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An association between increasing anaesthetic depth and decreased postoperative survival has been shown in observational studies; however, evidence from randomised controlled trials is lacking. Our aim was to compare all-cause 1-year mortality in older patients having major surgery and randomly assigned to light or deep general anaesthesia.

The cumulating long-term changes in stable macromolecules, including non-enzymatic glycosylation of proteins and oxidative stress, are main fundamental reasons for development of late complications in patients with diabetes mellitus type II. To evaluate some high-sensitive and specific proteins as early diagnostic tool and prognostic biomarkers of late complications of diabetes mellitus type 2 (T2DM). Proteomic studies of blood plasma in patients with T2DM were performed through one- and two-dimensional electrophoresis of proteins in polyacrylamide gel, in the presence of sodium dodecyl sulfate - according to Laemmli (SDS PAGE). The spectrum of 70 proteins was proposed as tools in clinical/laboratory diagnostics and as independent prognostic biomarkers - predicting early development of disease complications. The identified proteomic biomarkers in blood plasma of patients with T2DM could serve as drug targets for early prevention and successful treatment of disease complications.

Three experiments were conducted to evaluate spray-dried blood cells (SDBC) and crystalline isoleucine in nursery pigs. In Exp. 1, 120 pigs were used to evaluate 0, 2, 4, and 6% SDBC (as-fed basis) in a sorghum-based diet. There were six replicates of each treatment and five pigs per pen, with treatments imposed at an initial BW of 9.3 kg and continued for 16 d. Increasing SDBC from 0 to 4% had no effect on ADG, ADFI, and G:F. Pigs fed the 6% SDBC diet had decreased ADG (P< 0.01) and G:F (P= 0.06) compared with pigs fed diets containing 0, 2, or 4% SDBC. In Exp. 2, 936 pigs were used to test diets containing 2.5 or 5% SDBC (as-fed basis) vs. two control diets. There were six replicates of each treatment at industry (20 pigs per pen) and university (six pigs per pen) locations. Treatments were imposed at an initial BW of 5.9 and 8.1 kg at the industry and the university locations, respectively, and continued for 16 d. Little effect on pig performance was noted by supplementing 2.5% SDBC, with or without crystalline Ile, in nursery diets. Pigs fed the 5% SDBC diet without crystalline Ile had decreased ADG (P< 0.01), ADFI (P≤ 0.10), and G:F (P< 0.05) compared with pigs fed the control diets. Supplementation of Ile restored ADG, ADFI, and G:F to levels that were not different from that of pigs fed the control diets. In Exp. 3, 1,050 pigs were used to test diets containing 5, 7.5, or 9% SDBC (as-fed basis) vs. a control diet. There were six replicates of each treatment at the industry (20 pigs per pen) location and five replicates at the university (six pigs per pen) locations. Treatments were imposed at an initial BW of 6.3 and 7.0 kg at the industry and university locations, respectively, and continued for 16 d. Supplementation of 5% SDBC without crystalline Ile decreased ADG and G:F (P< 0.01) compared with pigs fed the control diet, but addition of Ile increased ADG (P< 0.01) to a level not different from that of pigs fed the control diet. The decreased ADG, ADFI, and G:F noted in pigs fed the 7.5% SDBC diet was improved by addition of Ile (P< 0.01), such that ADG and ADFI did not differ from those of pigs fed the control diet. Pigs fed diets containing 9.5% SDBC exhibited decreased ADG, ADFI, and G:F (P< 0.01), all of which were improved by Ile addition (P< 0.01); however, ADG (P< 0.05) and G:F (P= 0.09) remained lower than for pigs fed the control diet. These data indicate that SDBC can be supplemented at relatively high levels to nursery diets, provided that Ile requirements are met.

