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The orientation of the magnetic field (B-field) in the filamentary dark cloud GF 9 was traced from the periphery of the cloud into the L1082C dense core that contains the low-mass, low-luminosity Class 0 young stellar object (YSO) GF 9-2 (IRAS 20503+6006). This was done using SOFIA HAWC+ dust thermal emission polarimetry (TEP) at 216 um in combination with Mimir near-infrared background starlight polarimetry (BSP) conducted at H-band (1.6 um) and K-band (2.2 um). These observations were augmented with published I-band (0.77 um) BSP and Planck 850 um TEP to probe B-field orientations with offset from the YSO in a range spanning 6000 AU to 3 pc. No strong B-field orientation change with offset was found, indicating remarkable uniformity of the B-field from the cloud edge to the YSO environs. This finding disagrees with weak-field models of cloud core and YSO formation. The continuity of inferred B-field orientations for both TEP and BSP probes is strong evidence that both are sampling a common B-field that uniformly threads the cloud, core, and YSO region. Bayesian analysis of Gaia DR2 stars matched to the Mimir BSP stars finds a distance to GF 9 of 270 +/- 10 pc. No strong wavelength dependence of B-field orientation angle was found, contrary to previous claims., 18 pages, 6 figures ApJ, accepted

Bile acids (BAs) and BA receptors, including G protein-coupled bile acid receptor 1 (GPBAR1), represent novel targets for the treatment of metabolic and inflammatory disorders. However, BAs elicit myriad effects on cardiovascular function, although this has not been specifically ascribed to GPBAR1. This study was designed to test whether stimulation of GPBAR1 elicits effects on cardiovascular function that are mechanism based that can be identified in acute ex vivo and in vivo cardiovascular models, to delineate whether effects were due to pathways known to be modulated by BAs, and to establish whether a therapeutic window between in vivo cardiovascular liabilities and on-target efficacy could be defined. The results demonstrated that the infusion of three structurally diverse and selective GPBAR1 agonists produced marked reductions in vascular tone and blood pressure in dog, but not in rat, as well as reflex tachycardia and a positive inotropic response, effects that manifested in an enhanced cardiac output. Changes in cardiovascular function were unrelated to modulation of the levothyroxine/thyroxine axis and were nitric oxide independent. A direct effect on vascular tone was confirmed in dog isolated vascular rings, whereby concentration-dependent decreases in tension that were tightly correlated with reductions in vascular tone observed in vivo and were blocked by iberiotoxin. Compound concentrations in which cardiovascular effects occurred, both ex vivo and in vivo, could not be separated from those necessary for modulation of GPBAR1-mediated efficacy, resulting in project termination. These results are the first to clearly demonstrate direct and potent peripheral arterial vasodilation due to GPBAR1 stimulation in vivo through activation of large conductance Ca(2+) activated potassium channel K(Ca)1.1.

Background. A characteristic feature of prostatic adenocarcinoma is its great variation in biologic behavior. This variation and the observation that most carcinomas are of intermediate grade make standard histologic grading of limited value in determining the prognosis of a patient. DNA quantitation with the use of computer-assisted image analysis on Feulgen-stained nuclei was performed on the metastatic lymph nodes from patients with Stage D1 prostate carcinoma to determine whether ploidy was a useful predictor of survival or progression. The Gleason histologic score of the primary tumor, the number and extent of lymph node metastases, and the progression and survival intervals were documented. Treatment modalities included pelvic lymph node dissection, radical prostatectomy, external beam radiation therapy, and iodine 125 implantation.

This paper presents two integrated non-reflective bandpass filters. The filters are implemented in a silicon germanium (SiGe) BiCMOS technology and fully depleted silicon on insulator (FDSOI) CMOS technology. The purpose of these circuits is to explore the feasibility of passive filter applications on silicon substrates while maintaining low insertion loss and 50 Ohm impedance matching. The SiGe-based filter achieved 3.3-4.2 dB insertion loss across 3.5-4.5 GHz with input return loss better than -10 dB from 1-10 GHz. The FDSOI filter simulation yielded an insertion loss of 4.5 dB across the design frequency of 3.7-4.3 GHz.

