trace impurities present in the enriched molybdenum target can also lead to the unintended creation of other radioisotopes which constitute waste. The isotopic composition of the waste has to be investigated in order to determine how it can be handled, transported and safely stored. In this article, we report which waste radioisotopes are created alongside ^99mTc during target irradiation. Results are based on the gamma spectroscopy of waste produced. Significant complexities in the emission spectra made automated identification of radioisotopes inaccurate; complexities were resolved using a manual radioisotope identification procedure. The impact of target composition, integrated beam current and duration of target irradiation on the waste produced was studied. Results indicate that an average of 0.059  ±  0.003 GBq of waste is generated per 1 GBq of ^99mTc produced. Two-thirds of the total waste activity produced was attributed to ⁹⁹Mo (T _1/2  =  66 h) alone, while a total of fifty radioisotopes were found in the waste. Long-lived isotopes (T _1/2  >  2 months) constituted only 1% of the total waste activity at end of beam (EOB). In conclusion, it was determined that the waste generated during cyclotron-based ^99mTc production was acceptably low for routine clinical production.

A forced-convection gas target for the production of [11C]CH4

A forced-convection gas target for the production of [¹¹C]CH₄ on a 13 MeV cyclotron was constructed and tested. A small fan was incorporated into the back of the target, which mixes the target gas during irradiation. The effect of the forced convection alone on the target operation and the [¹¹C]CH₄ yield was measured. Forced convection improved the target yield by up to 16 ± 4%. In addition, improvement in heat transfer of up to 70% was observed to be a function of fan speed. Operating with forced convection allowed delivery of 21% higher beam currents while still staying in the acceptable pressure rise during irradiation, providing a 25 ± 7% greater yield.

Non-invasive spectroscopy of transfusable red blood cells stored inside sealed plastic blood-bags

After being separated from (donated) whole blood, red blood cells are suspended in specially formulated additive solutions and stored (at 4 °C) in polyvinyl chloride (PVC) blood-bags until they are needed for transfusion. With time, the prepared red cell concentrate (RCC) is known to undergo biochemical changes that lower effectiveness of the transfusion, and thus regulations are in place that limit the storage period to 42 days. At present, RCC is not subjected to analytical testing prior to transfusion. In this study, we use Spatially Offset Raman Spectroscopy (SORS) to probe, non-invasively, the biochemistry of RCC inside sealed blood-bags. The retrieved spectra compare well with conventional Raman spectra (of sampled aliquots) and are dominated by features associated with hemoglobin. In addition to the analytical demonstration that SORS can be used to retrieve RCC spectra from standard clinical blood-bags without breaking the sterility of the system, the data reveal interesting detail about the oxygenation-state of the stored cells themselves, namely that some blood-bags unexpectedly contain measurable amounts of deoxygenated hemoglobin after weeks of storage. The demonstration that chemical information can be obtained non-invasively using spectroscopy will enable new studies of RCC degeneration, and points the way to a Raman-based instrument for quality-control in a blood-bank or hospital setting.

Imaging study of using radiopharmaceuticals labeled with cyclotron-produced 99mTc

Cyclotron-produced ^99mTc (CPTc) has been recognized as an attractive and practical substitution of reactor/generator based ^99mTc. However, the small amount of ^92-98Mo in the irradiation of enriched ¹⁰⁰Mo could lead to the production of other radioactive technetium isotopes (Tc-impurities) which cannot be chemically separated. Thus, these impurities could contribute to patient dose and affect image quality. The potential radiation dose caused by these Tc-impurities produced using different targets, irradiation conditions, and corresponding to different injection times have been investigated, leading us to create dose-based limits of these parameters for producing clinically acceptable CPTc. However, image quality has been not considered. The aim of the present work is to provide a comprehensive and quantitative analysis of image quality for CPTc. The impact of Tc-impurities in CPTc on image resolution, background noise, and contrast is investigated by performing both Monte-Carlo simulations and phantom experiments. Various targets, irradiation, and acquisition conditions are employed for investigating the image-based limits of CPTc production parameters. Additionally, the relationship between patient dose and image quality of CPTc samples is studied. Only those samples which meet both dose- and image-based limits should be accepted in future clinical studies.

