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Objective: To review our experience with the various acetabular reconstruction techniques used during revision arthroplasty based on the defect in each patient., Material and Methods: We undertook a retrospective, descriptive, observational study of patients who underwent acetabular reconstruction during revision ar. throplasty, from January 1997 to January 2005. We documented the type of acetabular defect, the type of cup and graft used, the complications, and the pre- and postoperative assessment with the Harris scale. Data were analyzed with the SPSS software and the Wilcoxon test (p < 0.05)., Results: Seventy-six patients underwent surgery. Mean time elapsed between the primary replacement and the revision was 5 years. The acetabular defects found were: 16 type I, 22 type II, 30 type IIIA, and 8 type IIIB. The mean Harris score was 44 preoperatively and 76 postoperatively. The most frequently used technique involved the use of an autograft, a structural allograft with a porous threaded cup or a reinforcement ring. The most common complications included dislocation 5%, infection 3%, graft loss and cup loosening 21%, and loss of the hip center of rotation 15% (p < 0.05)., Conclusions: Acetabular reconstruction is technically challenging and involves high failure and complication rates, thus providing little improvement in patient activity. It is important to restore the hip center of rotation to improve function. The reconstruction techniques we used are the most common ones and are described in the literature.

Background: Non-compliance is a common cause of failed medical action, contributing to absence of regular check-ups. Our group has already published studies that analyse the level of non-compliance with appointments amongst patients attending our Allergology clinic, and we have made proposals for improvement., Objective: This article evaluates the results obtained three years after setting up and launching telephone reminders for patients' first appointments., Methods: All patients who were given appointments for first and subsequent visits during 2005 were included. A total of 18215 appointments were studied (3115 first appointments and 15100 subsequent ones). Of these, there were 2479 missed appointments (438 first appointments and 2041 subsequent ones), corresponding to 2215 patients (412 first visits and 1803 subsequent ones), with a mean of 1.12 appointments/patient/year., Results: The non-compliance rate was 13.61%. The most common non-compliers were men (14.11% missed appointments against 13.24% missed appointments in women) and in the age range 20-29 years and 30-39 years (16.46% and 15.28% non-compliance, respectively). The mean age of non-compliers was 34.55 +/- 14.73 years. We observed a significant number of patients who missed more than one appointment (5.12% of all non-compliers and 0.7% of all patients). Differences were found in the degree of non-compliance depending on the type of appointment (14.06% non-compliance with first visits and 13.52% with subsequent visits). We observed a significant increase in missed appointments during the Summer holidays; July and August showed the highest percentage of missed appointments for both the first visit (20.62% in July and 23.59% in August) and subsequent visits alike (16.14% in July and 14.23% in August)., Conclusions: A slight reduction in non-compliance was observed after implementing the proposals made in our previous study. In view of the high costs incurred from missed appointments, the government should finance studies to reduce this problem. The causes of non-compliance may be difficult to control, including present access to the public health service. We must be alert to and/or take preventive measures in young patients and cases of previous non-compliance. The degree of non-compliance is a quality indicator, because it reduces the yield of appointments, and it evidences a lack of cohesion of patients with Primary Health Care Units for first appointments, and with Specialist Care Units for subsequent appointments. Once certain levels of attendance have been attained, it is difficult to achieve an effect on this point in order to improve attendance rates.