Four experiments evaluated the efficacy of Na or Cl or their combination added to weanling pig diets that contained plasma protein and lactose on pig performance and N digestibility. The four experiments used a total of 563 crossbred pigs weaned at 22 ± 1 d of age averaging 6.4 kg body weight. The basal diet in each experiment contained 5.8% plasma protein and 20% lactose and analyzed .20% Na and .23% Cl. In Exp. 1, NaCl was added to treatment diets at 0, .20, .40, or .60%. The trial was conducted for a 21 d period in a randomized complete block (RCB) design in seven replicates. Improved growth rates (P< .01) and gain:feed ratios (P< .01) occurred up to a dietary salt level of .40%. In Exp. 2, we evaluated the interaction of Na and Cl on pig performance. The experiment was a 2 × 2 factorial arrangement in a RCB design conducted in seven replicates. Total dietary Na was .20 or .36%, and Cl was included at .25 or .45%. Although there was a numerical increase in pig gains with added Na, the response was not significant (P> .15), but both gains (P< .01) and gain:feed ratios (P< .01) increased at the higher dietary Cl level. In Exp. 3, we evaluated the effect of five dietary levels of Cl added at .06% increments to a basal diet that analyzed .34% Na and .20% Cl on postweaning pig performance. The experiment was a RCB design conducted in eight replicates. A growth response (P< .01) to the .38% Cl level occurred during the initial 14-d postweaning period and to the .32% Cl level from 14 to 21 d. Gain:feed ratio increased each week with added Cl, but it was significant only for the period from d 0 to 7 d (P< .01). A N digestibility trial, using the diets of Exp. 3, constituted Exp. 4, and groups of three pigs per stainless steel metabolism crate were pair-fed to pigs fed the basal diet. The experiment was a RCB design conducted in three replicates over a 3-wk period. The results demonstrated a weekly decrease in fecal N (P< .01), no effect on urinary N (P< .15), improved N retention (P< .01), and an improved apparent N digestibility (P< .01) to the .38% dietary Cl concentration during the initial 2 wk postweaning. These experiments suggest that although plasma protein contributed Na and Cl to the initial diets of weaned pigs, additional Na and Cl, but particularly Cl, improved pig growth, N retention, and N digestibility. The results suggest a dietary minimum of .38% total Cl level during the initial 2 wk postweaning.

A pulsed CO2laser Doppler system was used to monitor thunderstorm gust fronts. Wind shears associated with the gust fronts were measured and tracked.

The temperature, wavelength, and angle bandwidths in second harmonic generation of focused Gaussian beams in nonlinear crystals are evaluated. Numerical and experimental results are given for ADP as a function of the phase matching angle. These results show higher bandwidths compared with the plane wave case.

We previously identified two surface-exposed Mycoplasma arthritidis protein antigens, designated MAA1 and MAA2, that may be involved in cytadherence. Since adherence to host tissues is an important first step in most bacterial infections, we suggest that MAA1 and MAA2 may be virulence factors for M. arthritidis. In order to provide evidence for such a role, we conducted a series of experiments in which rats were actively immunized with each of these proteins purified from sodium dodecyl sulfate-polyacrylamide gels or passively immunized with poly- or monoclonal antibodies against MAA1 and MAA2. In each case, immunity against MAA1 and MAA2 conferred at least partial protection against M. arthritidis-induced disease. The greatest protection was achieved by passive immunization with monoclonal antibody A9a, directed against a surface-exposed epitope of putative adhesin MAA1. Because protective immunity in most bacterial infections is directed against major virulence factors, these results suggest that MAA1 and MAA2 may play a role in the pathogenesis of M. arthritidis-induced arthritis of rats, possibly by mediating initial colonization of joint tissues.

Linkage analysis with restriction fragment length polymorphisms for the gene for type II procollagen (COL2A1) was carried out in a family with the Stickler syndrome, or arthro-ophthalmopathy, an autosomal dominant disorder that affects the eyes, ears, joints, and skeleton. The analysis demonstrated linkage of the disease and COL2A1 with a logarithm-of-odds score of 1.51 at zero recombination. A newly developed procedure for preparing cosmid clones was employed to isolate the allele for type II procollagen that was linked to the disease. Analysis of over 7000 nucleotides of the gene revealed a single base mutation that altered a CG dinucleotide and converted the codon CGA for arginine at amino acid position alpha 1-732 to TGA, a stop codon. From previous work on procollagen biosynthesis, it is apparent that the truncated polypeptide synthesized from an allele with a stop codon at alpha 1-732 cannot participate in the assembly of type II procollagen, and therefore that the mutation would decrease synthesis of type II procollagen. It was not apparent, however, why the mutation produced marked changes in the eye, which contains only small amounts of type II collagen, but relatively mild effects on the many cartilaginous structures of the body that are rich in the same protein.