An X-band (8-12 GHz) low-noise amplifier (LNA) for receiver systems is presented. The microwave monolithic integrated circuit (MMIC) with no external matching components has been demonstrated using a 0.18 /spl mu/m silicon germanium (SiGe) bipolar CMOS (BiCMOS) technology. The amplifier employs a two-stage topology to achieve low noise figure and high linearity across 8-12 GHz. At 10 GHz the LNA yielded a gain of 24.2 dB, a noise figure of 1.68 dB, and a third-order intercept point of 17.5 dBm. The power dissipation of the circuit is 33.6 mW using a 1.8 V supply voltage. To the best of our knowledge, the circuit achieves the lowest noise figure for a wide bandwidth LNA realized in a SiGe technology.

Purpose: To determine whether autocrine motility factor receptor (AMFR) is detectable in the urine of patients with transitional cell carcinoma (TCC) of the bladder.Materials and Methods: We assayed the urine of 89 patients with bladder pathology and 28 normal controls for AMFR. A monoclonal antibody to AMFR was used.Results: All patients with muscle-invasive TCC tested positive for AMFR. Autocrine motility factor receptor was detectable for 80 percent of superficial tumors, with a correlation between AMFR and tumor grade. Seventy-five percent of control urines tested negative.Conclusions: Autocrine motility factor receptor is detectable in the urine of patients with TCC. Long-term follow-up and refinements in the assay should define the marker's utility for detection and prognosis.

Photodynamic therapy (PDT) principles were evaluated in management of benign prostatic hyperplasia (BPH) in a canine model. Five dogs were injected with benzoporphyrin derivative (BPD) and samples of prostate, bladder, urethra and rectum were taken at 1, 2, 3 and 4 hours and analyzed for BPD. Next, 16 dogs were treated with 100 Joules at 690 nm light form argon dye laser 1 hour after administration of BPD at 0.5 mg/kg using cylindrical diffuser tip fiber passed transurethrally. The prostates were harvested weekly up to 4 weeks and the size of the lesion was measured and the prostates were examined. Prostate had the highest BPD levels. Hemorrhagic lesion of 2.5 cm in diameter was noted at 1 week after PDT. At 3 and 4 weeks there were changes of glandular atrophy in the periurethral region. Minimally invasive technique of transurethral PDT causes glandular and stromal changes in the periurethral zone and has potential in the treatment of BPH.

The aim of the study was to determine the sensitivity and specificity of the lactate stress test in the detection of mitochondrial myopathies. Thirty one healthy subjects, 10 patients with non-mitochondrial myopathy and 26 patients with mitochondrial myopathy underwent lactate stress testing at a standardized workload of 30 W during 15 min on a bicycle ergometer. Lactate was determined before the exercise (R1), 5, 10, 15 min after starting the exercise (S5, S10, S15) and 15 min after finishing the exercise (R2). A result was interpreted as pathologic if more than two of the five lactate values were above the corresponding upper reference limits. The upper reference limits for the venous lactate at R1, S5, S10, S15 and R2 were 1.9, 2.0, 2.1, 2.0 and 1.7 mmol/l respectively. The lactate stress test was pathologic in 1/10 of the non-mitochondrial myopathies and in 18/26 of the mitochondrial myopathies. The sensitivity of the lactate stress test was 69%. The specificity of the test was 90%. In conclusion, the lactate stress test proved to be helpful for evaluating the integrity of the oxidative metabolism in the majority of patients with mitochondrial myopathy.

The optical absorption and transport scattering coefficients of normal prostate tissue have been measured in vivo in dogs. The measurements were made at 630 nm before and during treatment by Photofin® photodynamic therapy using interstitial optical fiber fluence-rate detectors. Corresponding measurements were made ex vivo, at 1 week after treatment, in the contralateral lobe. The optical properties were derived by applying a diffusion theory model to the fluence rates measured at two different source-detector fiber distances. While the in vivo pretreatment and in vivo contralateral post-treatment absorption and scattering values are self-consistent and in agreement with published data, significant changes were observed in the light fluence rates, and hence in the derived optical properties, during light irradiation. The possible causes of such changes are considered, and the implications for light dosimetry in photodynamic therapy are discussed.