Objectives: Idiopathic postpneumonectomy pulmonary edema is a leading cause of mortality after pneumonectomy. Postoperative hyperinflation of the remaining lung is an etiologic factor. We have demonstrated avoidance of postpneumonectomy pulmonary edema solely by changing management of the pneumonectomy space to a balanced drainage system. In sheep, we tested the following hypothesis: (1) Postoperative induced hyperinflation of the remaining lung can cause postpneumonectomy pulmonary edema. (2) A balanced drainage system can prevent its development., Methods: We performed 37 right-sided pneumonectomies in adult sheep. In experiment 1, after surgery, 10 sheep had continuous suction (5 kPa) applied through an intercostal catheter placed in the empty hemithorax to induce mediastinal shift and hyperinflation of the left lung without adverse hemodynamic sequelae. In experiment 2, 27 sheep were randomly allocated into 3 equal groups regarding management of the residual empty right hemithorax: balanced drainage, no intercostal drainage, and clamp-release intercostal underwater drainage. A fourth group of 9 sheep served as a sham controls placebo with the same anesthetic and a right thoracotomy., Results: All sheep tolerated surgery without adverse event. In experiment 1, there was significant mediastinal shift at necropsy in all sheep and 60% (n = 6) had postpneumonectomy pulmonary edema develop in the left lung (P = .023 vs sham). In experiment 2, incidences of postpneumonectomy pulmonary edema were as follows: 0 in balanced group (P = .057 vs other groups), 3 (30%) in no-drainage group, and 3 (30%) in clamp-release group. Only the 12 sheep with postpneumonectomy pulmonary edema had respiratory distress; the rest had uneventful recoveries., Conclusion: In a sheep model of postpneumonectomy pulmonary edema, hyperinflation from mediastinal shift is an etiologic factor. A balanced drainage system averts postpneumonectomy pulmonary edema. This is the first time such a causal relationship has been demonstrated, supporting our continued use of balanced drainage after pneumonectomy.

Mixed viral infections of heterologous viruses such as Potato virus Y (family Potyviridae, genus Potyvirus, PVY) and Potato leafroll virus (family Luteoviridae, genus Polerovirus, PLRV) are a regular occurrence in Idaho's potato, Solanum tuberosum (L.), cropping systems. An increased number of plant samples from Idaho's potato fields over the past 2 yr has serologically tested positive for both PVY and PLRV via double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) and exhibited more severe symptoms than singly-infected plants (PVY or PLRV). Several studies have extensively examined the mixed infection phenomenon but to the best of our knowledge, none have examined the effect of such infections on vector biology and preference. Laboratory studies were conducted to examine the effect of mixed viral (PVY-PLRV) infection on the fecundity and preference of two of the most efficient PVY and PLRV vectors, the green peach aphid, Myzus persicae (Sulzer), and the potato aphid, Macrosiphum euphorbiae (Thomas) (Hemiptera: Aphididae). M. persicae and M. euphorbiae adults were clip-caged (one adult per cage) to leaflets of PVY, PLRV, PVY-PLRV-infected, and noninfected potato plants. The number of nymphs produced in all four treatments was recorded after 96 h. M. persicae and M. euphorbiae fecundity was significantly higher on mixed infected plants than on singly infected plants or noninfected plants. Preference of alatae and apterae of M. persicae and M. euphorbiae was determined with the use of settling bioassays. Both alatae and apterae of M. persicae and M. euphorbiae preferentially settled on PVY-PLRV-infected plants than on singly infected plants (PVY or PLRV) or noninfected plants.

The objective of this study was to compare the distribution, mobility, and relative effectiveness of Zn from Zn-amino acids (Zn-AA) and Zn-DTPA-HEDTA-EDTA (Zn-CH) (DTPA, diethylenetriaminepentaacetate; HEDTA, N-2-hydroxyethyl-ethylenedinitrilotriacetate; and EDTA, ethylenedinitrilotetraacetate) sources by applying different Zn levels to weakly acidic and neutral soils in laboratory (incubation and soil column studies) and greenhouse conditions. The experiments were carried out for 60 days in incubation and column experiments and for 45 days in a greenhouse experiment. The zinc soil behavior was evaluated by DTPA-TEA and Mehlich-3 extractions and sequential speciation. The incubation experiment showed that the highest concentrations of available Zn in weakly acidic soil occurred with Zn-AA treatments, whereas in the neutral soil Zn-CH treatments produced the highest quantities of available Zn. The column experiment showed that in neutral soil, with slow to moderate permeability in the Ap and Bt horizons, only Zn-CH significantly increased the mobility of Zn through the column with respect to the control and the Zn-AA source: 31% of the Zn applied as synthetic chelate was leached from the column. The greenhouse experiment showed that, at different rates of Zn application, the Zn carriers increased Zn uptake by maize (Zea mays L.). The use of applied Zn by maize, or Zn utilization, was greatest when the Zn treatments were Zn-CH (3.3%) at 20 mg kg-1 and Zn-CH (4.9%) at 10 mg kg-1, in weakly acidic and neutral soils, respectively.