Human colostral leukocytes were investigated for their ability to release immunoglobulin A during phagocytosis of latex particles, heat-killed Candida albicans, or live Escherichia coli. Leukocytes readily phagocytosed latex or serum-opsonized candida or the E. coli. Colostral fluid was also opsonic for yeast and bacteria. Immunoglobulin release, which consisted mainly of secretory immunoglobulin A, began during the first 15 min of incubation with latex, opsonized yeast, or opsonized bacteria. Release was significantly increased from control levels by 30 or 60 min. The release of immunoglobulin A could be inhibited by incubating leukocytes at 4 degrees C. We conclude that phagocytosis and immunoglobulin A release by human colostral leukocytes are related. The data support the hypothesis that colostral leukocytes may play an active role in protecting infants from pathogenic microorganisms.

Macrophages and neutrophils that contain mainly secretory immunoglobulin A (IgA) comprise the majority of cells in human colostrum. These cell populations were separated and analyzed for their ability to release total IgA and secretory IgA when stimulated to phagocytose. Colostral macrophages phagocytosed opsonized bacteria and nonopsonized latex particles; at the same time, IgA was released. Neutrophils poorly phagocytosed opsonized bacteria but actively phagocytosed latex particles. In contrast to the macrophages, the neutrophils did not release IgA, even after active phagocytosis of latex. Consequently, colostral macrophages are the main source of IgA released from colostral leukocytes when these cells are exposed to organisms or particles that are phagocytosed. A function for colostral neutrophils which sequester IgA is proposed.

Immunoglobulin A antibodies with binding specificity for purified Klebsiella pneumoniae type 1 pili were detected by an enzyme-linked immunosorbent assay in 20 of 21 human samples (95%). The concentrations of secretory immunoglobulin A antibody in colostrum directed against the pili were calculated by comparison of experimental enzyme-linked immunosorbent assay values with values obtained from known secretory immunoglobulin A concentrations. The presence of antibodies to K. pneumoniae type 1 pili was confirmed by double diffusion-gel studies with selected specimens of colostrum. This study shows that in the majority of human colostral samples examined, secretory immunoglobulin A antibodies with specificity for K. pneumoniae type 1 pili can be commonly found in variable, but frequently high, concentrations.

Earlier studies implied a role for Mycoplasma arthritidis surface protein MAA2 in cytadherence and virulence and showed that it exhibited both size and phase variability. Here we report the further analysis of MAA2 and the cloning and sequencing of the maa2 gene from two M. arthritidis strains, 158p10p9 and H606, expressing two size variants of MAA2. Triton X-114 partitioning and metabolic labeling with [3H]palmitic acid suggested lipid modification of MAA2. Surface exposure of the C terminus was indicated by cleavage of monoclonal antibody-specific epitopes from intact cells by carboxypeptidase Y. The maa2 genes from both strains were highly conserved, consisting largely of six (for 158p10p9) or five (for H606) nearly identical, 264-bp tandem direct repeats. The deduced amino acid sequence predicted a largely hydrophilic, highly basic protein with a 29-amino-acid lipoprotein signal peptide. The maa2 gene was expressed in Escherichia coli from the lacZ promoter of vector pGEM-T. The recombinant product was approximately 3 kDa larger than the native protein, suggesting that the signal peptide was not processed in E. coli. The maa2 gene and upstream DNA sequences were cloned from M. arthritidis clonal variants differing in MAA2 expression state. Expression state correlated with the length of a poly(T) tract just upstream of a putative -10 box. Full-sized recombinant MAA2 was expressed in E. coli from genes derived from both ON and OFF expression variants, indicating that control of expression did not include alterations within the coding region.

A sporulation-specific sigma factor of Bacillus subtilis (sigma E) is formed by a proteolytic activation of a precursor protein (P31). Synthesis of the precursor protein is shown to be abolished in B. subtilis mutants with plasmid insertions as far as 940 base pairs upstream of the P31 structural gene (sigE), and processing of P31 to sigma E is blocked by a deletion in this upstream region. These results substantiate the view that sigE is the distal member of a 2-gene operon and demonstrate that the upstream gene (spoIIGA) is necessary for sigma E formation.

It will be possible to discuss only certain phases of this broad subject. Some procedures do not seem to be sufficiently well known, and require elucidation and emphasis in order to secure their more general adoption by those who prescribe lenses for the eyes. Before considering the prescribing of lenses for close work, the muscle conditions and static refraction for distance should be correctly determined. The latter is usually impossible without the proper use of cycloplegics, except in certain cases of myopia and in some people past middle life whose accommodation is weak or easily controlled. Sometimes the examiner must be satisfied with partial corrections, because fatigued yet determined, hypertrophied, habit-controlled, spasmodically contracting muscles are by no means limited to the young, but are often found in the eyes of the middle-aged with their more inelastic resisting lenses.There are many young persons who suffer more or less distress, e.