US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012

OBJECTIVE

Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements.

RESULTS

Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%).

CONCLUSION

Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.

Graphical user interface for yield and dose estimations for cyclotron-produced technetium

The cyclotron-based (100)Mo(p,2n)(99m)Tc reaction has been proposed as an alternative method for solving the shortage of (99m)Tc. With this production method, however, even if highly enriched molybdenum is used, various radioactive and stable isotopes will be produced simultaneously with (99m)Tc. In order to optimize reaction parameters and estimate potential patient doses from radiotracers labeled with cyclotron produced (99m)Tc, the yields for all reaction products must be estimated. Such calculations, however, are extremely complex and time consuming. Therefore, the objective of this study was to design a graphical user interface (GUI) that would automate these calculations, facilitate analysis of the experimental data, and predict dosimetry. The resulting GUI, named Cyclotron production Yields and Dosimetry (CYD), is based on Matlab®. It has three parts providing (a) reaction yield calculations, (b) predictions of gamma emissions and (c) dosimetry estimations. The paper presents the outline of the GUI, lists the parameters that must be provided by the user, discusses the details of calculations and provides examples of the results. Our initial experience shows that the proposed GUI allows the user to very efficiently calculate the yields of reaction products and analyze gamma spectroscopy data. However, it is expected that the main advantage of this GUI will be at the later clinical stage when entering reaction parameters will allow the user to predict production yields and estimate radiation doses to patients for each particular cyclotron run.

A real-time intercepting beam-profile monitor for a medical cyclotron

There is a lack of real-time continuous beam-diagnostic tools for medical cyclotrons due to high power deposition during proton irradiation. To overcome this limitation, we have developed a profile monitor that is capable of providing continuous feedback about beam shape and current in real time while it is inserted in the beam path. This enables users to optimize the beam profile and observe fluctuations in the beam over time with periodic insertion of the monitor.

Learning from incident reports in the Australian medical imaging setting: handover and communication errors

OBJECTIVE

To determine the type and nature of incidents occurring within medical imaging settings in Australia and identify strategies that could be engaged to reduce the risk of their re-occurrence.

METHODS

71 search terms, related to clinical handover and communication, were applied to 3976 incidents in the Radiology Events Register. Detailed classification and thematic analysis of a subset of incidents that involved handover or communication (n=298) were undertaken to identify the most prevalent types of error and to make recommendations about patient safety initiatives in medical imaging.

RESULTS

Incidents occurred most frequently during patient preparation (34%), when requesting imaging (27%) and when communicating a diagnosis (23%). Frequent problems within each of these stages of the imaging cycle included: inadequate handover of patients (41%) or unsafe or inappropriate transfer of the patient to or from medical imaging (35%); incorrect information on the request form (52%); and delayed communication of a diagnosis (36%) or communication of a wrong diagnosis (36%).

CONCLUSION

The handover of patients and clinical information to and from medical imaging is fraught with error, often compromising patient safety and resulting in communication of delayed or wrong diagnoses, unnecessary radiation exposure and a waste of limited resources. Corrective strategies to address safety concerns related to new information technologies, patient transfer and inadequate test result notification policies are relevant to all healthcare settings.

ADVANCES IN KNOWLEDGE

Handover and communication errors are prevalent in medical imaging. System-wide changes that facilitate effective communication are required.

Every partridge counts, successful techniques used in the captive conservation breeding programme for wild grey partridge in Ireland

Between 1998 and 2001 the last remaining wild grey partridge (Perdix perdix) population in Ireland faced imminent extinction with an estimated spring population of 4–6 pairs, and an autumn population of 22–24 birds. A captive breeding programme began in 2002 with two pairs of grey partridge. In the most successful year in 2010, 39 pairs produced a total of 510 chicks. Average chick survival rate was 65.13%. At 88.9 the highest chick survival rate was achieved in 2011. Chick survival of parent–reared birds in captivity is defined by the number of juveniles surviving at age six weeks: similar to estimations used for wild populations of grey partridge. Family coveys were released in late summer to early autumn. In most instances the entire family cohort was released as one unit. However, in coveys of twenty or above, an average of five parent–reared poults were held back as breeding stock for the following year. In early spring of the following year, birds held back were paired with single males or females trapped from the wild. The techniques we used were traditional and labour intensive but highly effective. We recommend that other grey partridge recovery projects should consider captive breeding using the methods employed in this programme to compliment other game management methods used.