Prior to a possible clinical application of photodynamic therapy (PDT) for prostatic diseases such as benign prostatic hyperplasia and prostate cancer, optical properties of the prostate gland need to be studied. The specific objectives of this study were (1) to determine the light penetration depth, (2) to document the photosensitizer levels in the prostate, and (3) to document the lesion size after PDT. Sixteen dogs were injected with Photofrin II (1, 3 and 5 mg/kg) 24 hrs prior to laser application. After laparotomy and exposure of prostate, monochromatic light (630 nm, via an argon pumped dye laser) was applied through an isotropic fiber at 100 mw for a total dose of 400 joules. Continuous light fluence and temperature were documented. Prostates were harvested at 1 week and examined histologically for the lesion size. Four sham dogs were treated without Photofrin II. At Photofrin doses of 1, 3 and 5 mg/kg the mean prostatic Photofrin levels were 1.78 plus or minus 0.33, 1.47 plus or minus 0.08 and 1.95 plus or minus 0.44 (mu) gm/ml. The mean light penetration depths were 2.08, 1.37 and 1.64 mm respectively. Photofrin dose escalation (1, 3 and 5 mg/kg) increased the lesion size to radius of 4.1 plus or minus 0.9 mm, 4.4 plus or minus 0.8 mm and 6.3 plus or minus 0.9 mm. There were no lesions seen in sham dogs. These results demonstrate that light penetration in prostate is consistent and therapeutic levels of photosensitizer are achieved in prostatic tissue. Moreover, increasing size of the lesions were documented with dose escalation.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

To provide basic scientific information for utilizing photodynamic therapy to treat prostatic carcinoma, PDT dosimetry and effective treatment volume were investigated using canine prostate as an in vivo animal model. The prostate glands were surgically exposed. Isotropic tip fibers were inserted into the gland for either light irradiation or detection. PDT doses of 400 J and 1, 3 or 5 mg/kg Photofrin were used for single fiber irradiation treatments. All animals were terminated at 1 week and the prostates evaluated histopathologically. The results show that the lesion size was dependent on the treatment dose. The maximum lesion dimension was approximately 1.6 cm. The data acquired from the single fiber irradiation study were then used to plan for multi-fiber interstitial PDT treatments with a goal of achieving a larger treatment volume for practical purpose. The data indicate that the lesion size from the multiple fiber treatment could be predicted based on the single fiber treatment with the light pattern summed from all sources.© (1994) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

The present study explores the possibility of utilizing photodynamic therapy (PDT) in treating localized prostate carcinoma. Optical properties of ex vivo human prostatectomy specimens, and in vivo and ex vivo dog prostate glands were studied. The size of the PDT induced lesion in dog prostate was pathologically evaluated as a biological endpoint. The data indicate that the human normal and carcinoma prostate tissues have similar optical properties. The average effective attenuation depth is less in vivo than that of ex vivo. The PDT treatment generated a lesion size of up to 16 mm in diameter. The data suggest that PDT is a promising modality in prostate cancer treatment. Multiple fiber system may be required for clinical treatment.© (1993) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

The use of Doppler ultrasound as a means of obtaining cardiac output (CO) measurements quickly, easily, and noninvasively has been made possible by recent technologic developments. We evaluated a new pulse Doppler ultrasonic unit (Velcom-100, Waters Instruments, Inc) in the Surgical Intensive Care Unit at the University of Michigan Medical Center. Accuracy of this device was determined by comparison of CO results obtained from the Velcom-100 (COV) against those of conventional thermal dilution cardiac output (COT) measurements. Twenty-six postoperative patients were used for this study, ranging in age from 20 to 82 years old. Initial studies prior to in vivo standardization demonstrated a significantly lower result (p = 0.039) for the Velcom-100 with a mean difference of 0.86 L/min (COT-COV). This comparison was significantly improved in subsequent studies following in vivo standardization (COT-COV = 0.02 L/min, p = 0.646). Linear regression analysis showed a significant, positive correlation between the two results (r = 0.82, p less than 0.05) indicating an excellent trending capability for the Velcom-100. Our evaluation found the Velcom-100 to be user friendly, allowing rapid training of ICU technicians and applicability for postoperative monitoring.