Besides the established role of interleukin-12 (IL-12) and IL-18 on interferon-gamma (IFN-gamma) production by natural killer (NK), T, and B cells, the effects of these cytokines on macrophages are largely unknown. Here, we investigated the role of IL-12/IL-18 on nitric oxide (NO) and tumor necrosis factor-alpha (TNF-alpha) production by CD11b(+) adherent peritoneal cells, focusing on the involvement of endogenously produced IFN-gamma. C57BL/6 cells released substantial amounts of NO when stimulated with IFN-gamma or lipopolysaccharide (LPS), but failed to respond to IL-12 or IL-18 or both. However, IL-12/IL-18 pretreatment was able to program these cells to release 6-8-fold more NO and TNF-alpha in response to LPS or Trypanosoma cruzi stimulation, with NO levels directly correlating with macrophage resistance to intracellular parasite growth. Analysis of IL-12/IL-18-primed cells from mice deficient in IFN-gamma, IFNGR, and IFN regulatory factor-1 (IRF-1) revealed that these molecules were essential for LPS-induced NO release, but TNF-alpha production was IFN-gamma independent. Conversely, the myeloid differentiation factor 88 (MyD88)-dependent pathway was indispensable for IL-12/IL-18-programmed LPS-induced TNF-alpha production, but not for NO release. Contaminant T and NK cells largely modulated the IL-12/IL-18 programming of LPS-induced NO response through IFN-gamma secretion. Nevertheless, a small population of IFN-gamma(+) cells with a macrophage phenotype was also identified, particularly in the peritoneum of chronically T. cruzi-infected mice, reinforcing the notion that macrophages can be an alternative source of IFN-gamma. Taken together, our data contribute to elucidate the molecular basis of the IL-12/IL-18 autocrine pathway of macrophage activation, showing that endogenous IFN-gamma plays an important role in programming the NO response, whereas the TNF-alpha response occurs through an IFN-gamma-independent pathway.

A fast and simple flow-through optosensor was designed and characterized for the direct screening of four tetracycline (TCC) antibiotics (tetracycline, oxytetracycline, chlortetracycline and doxycycline) in water and bovine milk samples. The proposed optosensor provides rapid binary yes/no overall responses, being appropriate for the screening of this family of antibiotics above or below a pre-set concentration threshold. The experimental set-up is based on a flow-injection manifold coupled on-line to a phosphorescence detector. Aliquots of the samples are pretreated with Eu(III) to form room temperature phosphorescent metal chelates and injected in the flow manifold. Those chelates are then on-line retained on a conventional flow-cell (packed with polymeric Amberlite XAD-4 particles) which is placed inside the cell holder of the phosphorimeter. After the emission is registered, the antibiotic-metal complexes are eluted from the packed resin with 1M HCl (for milk samples a second regeneration step, using methanol, should be performed). A sample throughput of about 20 samples per hour was obtained. Optimum experimental conditions include a pH 9, a Eu(III) concentration of 2 x 10(-4) M and 8 mM sodium sulphite as chemical deoxygenant. The phosphorescence emitted by the europium-TCC complexes was measured at 394 and 617 nm for excitation and emission wavelengths, respectively. The unreliability region, given by the probability of false positives and false negatives, respectively (set at 5% in both cases) was in the range between 0.2 and 11.6 nM for detection of tetracyclines in water samples (at a cut-off level of 4 nM) and in the range between 165 and 238 nM for detection of tetracyclines in milk (cut-off level fixed at the normative EU level of 200 nM). Finally, the applicability of the proposed screening optosensor was tested for the reliable control of tetracyclines in contaminated and uncontaminated water and milk samples.

Purpose: We present our experience with dismembered left-sided pyeloplasty using a transmesocolic technique as a way to reduce operative time and facilitate repair by avoiding colon displacement., Patients and Methods: Between January 2004 and January 2006, a total of 11 transmesocolic laparoscopic pyeloplasties were performed by the same surgeon at our institution. The mean patient age was 41.6 years (range 14-65 years). Operative records and follow-up were reviewed., Results: A dismembered Anderson-Hynes pyeloplasty was carried out in nine patients (82%), while a Y-V plasty (9%) and a Fengerplasty (9%) were done in one patient each. Crossing vessels were observed in 8 patients (73%). A ureteral stent was left in all patients. The mean operative time was 88.6 minutes (range 60-125 minutes), and blood loss was minimal. Compared with classic transperitoneal laparoscopic left pyeloplasties, transmesocolic cases showed a significant reduction in operative time (88.6 minutes v 117 minutes; P < 0.05). There were no intraoperative complications or open conversions. The mean hospital stay was 2.1 days (range 2-3 days). Only 1 patient (9%) demonstrated narrowing of the anastomosis, which occurred 12 months after a Fengerplasty., Conclusions: The transmesocolic approach to a dilated left pelvis enables a shorter operative time without increasing morbidity. More patients and longer follow-up are necessary to determine its effect on convalescence.