Precision placement of separated dairy sludge improves early phosphorus nutrition and growth in corn ( L.)

Efficient use of manure nutrients by crops is necessary to minimize losses to the environment. This field study examined the possibility of replacing side-banded mineral P with precision-placed high-P sludge (6.2-11.0% dry matter) obtained after settling dairy manure slurry. The sludge was injected at about 30 kg P ha (36.0-51.2 m ha) into the soil at corn row spacing, and the corn was planted 5, 10, and 15 cm beside the injection furrow. Controls included no added P and side-banded commercial P fertilizer. The treatments were tested on corn with low and high root colonization by arbuscular mycorrhizae (AM). The study showed that sludge did not impede AM root colonization, corn germination, or seedling growth. Corn plants with both high and low levels of AM colonization responded to the sludge from the three-leaf stage and showed the greatest benefit at the six-leaf stage. Corn responded more to sludge placed at 5 than at 15 cm from the corn rows, whereas the response at the 10-cm spacing was intermediate. There was little difference in seedling growth or final harvest parameters between the side-banded fertilizer P and the 5-cm sludge treatment. The results show a new way to use manure nutrients, namely precision-placement sludge for corn. This may obviate the need for chemical fertilizers for improving farm nutrient balances. Other anticipated benefits are less energy use for hauling and injection of the sludge fraction and reduced risk of nutrient loss by runoff and volatilization (ammonia) and nuisance odors due to injection.

Removing solids improves response of grass to surface-banded dairy manure slurry: a multiyear study

Removing solids from slurry manure helps balance nutrients to plant needs and may increase soil infiltration rate toreduce loss of ammonia. The long-term effects of applying the separated liquid fraction (SLF) of dairy slurry with surface banding applicators are not well known. This 6-yr study compared the yield, N recovery, and stand persistence of tall fescue (Festuca arundinacea Schreb.) receiving SLF at 300 (SLF300) and 400 (SLF400) kg ha(-1) yr(-1) of total ammoniacal N (TAN); whole dairy slurry (WS) at 200 (WS200), 300 (WS300), and 400 (WS400) kg TAN ha(-1) yr(-1); and mineral fertilizerat 300 kg N ha(-1) yr(-1). The slurries were applied four times per year by surface banding, a technique that reduces ammonia emission and canopy contamination. Grass yield and N uptake were significantly higher for SLF300 than WS300 atequivalent rates of TAN. At similar total N, yield and N uptake were much greater for SLF than WS (2 Mg DM ha(-1) and 75 kg N ha(-1), respectively). Apparent total N recoverywas 63% greater for SLF300 than WS300 due to less ammonia loss and less immobile N. The apparent recovery of total N was 31% higher for Fert300 than for SLF300. Yield and N uptake for SLF300 and WS300 were similar in Harvests 1 and4, but SLF had higher values under hot and dry conditions in Harvests 2 and 3. Using SLF rather than WS will increase crop yield and allow higher application volumes near barns, whichwill reduce hauling costs.