Hematoporphyrin derivative photodynamic therapy has very important clinical applicability in the diagnosis and treatment of transitional cell carcinoma of the bladder, but many aspects of the photodynamic process are yet to be elucidated. This paper investigates the role of dihematoporphyrin ether (DHE) concentration, the duration of light exposure, and the initial size of the tumors in the treatment of a transplantable murine transitional cell tumor system.The best results were noted in tumors less than sixmm. in diameter when treated with 15mg./kg. DHE and exposed to 100 to 180 minutes of visible light. Animals with small initial tumor size combined with higher DHE concentration and longer light exposure time were most likely to show tumor response.

Pedal lymphangiography was done on 38 patients with stages O, A and B carcinoma of the prostate. The lymphangiograms were positive in 19 cases and negative in 19. Of 18 patients who underwent lymphadenectomy (9 with positive and 9 with negative studies) operative findings confirmed the lymphangiogram in 15 (83 per cent). In the 6 patients with osseous metastases and/or enzyme elevation, the lymphangiogram was positive. Furthermore, 13 patients with positive lymphangiograms had negative osseous and enzyme survey, emphasizing that nodal involvement may be the earliest finding in disseminated carcinoma of the prostate. The value of lymphangiography in staging carcinoma of the prostate prior to radical prostatectomy or irradiation seems well established.

We investigated 112 patients with end stage renal disease. Clinical evaluations included cystoscopy, cystometry, voiding cystography, bilateral retrograde pyelograms, history and physical examination, and appropriate serum and urinary studies. Of the 112 patients 28 (25 per cent) had significant abnormalities of the urinary tracts. Of the 28 patients 17 had lower tract abnormalities, such as detrusor hyporeflexia, obstructing prostatic hyperplasia and urethral stricture, and 11 had upper tract disease, 9 of whom required a pre-transplant surgical procedure. Included in the group of 9 patients were those with polycystic kidneys, staghorn calculi, renin-related renal hypertension, chronic pyelonephritis and persistent vesicoureteral reflux. None of the azotemic patients had significant morbidity with the timing of the surgical procedures. We believe that eradication of such conditions in the pre-transplant period resulted in a more suitable candidate for renal transplantation. Furthermore, we believe that our finding of 25 per cent abnormalities underscores the need for early urologic evaluation of these patients to ensure their functional capabilities as a recipient.

During the 5 year period from June 1, 1965, to June 1, 1970, 37 patients were treated with some type of pelvic exenteration at the University of Michigan Medical Center. Total pelvic exenteration was performed in over 60 per cent of the cases. Of 14 patients operated upon 3 or more years ago, 7 are alive and clinically free of disease. The operative mortality in the cases reported is 2.7 per cent. Of 21 patients treated 2 or more years ago, 6 had regional lymph node involvement and all have died of disease. Twelve of the 15 patients with no nodal involvement are alive and clinically free of disease. The importance of various technical points to include “ski positioning” of the patient on the operating table, development of a peritoneal sling to be used as a pelvic cover, preparation of a ureterosigmoid conduit for urinary diversion, and prophylactic compartmentalization of the inferior vena cava are described in detail. Vaginal reconstruction when desired is performed at a later date.

A case is reported of a patient with aberrant right renal artery arising at the level of the eleventh thoracic segment associated with renal artery aneurysm and systemic hypertension. Knowledge of the existence of aberrant renal arteries is important because they may be inadvertently damaged during renal surgery and their presence must be considered in evaluating a donor kidney for possible renal transplantation.

A case of recurrent metastatic pheochromocytoma in pregnancy is reported. Localization of the extra-adrenal tumor sites was accomplished by inferior vena caval catheterization with segmental determinations of epinephrine and norepinephrine levels. Profiles of urinary catecholamine excretion in uncomplicated pregnancies are also presented. To assess daily fluctuations in catecholamine excretion, a series of daily determinations of 24 hour urinary epinephrine and norepinephrine were performed in one subject with an uncomplicated pregnancy from the thirty-second week of gestation until delivery.