A smooth reaction of [(mu3-S)(mu3-OH)Pd3(CwedgeN)3] (2) with [(mu2-X)2Pd2(CwedgeN)2] (2:1; HCwedgeN = p-C2H5OC6H4CH=NC6H4-p-C2H5, X = OH, Cl) provides [(mu4-S){(mu2-OH)Pd2(CwedgeN)2}2] (3) and [(mu4-S)(mu2-Cl)(mu2-OH)Pd4(CwedgeN)4] (4). Treatment of 3 with HCl (molar ratio 1:2) leads to the corresponding tetranuclear complex [(mu4-S)(mu2-Cl)2Pd4(CwedgeN)4] (5). The three complexes contain a (mu4-S)Pd4 core. A density functional theory study of the bonds in 3 supports that the bonding of the S atom can be described in terms of four two-center two-electron S-Pd bonds, in contrast to most other (mu4-S)M4 systems in the literature, where the presence of M-M bonds prevents a bond-localized description of the molecule. The X-ray structures of 2, 3, and 5 are reported.

Three cases of children admitted to the Pediatric Intensive Medicine Unit in the months of February to March 2004 with the diagnosis of streptococcal toxic shock syndrome are presented. Two were under 2 years of age and the initial symptoms suggested viriasis. They evolved towards septic shock with early multiorganic failure and then death due to massive hemoptysis, ventricular fibrillation due to hyperkaliemia. Streptococcus pyogenes with serotypes M1T1 was isolated in all the cases and the patients had the clinical criteria of streptococcal toxic shock syndrome. Their course was unfavorable in spite of the resuscitation steps, early antibiotic treatment and artificial support of the different organic failures. We stress the rareness of the cases, early age, its appearance in a short period of time, its sudden onset and the null response to treatment initiated.

Ethnic and American identity, as well as positivity and negativity toward multiple social groups, were assessed in 392 children attending 2nd or 4th grade in various New York City neighborhoods. Children from 5 ethnic groups were recruited, including White and Black Americans, as well as recent immigrants from China, the Dominican Republic, and the former Soviet Union. For ethnic minority children, greater positivity bias (evaluating one's ingroup more positively than outgroups) was predicted by immigrant status and ethnic identity, whereas negativity bias (evaluating outgroups more negatively than one's ingroup) was associated with increased age, immigrant status, and (among 4th graders only) ethnic identity. In addition, a more central American identity was associated with less intergroup bias among ethnic minority children.

A selective optosensor for benzo[a]pyrene (BaP) determination in water samples, using a molecularly imprinted polymer (MIP) for the recognition of the analyte, has been developed. Detection was based on measurements of the native strong room temperature phosphorescence (RTP) emission from the BaP recognized by the MIP. The non-covalent MIP was synthesized using BaP as a molecular template. Different halogenated-bisphenol A compounds were compared as precursors in the polymerization (thus ensuring the presence of a heavy atom, required to induce RTP emission from the analyte). In the developed optosensor, samples are injected in a flow system and the analyte is on-line retained onto the polymeric material. In the absence of oxygen (using sodium sulfite as the oxygen scavenger) the heavy atom present in the MIP structure induced analytically useful RTP emission from the recognized BaP. After measurement of the luminescent emission, the sensing material can be easily regenerated by passing 2 mL of methanol over the MIP. The optosensor demonstrated a very high selectivity for BaP determination in water even in the presence of other luminophores that could be non-specifically adsorbed onto the MIP surface. Under optimal experimental conditions, a benzo[a]pyrene detection limit of 10 ng L(-1) (20 mL sample injection volume) was achieved with good reproducibility (a RSD of 3% was obtained for 1 microg L(-1) BaP). Finally, the proposed optosensor was successfully applied to the analysis of spiked natural water with BaP.