Enhancing soil infiltration reduces gaseous emissions and improves N uptake from applied dairy slurry

Rapid infiltration of liquid manure into the soil reduces emissions of ammonia (NH(3)) into the atmosphere. This study was undertaken to assess the effects of two low-cost methods of assisting infiltration of applied dairy slurry on emissions of NH(3), nitrous oxide (N(2)O), and on crop N uptake. The two methods were removing of solids by settling-decantation to make the manure less viscous and mechanically aerating the soil. Ammonia emissions were measured with wind tunnels as percentage of applied total ammoniacal nitrogen (TAN) while emissions of N(2)O were measured with vented chambers. Mechanically aerating the soil before manure application significantly reduced emissions of NH(3) relative to the nonaerated soil in spring (38.6 to 20.3% of applied TAN), summer (41.1 to 26.4% of applied TAN) and fall (27.7 to 13.6% of applied TAN) trials. Decantation of manure had no effect on NH(3) emissions in spring, tended to increase emissions in summer and significantly decreased emissions in fall (30.3 to 11.1% of applied TAN). Combining the two abatement techniques reduced NH(3) emission by 82% in fall, under cool weather conditions typical of manure spreading. The two abatement techniques generally did not significantly affect N(2)O emissions. Uptake of applied N by Italian ryegrass (Lolium multiflorum Lam.) was generally significantly greater with decanted than from whole manure but the effect of aeration was generally small and not significant. The study shows that low cost methods that assist manure infiltration into the soil may be used to greatly reduce ammonia loss without increasing N(2)O emissions, but efficacy of abatement methods is affected by weather conditions.

All-optical memory based on the injection locking bistability of a two-color laser diode

We study the injection locking bistability of a specially engineered two-color semiconductor Fabry-Pérot laser. Oscillation in the uninjected primary mode leads to a bistability of single mode and two-color equilibria. With pulsed modulation of the injected power we demonstrate an all-optical memory element based on this bistability, where the uninjected primary mode is switched with 35 dB intensity contrast. Using experimental and theoretical analysis, we describe the associated bifurcation structure, which is not found in single mode systems with optical injection.

Effect of low and high forage diet on enteric and manure pack greenhouse gas emissions from a feedlot

The objectives of this study were to assess enteric methane (CH4) production by beef steers fed one of two isocaloric diets with different forage:grain ratios and to quantify greenhouse gas (GHG) emissions from bedded manure packs in the eight feedlot pens holding these steers (14 head pen-1). Five animals (252 ± 20 kg) in each pen were randomly selected for measurement of CH4 emissions over the course of the 126-d feeding trial. Two 24-h gas collections were completed for each steer in each of three collection periods using the sulfur hexafluoride tracer gas technique. The fluxes of nitrous oxide (N2O), methane (CH4) and carbon dioxide (CO2) from bedding packs were measured using vented static chambers in each sampling period. Methane production (L d-1) was 42% higher (P < 0.05) from steers fed the low forage:grain ratio than from steers fed the high forage:grain ratio. Overall, methane production (% of gross energy intake) ranged from 0.9 to 6.9% on the low forage:grain diet and from 0.7 to 4.9% on the high forage:grain diet. Daily CH4 emissions were similar in the first two periods and increased during the third sampling period. There was no effect of diet on manure pack temperature during sampling, however, the manure pack was deeper (P < 0.05) in pens holding animals fed the high forage:grain diet. Furthermore, diet had no effect on the manure pack fluxes. Total daily non-CO2 emissions from enteric and manure pack sources (CO2 equivalent) were different (P < 0.05) between dietary treatments and averaged 1931 ± 81 g head-1 d-1 for the low forage:grain and 1394 ± 81 g head-1 d-1 for the high forage:grain diet. Key words: Feedlot steers, greenhouse gases, enteric fermentation, manure packs

Water-cooled grid support for high-power irradiation with thin target windows

A new thin window support system for the accelerator production of positron emitters (e.g. 17F, 18F 11C, 15O) has been developed. The integrated support grid and cooling design has been optimized for 6-13 MeV protons or deuterons. The water-cooled support grid regularly operated at > 100 microA of 6 MeV deuterons and protons. The grid performed without failure at > or = 50 microA of 13 MeV protons on a 3.1 MPa gas target using 25.4 microm aluminum target foil. Transmission for the smallest hole grid of 72% based on uniform parallel beam agreed with the measured yield of 71 +/- 1% compared to the theoretical maximum yield.