Abstract: Rarely, hepatic metastases can simulate hepatic infiltrative diseases. We present a case of a patient with advanced metastatic renal cell carcinoma who developed hepatomegaly and clinical signs of hepatocellular injury. On magnetic resonance imaging, the injury simulated a diffuse process, e.g., acute fulminant viral or chemical hepatitis or drug toxicity. Despite its high resolution, magnetic resonance imaging might not depict focal lesions in patients with extensive metastases. In correlation with clinical history, malignant disease should be considered when diffusely abnormal hepatic signal intensity is noted.

The generation of tunable cw radiation by sum-frequency mixing the output of a Rhodamine 6G laser and selected output lines of an argon-ion laser in an angle-tuned KDP crystal has been investigated. This technique, coupled with second-harmonic generation of the Rhodamine 6G laser, provides a simple source of cw ultraviolet radiation, continuously tunable from 257 to 320 nm, with a maximum output power in excess of 250 μW and a bandwidth of less than 0.03 nm.

Broadly tunable cw uv radiation has been generated by frequency doubling and sum frequency mixing in ADP, ADA, and RDP, using the output of a Kr laser, a Rh6G dye laser, and an oxazine 1 dye laser. Continuous tunable uv radiation has been obtained from 285 nm to 400 nm with a maximum power of 750 μW at 313 nm and with powers in excess of 5 μW from 290 nm to 390 nm.

IT has been known for more than 10 years that there are two light-induced electron paramagnetic resonance (EPR) signals in plants. A recent review has summarized what is known about them1. My purpose here is to characterize in a preliminary way a hitherto unreported light-induced EPR signal in Anacystis nidulans, which I name signal III. This signal can readily be distinguished from the other two signals. I do not know why nobody has detected it before, but it is real, and its source is being investigated.

A pulsed ruby laser (wavelength, 694.3 nanometers) was used to measure the dependence on light intensity of light-induced electron paramagnetic resonance (ERR) signal 1 for short flashes of uniform duration (400 microseconds). Approximately 1018photons per square centimeter per flash from the unattenuated beam were available to the sample of subchloroplast "system 1" particles from spinach. The experimental dependence of the EPR signal height plotted as a function of the total number of incident photons per flash was exponential. From measurement of the slope at a very low relative photon flux and the saturated EPR signal amplitude, the value for the cross section or "effective size" of the light-induced paramagnetic unit, σEPR, was found to be 300 × 10-17square centimeter. This result is compared with a measured optical absorption cross section, σ694nm, of 2.5 × 10-17square centimeter, for the identical sample at the laser wavelength. The hundredfold difference in size supports the thesis that the paramagnetic state is a property of an aggregate of chlorophyll molecules of the same general size as the photosynthetic unit.

BackgroundIn 2009 in the Barossa Valley, South Australia, a group formed to promote the Respecting Patient Choices Program and ACP in their community. The group represents nurses, (aged and acute sites), doctors, lawyers, Ministers of Religion, Justices of the Peace, Emergency Services and community members.Location of documentsNumber surveyedAverage age% Male% Female% with ACPLawyers office (%)Doctors surgery (%)Local hospital (%)200925793664162525020101667465418110620118866226827.560321820127566257532442217AimTo determine if active promotion of ACP has improved awareness and acceptance in the communityMethodData collected over a 4 year period to determine public awareness of ACP in our local community. Information collected included age, gender, existing ACP documents and their storage location. At the end of the 4 year period data collected was analysed to determine if the pro-active approach had been effective in the above stated areas.ResultsOver 4 years the table shows a 100% increase of people with Advanced Care Plans. The unexpected positive outcome is the shift in awareness of ACP to younger age groups. Anecdotally people surveyed indicated an awareness of the Respecting Patient Choices branding and literature received through legal services, health services, medical centres and community avenues.DiscussionDirect contact with individuals has proven to be an effective way to promote community awareness and acceptance of ACP in the rural community.ConclusionData collected proves that active promotion of ACP with the community results in a positive change of attitude towards ACP—no longer a taboo subject.

Letters to the editor are presented in response to articles in previous issues including "A Bird for All Seasons" in the May 2011 issue, Robert Dance's artwork "Cape Lookout Classics," featured in "The Jean Dale Lives Again" article in the May 2011 issue, and about the proposed changes in the periodical.