Objectives: We report a series of patients with stage I non seminomatous testicular cancer in whom laparoscopic retroperitoneal lymphadenectomy was carried out., Methods: Between March 1993 and January 2004 100 and patients with the diagnosis of stage I non seminomatous testicular cancer underwent laparoscopic retroperitoneal lymphadenectomy (LRPL). All operations were performed by the same surgeon (O.A.C). Clinical data were collected prospectively in a database. Patients' demographic data, operative time, estimated blood loss, hospital stay, operative and post operative complications, convention rate and follow-up were all analyzed., Results: 111 LRPL were performed in 111 patients with a mean age of 29.3 years (range 15-44 years). 61 procedures were right-LRPL and 50 left-LRPL. Mean operative time was 138 minutes (range 60-300 minutes). Introoperative complications appeared in 10 cases (9%), 9 vascular complications (8.1%) and 1 duodenal lesion (0.9%). Conversion to open surgery was necessary in three patients (2.7%). Mean hospital stay was 43.3 hours (range 24-120). 5 patients (4.5%) had tumor recurrence, with a mean follow-up of 30 months (range 24-94 months). Recurrences were localized in the retroperitoneum, mediastinum and lungs. Recurrence time varied between four and 64 months., Conclusions: LRPL offers oncological results equivalent to open surgery, with the advantage of being minimally invasive and its consequent decrease in morbidity. The laparoscopic retroperitoneal lymphadenectomy is a good option for the management of patients with stage 1 testicular cancer.

Background: Systematic comparisons between genomic sequence datasets have revealed a wide spectrum of sequence specificity from sequences that are highly conserved to those that are specific to individual species. Due to the limited number of fully sequenced eukaryotic genomes, analyses of this spectrum have largely focused on prokaryotes. Combining existing genomic datasets with the partial genomes of 193 eukaryotes derived from collections of expressed sequence tags, we performed a quantitative analysis of the sequence specificity spectrum to provide a global view of the origins and extent of sequence diversity across the three domains of life., Results: Comparisons with prokaryotic datasets reveal a greater genetic diversity within eukaryotes that may be related to differences in modes of genetic inheritance. Mapping this diversity within a phylogenetic framework revealed that the majority of sequences are either highly conserved or specific to the species or taxon from which they derive. Between these two extremes, several evolutionary landmarks consisting of large numbers of sequences conserved within specific taxonomic groups were identified. For example, 8% of sequences derived from metazoan species are specific and conserved within the metazoan lineage. Many of these sequences likely mediate metazoan specific functions, such as cell-cell communication and differentiation., Conclusion: Through the use of partial genome datasets, this study provides a unique perspective of sequence conservation across the three domains of life. The provision of taxon restricted sequences should prove valuable for future computational and biochemical analyses aimed at understanding evolutionary and functional relationships.

One hundred and ten melon accessions from different origins were evaluated for resistance to race 1.2 of Fusarium oxysporum f.sp. melonis (Fom). Artificial inoculations were performed and plants were scored for presence or absence of symptoms. The screening revealed that sources of resistance to this fungus are limited. However, a few resistant accessions were found. The accessions 'Kogane Nashi Makuwa', 'C-211' and 'C-40' from Japan provided the highest resistance to both patotypes of race 1.2 of Fom which seems to confirm that the Far East is a rich area in resistances to this race. We also detect an interesting degree of resistance in 'BG-5384', a Portuguese accession that may be classified as belonging to the botanical variety inodorus.

The detection of gene fusion events across genomes can be used for the prediction of functional associations of proteins, including physical interactions or complex formation. These predictions are obtained by the detection of similarity for pairs of 'component' proteins to 'composite' proteins. Since the amount of composite proteins is limited in nature, we augment this set by creating artificial fusion proteins from experimentally determined protein interacting pairs. The goal is to study the extent of protein interaction partners with increasing phylogenetic distance, using an automated method. We have thus detected component pairs within seven entire genome sequences of similar size, using artificially generated composite proteins that have been shown to interact experimentally. Our results indicate that protein interactions are not conserved over large phylogenetic distances. In addition, we provide a set of predictions for functionally associated proteins across seven species using experimental information and demonstrate the applicability of fusion analysis for the comparative genomics of protein interactions.