Cdc13 delivers separate complexes to the telomere for end protection and replication

In Saccharomyces cerevisiae, the telomere binding protein Cdc13 mediates telomere replication by recruiting telomerase, and also performs an essential function in chromosome end protection. We show here that delivery of the Stn1 protein to the telomere, by fusing the DNA binding domain of Cdc13 (DBD(CDC13)) to Stn1, is sufficient to rescue the lethality of a cdc13 null strain and, hence, provide end protection. Telomere replication is still defective in this strain, but can be restored by delivering telomerase to the telomere as a DBD(CDC13)-telomerase fusion. These results establish Stn1 as the primary effector of chromosome end protection, whereas the principal function of Cdc13 is to provide a loading platform to recruit complexes that provide end protection and telomere replication.

Can induced theta vacua be created in heavy-Ion collisions?

We discuss a phenomenon important to the development of the early Universe which may be experimentally testable in heavy-ion collisions. An arbitrary induced straight theta vacuum state should be created in heavy-ion collisions, similar to the creation of the disoriented chiral condensate. It should be a large domain with a wrong straight theta(ind) not equal0 orientation which will mimic the physics of the early Universe when it is believed that the fundamental parameter straight theta(fund) not equal0. We test this idea numerically in a simple model where we study the evolution of the phases of the chiral condensates in QCD with two quark flavors with nonzero straight theta(ind) parameter. We see the formation of a nonzero straight theta(ind) vacuum on a time scale of 10(-23) s.

Fetal and Infant Mortality Review: an evolving process

Fetal and Infant Mortality Review (FIMR) has been a dynamic process from its inception in the 1980s. Essentially, it is a local, community-driven process that has grown and been refined as more communities adopt the methodology. The National Fetal and Infant Mortality Review (NFIMR) Program, a partnership between the federal Maternal and Child Health Bureau and the American College of Obstetricians and Gynecologists, serves as a resource for state and local communities implementing FIMR. In this issue of the Maternal and Child Health Journal, two articles by Baltay et al. and Grason and Misra examine the implementation of FIMR in the original federal Healthy Start programs and present findings of interest to the MCH community.

Schatzki ring in children and young adults: clinical and radiologic findings

BACKGROUND

The Schatzki ring is a well-known clinical and radiologic entity in adults, but is thought to be rare in childhood. Objective. To review the clinical presentations and radiologic findings of children and young adults with Schatzki rings.

MATERIALS AND METHODS

A retrospective review of all barium swallow examinations done between 1990 and 1996 revealed 20 patients with Schatzki rings.

RESULTS

The most frequent presenting symptoms of these patients were progressive dysphagia with solid food and acute food impaction. Radiographic findings of Schatzki rings were typical in all cases. Twelve patients had endoscopy and all had evidence of esophagitis.

CONCLUSION

Schatzki rings are not rare in childhood. The patients are symptomatic, presenting with either progressive dysphagia with solids or acute food impaction. A thorough evaluation of the distal esophagus should be performed in patients with a suggestive clinical history.

Ten-year survival of Down syndrome births

OBJECTIVE

To determine the survival status of children with Down syndrome (DS), and to document factors influencing survival.

DESIGN

Follow-up study of cases identified from the Dublin European Register of Congenital Anomalies and Twins (EUROCAT) Register. Follow-up was attempted for each case until death or 1992 or until the date last known to be alive.

SETTING

Eastern Health Board, Dublin.

SUBJECTS

In all, 389 DS children, born between 1 January 1980 and 31 December 1989 were followed up.

RESULTS

Survival rates of 88% at one year and 82% at 10 years were found. There was a non-significant improvement in survival between the cohort born in 1980-1984 and that born in 1985-1989. Congenital heart defects reduced survival to 72% and complete atrio-ventricular canal defects (CAVD) had the poorest prognosis (58% survival at 10 years). Cases with CAVD showed a trend towards improved survival when surgically treated. Maternal age mother's county of residence, sex of infant, season of birth and presence of additional non-cardiac congenital anomalies had no impact on survival.

CONCLUSIONS

Four out of five DS children now survive at least 10 years. Adequate educational and health service provision needs to be made for them, especially those with congenital heart defects. The need for studies which compare survival and quality of life in DS children with CAVD who undergo cardiac surgery versus those who do not, taking account of various selection factors, is identified.