Vesical neck contractures occur following 5 to 10 per cent of transurethral prostatectomies and an even smaller number of enucleative prostatectomies. Recurrences following both conservative and surgical treatment are common and present management problems to the urologist. Seven patients with recurrent vesical neck contractures were managed with reresection and steroid injection. One hundred per cent of patients responded to this although 1 patient required two procedures. The use of hydrocortisone sodium succinate (Solu-Cortef) versus triamcinolone acetonide (Kenalog) preparations are discussed.

Improved modalities to treat metastatic renal cell carcinoma will require an aggressive surgical and chemotherapeutic approach. Nephrectomy with hormonal and non-hormonal chemotherapy does improve median survival and 3-year survival significantly. The use of xenogeneic specific immune ribonucleic acid and Bacillus Calmette-Guerin offers promising immunotherapeutic modalities that may be combined with surgical and chemotherapeutic regimens. Early diagnosis of metastatic disease is important to evaluate properly the results of various modalities of treatment and possibly to improve the efficiency of these modalities. The management of solitary metastatic nodules should involve aggressive resection of the primary and metastatic nodule. Adjuvant hormonal and non-hormonal chemotherapy should be considered in all stages of the disease.

Experience with 2 cases of healed traumatic rupture of the corpora cavernosa has demonstrated success in restoration of function by surgical intervention when previous conservative treatment proved unsuccessful.

The testicular Sertoli cell tumor is generally considered a benign tumor that can be treated by orchiectomy and close follow-up. It accounts for less than 1.5 per cent of testis tumors and may be malignant in 10 per cent of cases. Approximately 30 per cent have endocrine activity. We present 5 additional cases to the 75 previously reported in the world literature.

Xanthogranulomatous pyelonephritis in children, contrary to adult onset, rarely is associated with non-function or calcification. The lesion is predominantly on the left side in children. There appears to be a normal humoral but temporarily impaired cellular immune response in addition to sustained depression of polymorphonuclear chemotaxis. The etiology of this is uncertain but may be attributed partially to hyperosmolarity of serum and urine, and to leukocyte specific antinuclear antibodies. The presence of leukocyte specific antinuclear antibody or cold agglutinins may interfere with normal phagocyte chemotaxis requiring tissue macrophages to produce a xanthogranulomatous reaction to bacterial invasion.

Epidermoid cysts are rare benign tumors of the testicle whose management is controversial. Only 186 cases have been reported, and most were treated with radical orchiectomy. We report 2 cases managed with local excision, and we review the world literature.

Using an occlusion balloon catheter during percutaneous removal of renal calculi can increase the success of obtaining a nephrostomy as well as enhance the removal of stone fragments.

Since 1959, 39 cases of eosinophilic cystitis have been reported in the literature. Eosinophilic cystitis is a rare form of allergic cystitis in patients who usually have a strong allergic history. It mimics other forms of intractable cystitis, such as interstitial cystitis, tuberculosis and bladder neoplasms. It is caused by various antigens that form immune complexes at the bladder level and stimulate eosinophilic infiltration. Food allergens, medications, topical agents and parasites have been implicated. The diagnosis is made by excluding all other forms of cystitis.

Water cystometry and external urethral spincter electromyography permit an accurate diagnosis and provide a rational foundation for treatment of both neurogenic and nonneurogenic vesical dysfunction. The techniques are compatible with and have enhanced our understanding of the pathophysiology of micturition. Properly performed and interpreted, water cystometry and urethral sphincter electromyography a) are an integral part of the work-up of any patient with incontinence or urinary tract infection, b) together with urethral pressure profilometry and uroflowmetry, assist in the selection of those patients who will or will not benefit from attempted surgical correction of incontinence, and c) can be employed to monitor preoperative and postoperative sequelae of major spinal or paraspinal surgery.