The effect of six Zn sources (Zn-phenolate, Zn-EDDHA, Zn-EDTA, Zn-lignosulfonate, Zn-polyflavonoid, and Zn-glucoheptonate) was studied by applying different Zn levels to a representative Calcic Haploxeralf neutral soil (the predominant clay is montmorillonite) in incubation and greenhouse experiments. Zinc soil behavior was evaluated by sequential DTPA and Mehlich-3 extraction procedures. In the incubation experiment, the highest percentage recovery values of Zn applied to soil occurred in the water-soluble plus exchangeable fraction (29%) in fertilization with 20 mg of Zn kg(-1) of Zn-EDTA fertilizer. In the greenhouse experiment with maize (Zea mays L.), a comparison of different Zn carriers showed that the application of six fertilizers did not significantly increase the plant dry matter yield among fertilizer treatments. The highest yield occurred when 20 mg of Zn kg(-1) was applied as Zn-EDDHA fertilizer (79.4 g per pot). The relative effectiveness of the Zn sources in increasing Zn concentration in plants was in the following order: Zn-EDTA (20 mg kg(-1)) > Zn-EDDHA (20 mg kg(-1)) approximately Zn-EDTA (10 mg kg(-1)) > Zn-EDDHA (10 mg kg(-1)) approximately Zn-phenolate (both rates) approximately Zn-polyflavonoid (both rates) approximately Zn-lignosulfonate (both rates) approximately Zn-glucoheptonate (both rates) > untreated Zn. The highest amounts of Zn taken up by the plants occurred when Zn was applied as Zn-EDTA fertilizer (20 mg kg(-1), 7.44 mg of Zn per pot; 10 mg kg(-1) Zn rate, 3.93 mg of Zn per pot) and when Zn was applied as Zn-EDDHA fertilizer (20 mg kg(-1) Zn rate, 4.66 mg Zn per pot). After the maize crop was harvested, sufficient quantities of available Zn remained in the soil (DTPA- or Mehlich-3-extractable Zn) for another harvest.

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Homogeneous Functional Groups (HFG) for Diagnostic Techniques in the Allergy Department of the Virgen de la Arrixaca University Hospital in Murcia (Spain) and the healthcare products generated. Based on the 2005 budget, variable costing was used to calculate the costs of the healthcare products generated (skin tests, investigation of drug allergies, etc.) by one of the three HFG (the HFG for complementary investigations). On the basis of these costs, and taking as the unit the cost of one skin prick test, we assigned relative units of value (RUV) to each of the products in our services portfolio. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) to take the decisions required to optimize resources, clinical management and complementary tests should go hand-in-hand.

Bimetallic palladium(II)-rhodium(I) and gold(I)-rhodium(I) complexes of the type [(4,4'-Me2-bipy)(C6F5)Pd(mu-PPh(3-n)Pyn)Rh(diene)](BF4)2 and [(C6F5)Au(mu-PPh(3-n)Pyn)Rh(diene)](BF4) (n = 2, 3; Py = 2-pyridyl) have been synthesized. The P donor atom of the bridging ligands (mu-PPh(3-n)Pyn) is coordinated to the Pd or to the Au center. The resulting complexes react with [Rh(diolefin)(solv)2]+ (solv = acetone) in a way similar to pyrazolylborates, affording square-planar or pentacoordinated rhodium complexes with two or the three N-donor ends chelating the Rh atom. The metallacycles formed upon chelation can adopt one of two conformations in the square-planar Rh(I) complexes, either bringing the other metal close to the Rh center or bringing it to a remote position. The first conformation is preferred for the gold P-coordinated complexes and the second for the palladium complexes. The X-ray structures of [(4,4'-Me2-bipy)](C6F5)Pd(mu-PPhPy2)Rh(COD)](BF4)2 (COD = 1,5 cyclooctadiene) and [Au(C6F5)(mu-PPhPy2)Rh(TFB)](BF4) (TFB = 5,6,7,8-tetrafuoro-1,4-dihydro-1,4-etenonaphthalene) are reported.

