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Determinations were made of the median lethal concentration (LC 50 ) and median lethal time (LT 50 ) of conidia and blastospores of B. bassiana against adult Nephotettix virescens (green leafhoppers). There was no significant difference between the LC 50 values for blastospores produced in carbon- and nitrogen-limited cultures, but both types of blastospores were significantly less virulent than conidia. The LT 50 values of conidia and of blastospores from nitrogen-limited cultures were significantly lower than the value for blastospores produced in carbon-limited culture. The LT 50 values of conidia and blastospores increased during storage at 25 °C and were inversely related to spore viability. At all but one concentration tested, nitrogen-limited blastospores ‘adhered’ to insects more strongly than did carbon-limited blastospores. Fewer spores germinated on insect wings than on agar medium and of the three spore types studied, maximal germination on insect wings was observed with nitrogen-limited blastospores.

s / Pancreatology 16 (2016) S1eS63 S32 Conclusion: Repeated FNA or serum CA19-9 levels were helpful in improving the diagnosis.

Background We investigated whether combinations of serum cytokines, used with logistic disease predictor models, could facilitate the detection of pancreatic ductal adenocarcinoma (PDAC). Methods The serum levels of 27 cytokines were measured in 241 subjects, 127 with PDAC, 49 with chronic pancreatitis, 20 with benign biliary obstruction and 45 healthy controls. Samples were split randomly into independent training and test sets. Cytokine biomarker panels were selected by identifying the top performing cytokines in best fit logistic regression models during multiple rounds of resampling from the training dataset. Disease prediction by logistic models, built using the resulting cytokine panels, was evaluated with training and test sets and further examined using resampled performance evaluation. Results For the discrimination of PDAC patients from patients with benign disease, a panel of IP-10, IL-6, PDGF plus CA19-9 offered improved diagnostic performance over CA19-9 alone in the training (AUC 0.838 vs. 0.678) and independent test set (AUC 0.884 vs. 0.798). For the discrimination of PDAC from CP, a panel of IL-8, CA19-9, IL-6 and IP-10 offered improved diagnostic performance over CA19-9 alone with the training (AUC 0.880 vs. 0.758) and test set (AUC 0.912 vs. 0.848). Finally, for the discrimination of PDAC in the presence of jaundice from benign controls with jaundice, a panel of IP-10, IL-8, IL-1b and PDGF demonstrated improvement over CA19-9 in the training (AUC 0.810 vs. 0.614) and test set (AUC 0.857 vs. 0.659). Conclusions These findings support the potential role for cytokine panels in the discrimination of PDAC from patients with benign pancreatic diseases and warrant additional study.

Study objective: To determine the accuracy and application of pelvic ultrasound performed by emergency physicians in detecting ectopic pregnancy (EP) in complicated first-trimester pregnancies. Methods: We studied consecutive pelvic ultrasounds performed in all women who presented with abdominal pain or vaginal bleeding during the first trimester of pregnancy over a 6-month period. Patients with clinical evidence of incomplete abortion were not included. We compared ultrasound results with subsequent ultrasound findings by the radiology department and correlated them with follow-up diagnoses and outcomes. Results: Of the 136 eligible patients, a final diagnosis was rendered in 125; 11 were lost to follow-up. These ED ultrasound findings were recorded: established intrauterine pregnancy (IUP) with embryonic structures, 87 (70%); indeterminate scan revealing no distinct evidence of IUP or EP, 15 (12%); early intrauterine gestational sac of less than 6 weeks without embryonic structures, 12 (10%); EP, 8 (6%); blighted ovum, 2 (2%); and molar pregnancy, 1 (1%). The initial ED ultrasound determination was consistent with radiology department findings, final outcome, or both in 121 (96%) (95% confidence interval [CI], 91% to 97%). ED ultrasound accurately identified 87 pregnancies with intrauterine embryonic structures, including 5 patients with fetal demise (95% CI, 97% to 100%). Diagnosis of pregnancy location in these 87 patients effectively ruled out EP, with a negative predictive value of 100%. The sensitivity and specificity of ED ultrasound in the detection of EP were 90% and 88%, respectively. Conclusion: Pelvic ultrasonography performed by emergency physicians can be used to rule out EP and make an accurate diagnosis in most patients with complicated first-trimester pregnancies during the initial ED visit. The remaining patients at risk can be identified and a diagnosis made by means of follow-up ultrasound and serial hCG determinations. [Durham B, Lane B, Burbridge L, Balasubramaniam S: Pelvic ultrasound performed by emergency physicians for the detection of ectopic pregnancy in complicated first-trimester pregnancies. Ann Emerg Med March 1997;29:338-347.]

Victoria E. Shaw , Claire Jenkinson , Brian Lane , Bill Greenhalf , John P. Neoptolemos , Eithne Costello . 1 Liverpool Cancer Research-UK Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK 2 Liverpool National Institute for Health Research Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK

weight). Conclusions: A statistically significant association was found between the number of adjustments per year and weight loss. Patients who underwent more adjustments experienced improved weight loss compared with those who had fewer adjustments. It seemed to take a few adjustments for each patient to sense the right amount of restriction. Each extra visit also provided an opportunity to reinforce appropriate lifestyle changes that are important for longterm weight loss. PII: S1550-7289(05)00152-8

A spark gap was designed and constructed to measure the time dependent arc resistance. The arc current was measured and the arc resistance calculated using the current and the other circuit parameters. Typical operating parameters were: unipolar pulse, 35 kV breakdown voltage, 30 kA peak current, and 1.15 kJ total energy per shot. The dissipated arc energy was calculated from the arc current and resistance and found to be between 4.5% and 10.5% of the total energy. Arc resistance vs time curves were obtained for all possible combinations of three electrode materials (304 Stainless Steel, ACF-IOQ Graphite, and 3w3 Copper-Tungsten), three gases (Air, N2, and SF6), and three gas pressures ( 1 , 2, and 3 atmospheres). Statistical analysis was performed on the resultant data. Essential results are: within the statistical and measurement errors, the resistance is independent of the electrode material. For each gas, R is approximately proportional to pd (pressure and gap distance). The constants of proportionality are (31 ± 7) mΩ/(cm bar) for air, (47 + 15) mΩ/(cm bar) for N2, and (76 ± 17) mΩ/(cm bar) for SF6.

Ten patients who sustained pancreatic trauma over a 10 year period are reviewed. Nine of the patients underwent emergency laparotomy. One patient was treated conservatively; his pancreatic injury was subsequently confirmed by endoscopic retrograde pancreatography (ERCP). In 9 patients the injury resulted from a road traffic accident and in 1 patient the injury was due to a kick in the upper abdomen. Associated injuries were present in 5 patients. Preoperative amylase estimation proved helpful in the diagnosis of 4 patients and ERCP in the case of 2 others. The post operative mortality was 20%. The post operative morbidity was 60%. Although no single procedure uniformly applies to these complex injuries, we advocate simple drainage for only trivial injury; for major injury of the body and tail we recommend distal resection. Whipple’s operation is reserved only for severe injuries to the head of the pancreas and/or duodenum.