Five patients were treated with gonadotropin and topical testosterone for micropenis associated with hypothalamic hypogonadotropic hypogonadism. All patients received 1,000 units of gonadotropin weekly for 3 weeks, with a 6-week interval followed by 10% topical testosterone cream twice daily for 3 weeks. Serum testosterone levels were measured and remained equivalent for both modes of therapy. Average penile growth response with gonadotropin was 14.3% increase in length and 5.0% increase of girth. Topical testosterone produced an average increase of 60% in penile length and 52.9% in girth. The greatest growth response occurred in prepubertal male subjects with a minimal response in postpubertal male subjects. This study suggests that 10% topical testosterone cream twice daily will produce effective penile growth. The response appears to be greater in younger children, which is consistent with previously published studies of age-related 5 reductase activity.

The in vivo effect of hyperthermia and chemotherapy was studied in a murine transitional cell carcinoma model. Localized hyperthermia (43.5C) of 60 and 90 minutes duration was combined with systemic doxorubicin hydrochloride, cis-platinum, cyclophosphamide or mitomycin to treat tumors implanted into the hind legs of C3H mice. The data were compared to the results obtained from the application of hyperthermia or chemotherapy alone as well as to the natural growth rate of untreated tumors. Untreated tumors grew with an exponential rate and had a doubling time of 4 +/- 1.5 days. Animals bearing such tumors survived for 25 +/- 7 days. When treated with hyperthermia alone, there was no significant reduction in the growth rate and no improvement was noted in the survival time. Treatment with doxorubicin hydrochloride, cyclophosphamide or mitomycin administered alone was likewise not effective. Cis-platinum alone was able to induce a minimal decrease in the growth rate. When the administration of chemotherapy was accompanied by hyperthermia, significant synergistic effect was noted for doxorubicin hydrochloride, cis-platinum and cyclophosphamide (p less than .01); only the mitomycin and hyperthermia combination failed to improve survival and decrease the growth rate. The duration of the hyperthermia exposure influenced the degree of tumor response. Hyperthermia of 90 minutes duration resulted in consistently greater decrease in tumor growth rate with doxorubicin hydrochloride, cis-platinum or cyclophosphamide than 60 minutes of hyperthermia combined with the same agents. These results indicate that local hyperthermia combined with doxorubicin hydrochloride, cis-platinum or cyclophosphamide can induce tumor regression, increase tumor doubling time and improve the survival of the tumor-bearing animal. Only the hyperthermia-mitomycin combination did not result in significant improvement from the baseline values. Thus, hyperthermia combined with selected chemotherapeutic agents can have an adjuvant effect in the treatment of established, implanted mouse bladder tumors.

In six infants and children, acute renal failure, following diarrhea, was associated with hemolytic anemia and thrombocytopenia. This combination of findings, referred to as the hemolytic uremic syndrome, has been recognized with increasing frequency. Four of six patients died despite treatment by transfusion and dialysis. The pathological findings were not uniform and included glomerulonephritis, thrombotic thrombocytopenic purpura, and renal cortical necrosis. The etiology remains obscure. Available evidence suggests that a hypersensitivity process is involved in the pathogenesis.

THE RADICAL surgical treatment of recurrent carcinoma of the cervix was first proposed by Brunschwig in 1948. 1 With the accumulation of experience, operative morbidity and mortality has steadily decreased so that current rates are quite acceptable. 2-4 Sufficient time has elapsed so that definitive five-year survival statistics have been accumulated, 2-4 and these justify the continued utilization of pelvic exenteration for the treatment of recurrent carcinoma of the cervix and other pelvic malignancies. However, controversy or at least a certain amount of confusion exists regarding who should perform such surgery. It is immediately apparent that in removing the female reproductive organs, pelvic lymphatics, bladder, urethra, distal ureters, rectosigmoid, rectum and anus en bloc, and creating a sigmoid colostomy and a form of urinary diversion that one involves the separate disciplines of general surgery, gynecology, and urology. It is uncommon to-day for one surgeon to be competent enough in all

Excessive absorption of carbon tetrachloride results in a clinical complex manifesting depression of the central nervous system (CNS) followed by hepatic and renal damage. Infrared analysis of the breath is a rapid, specific means of establishing the diagnosis and estimating the amount of drug absorbed. Prompt initiation of intravenous therapy with mannitol may minimize the renal damage and prevent renal failure. These principles are illustrated by the case history of a woman aged 29 who, in an unsuccessful attempt at suicide, ingested a mixture of carbon tetrachloride and methanol.