Health resources are limited and consequently real cost generators must be identified to optimize resources. In the present article, we describe the structure of the Allergy Unit of the University Hospital Virgen de la Arrixaca in Murcia (Spain), the health area in which allergic patients are attended, and the final healthcare products generated. Based on the 2004-2005 budget, variable costing was used to calculate the costs of the healthcare products generated (first visits, subsequent visits, and diverse laboratory tests) by two of the three homogeneous functional groups (HFG), i.e., HFG of the ambulatory service and HFG of complementary tests. The following conclusions can be drawn: 1) the current system of variable costing provides information, which should be useful to health professionals; 2) the real cost generators in the microcosm of daily clinical practice should be identified to allow resource reallocation; 3) the costing system used enables modifications to be made that allow decision making on optimal use of the budget; 4) clinical management and complementary tests should go hand in hand with a view to optimizing resources.

We describe the case of a 20-year-old man who developed severe thrombocytopenia and hemorrhagic complications 5 months after beginning pegylated interferon therapy for chronic hepatitis C. Interferon therapy was stopped and platelets were transfused, but the platelet count did not increase until treatment with immunoglobulins and intravenous corticosteroids was started. Therefore, we believe this would suggest a possible autoimmune mechanism for the development of thrombocytopenia with interferon therapy. Mild reduction in platelets count is a common adverse effect of this drug. Nevertheless, severe decreases and secondary serious hemorrhagic complications have been infrequently described in the literature.

Background: Optimal therapy for patients with coronary artery disease and chronic poor left ventricular function, given the absence of randomized trials, is unclear. Although coronary surgery has been performed in such patients for 25 years, it is perceived as high risk and unproven long-term benefit, especially if thallium scanning fails to demonstrate large areas of viability. We report the results of coronary surgery in these patients., Methods: Retrospective analysis by a standardized patient questionnaire, of 107 such consecutive patients offered coronary surgery., Results: Mean follow-up was 3.3 years (range, 0.5-5.5); average patient age was 64.4+/-1 years. Preoperative thallium scans were performed solely on 31 patients with none or mild angina, of which 10 (32%) demonstrated large areas of viable myocardium. Perioperative mortality was 1.9%. On multivariate analysis, factors predictive of increased perioperative death were recent myocardial infarction (p<0.001) and nonelective surgery (p<0.001). Kaplan-Meier 5-year survival and freedom from major adverse cardiac events were 72.3 and 82.3%, respectively. In 21 patients, with preoperative nil-to-mild angina and nil-to-small areas of myocardial viability, thallium scanning failed to predict a successful outcome., Conclusion: Offering coronary surgery to these patients irrespective of thallium testing is safe and effective in the medium term. Early surgery is recommended.

In the present work, we show that intracellular Trypanosoma cruzi is rarely found in the livers of acutely infected mice, but inflammation is commonly observed. The presence of numerous intrahepatic amastigotes in infected gamma interferon (IFN-gamma)-deficient mice corroborates the notion that the liver is protected by an efficient local immunity. The contribution of different cell populations was suggested by data showing that CD4- and CD8-deficient mice were able to restrain liver parasite growth. Therefore, we have characterized the liver-infiltrating lymphocytes and determined the sources of IFN-gamma during acute T. cruzi infection. We observed that natural killer (NK) cells increased by day 7, while T and B cells increased by day 14. Among CD3+ cells, CD4+, CD8+, and CD4- CD8- cell populations were greatly expanded. A large fraction of CD3+ cells were positive for PanNK, a beta1 integrin expressed by NK and NK T cells. However, these lymphocytes were not classic NK T cells because they did not express NK1.1 and showed no preferential usage of Vbeta8. Otherwise, liver NK T (CD3+ NK1.1+) cells were not increased in acutely infected mice. The majority of PanNK+ CD4+ and PanNK+ CD8+ cells expressed T-cell receptor alphabeta (TCRalphabeta), whereas PanNK+ CD4- CD8- cells were positive for TCRgammadelta. In fact, gammadelta T cells showed the most remarkable increase (40- to 100-fold) among liver lymphocytes. Most importantly, intracellular analysis revealed high levels of IFN-gamma production at day 7 by NK cells and at day 14 by CD4+, CD8+, and CD4- CD8- TCRgammadelta+ cells. We concluded that NK cells are a precocious source of IFN-gamma in the livers of acutely infected mice, and, as the disease progresses, conventional CD4+ and CD8+ T cells and gammadelta T cells, but not classic NK-T cells, may provide the IFN-gamma required for liver protection against T. cruzi.