Potential for radioactive patient excreta in hospital trash and medical waste

Radioactive excreta from nuclear medicine patients can enter solid waste as common trash and medical biohazardous waste. Many landfills and transfer stations now survey these waste streams with scintillation detectors which may result in rejection of a hospital's waste. Our survey indicated that on the average either or both of Boston University Medical Center Hospital's waste streams can contain detectable radioactive excreta on a weekly basis. To avoid potential problems, radiation detectors were installed in areas where housekeepers carting trash and medical waste must pass through to ensure no radioactivity leaves the institution.

A 20 nucleotide upstream element is essential for the nopaline synthase (nos) promoter activity

The nopaline synthase (nos) promoter is expressed in a wide range of plant cell types and regulated by various developmental and environmental factors. The nos upstream control region essential for this regulation was studied by means of synthetic oligomers using transient and stable transformation systems. Insertion of a 20 nucleotide sequence containing two hexamer motifs and a spacer region into deletion mutants lacking the upstream control region was essential for promoter activity. Mutation of one or more nucleotides of either hexamer sequence significantly altered the strength of expression of the nos promoter. Point mutations within the spacer region also strongly influenced promoter strength. Insertion of multiple copies of the 20 nucleotide sequence into the nonfunctional deletion mutants proportionally increased the promoter activity. These results suggest that this twenty nucleotide sequence is essential for the nos promoter to function. Substitution of the nos element with the ocs or 35S as-1 which contain similar hexamer motifs restored not only promoter activity but also responses to wounding, auxin, methyl jasmonate, and salicylic acid.

Bilateral ureteral obstruction and renal failure due to a perforated appendix

Bilateral ureteral obstruction secondary to appendicitis is rare. We here report a case in which the obstruction caused anuria and renal failure.

Left ventricular regional wall motion assessment by radionuclide ventriculography: a comparison of cine display with Fourier imaging

Radionuclide ventriculography and contrast ventriculography were performed in two comparable projections on 50 patients with suspected coronary artery disease. The efficacy of conventional cine display and Fourier image analysis of the radionuclide ventriculogram was compared using contrast ventriculography as the gold standard. Of seven different combinations of Fourier images, the combination of left anterior oblique amplitude and phase and left posterior oblique amplitude and phase provided the highest sensitivity (87%), specificity (83%), accuracy (86%), and kappa coefficient (0.64). To increase statistical power, segment data were collapsed to global data in which a heart was considered normal if all segments were normal and abnormal if one or more segments were abnormal. Fourier images had higher sensitivity (Fourier 87%, cine 47%); lower specificity (Fourier 83%, cine 92%), higher accuracy (Fourier 86%, cine 58%), and higher kappa coefficient (Fourier 0.64, cine 0.25), and these differences were statistically significant (p less than 0.01).

Identification of a transmembrane glycoprotein specific for secretory vesicles of neural and endocrine cells

Several types of cells store proteins in secretory vesicles from which they are released by an appropriate stimulus. It might be expected that the secretory vesicles in different cell types use similar molecular machinery. Here we describe a transmembrane glycoprotein (Mr approximately 100,000) that is present in secretory vesicles in all neurons and endocrine cells studied, in species from elasmobranch fish to mammals, and in neural and endocrine cell lines. It was detected by cross-reactivity with monoclonal antibodies raised to highly purified cholinergic synaptic vesicles from the electric organ of fish. By immunoprecipitation of intact synaptic vesicles and electron microscopic immunoperoxidase labeling, we have shown that the antigenic determinant is on the cytoplasmic face of the synaptic vesicles. However, the electrophoretic mobility of the antigen synthesized in the presence of tunicamycin is reduced to Mr approximately 62,000, which suggests that the antigen is glycosylated and must therefore span the vesicle membrane.

A radioisotopic method for determining optimum non-surgical therapy for advanced cancer. I. Experimental data

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A radioisotopic method for determining optimum non-surgical therapy for advanced cancer. II. Clinical experience

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