Identification of protein-protein interactions often provides insight into protein function, and many cellular processes are performed by stable protein complexes. We used tandem affinity purification to process 4,562 different tagged proteins of the yeast Saccharomyces cerevisiae. Each preparation was analysed by both matrix-assisted laser desorption/ionization-time of flight mass spectrometry and liquid chromatography tandem mass spectrometry to increase coverage and accuracy. Machine learning was used to integrate the mass spectrometry scores and assign probabilities to the protein-protein interactions. Among 4,087 different proteins identified with high confidence by mass spectrometry from 2,357 successful purifications, our core data set (median precision of 0.69) comprises 7,123 protein-protein interactions involving 2,708 proteins. A Markov clustering algorithm organized these interactions into 547 protein complexes averaging 4.9 subunits per complex, about half of them absent from the MIPS database, as well as 429 additional interactions between pairs of complexes. The data (all of which are available online) will help future studies on individual proteins as well as functional genomics and systems biology.

Motivation: CoGenT++ is a data environment for computational research in comparative and functional genomics, designed to address issues of consistency, reproducibility, scalability and accessibility., Description: CoGenT++ facilitates the re-distribution of all fully sequenced and published genomes, storing information about species, gene names and protein sequences. We describe our scalable implementation of ProXSim, a continually updated all-against-all similarity database, which stores pairwise relationships between all genome sequences. Based on these similarities, derived databases are generated for gene fusions--AllFuse, putative orthologs--OFAM, protein families--TRIBES, phylogenetic profiles--ProfUse and phylogenetic trees. Extensions based on the CoGenT++ environment include disease gene prediction, pattern discovery, automated domain detection, genome annotation and ancestral reconstruction., Conclusion: CoGenT++ provides a comprehensive environment for computational genomics, accessible primarily for large-scale analyses as well as manual browsing.

Potato leafroll virus (PLRV) causes one of the most serious aphid-transmitted diseases affecting yield and quality of potatoes, Solanum tuberosum (L.), grown in the United States. The green peach aphid, Myzus persicae (Sulzer), is considered to be by far the most efficient vector of this virus. Even the most strict aphid control strategy may not prevent the spread of PLRV unless measures also are taken to keep virus source plants within and outside the crop at a minimum. Hairy nightshade, Solanum sarrachoides (Sendtner), is one of the preferred weed hosts for green peach aphid. The potential of this weed as an aphid reservoir and virus source and its spread or perpetuation were investigated. With the use of double antibody sandwich enzyme-linked immunosorbent assay, it was confirmed that green peach aphid can transmit PLRV to hairy nightshade and that aphids can become viruliferous after feeding on infected hairy nightshade plants. Transmission from hairy nightshade to potato is 4 times the rate of potato to potato or potato to hairy nightshade. The green peach aphid preferred hairy nightshade over potato plants and reproduced at a higher rate on hairy nightshade than on potato. Therefore, a low level of PLRV-hairy nightshade infection could enhance the disease spread in the field.

Several morphological works have shown that the globus pallidus (GP) contains the highest density of 5-HT1B receptors within the telencephalon. However, the role of these receptors in the spiking of GP neurons in vivo is unknown. In the present work, we use single-unit extracellular recordings in the anesthetized rat to analyze changes in the firing rate of GP neurons evoked by local activation and blockade of 5-HT1B receptors. Intrapallidal administration of serotonin, or the serotonin uptake inhibitor fluoxetine, predominantly produced an excitatory effect in the basal firing rate of GP neurons. The 5-HT1B receptor agonist, L-694,247, caused a dose-dependent excitatory effect on most pallidal neurons tested. Blockade of 5-HT1B receptors by intrapallidal application of methiothepin predominantly caused inhibition in GP neurons firing rate. Moreover, methiothepin diminished the excitatory effect evoked by L-694,247. Furthermore, local serotonin did not evoke significant changes in the basal firing rate of GP neurons in unilateral striatal lesioned rats. Taken all together, these results suggest that serotonin 5-HT1B receptors significantly contribute to the control of spiking of the rat GP neurons, and that the 5-HT1B receptors exerting this control are most likely localized in the striato-pallidal pathway.

Cold urticaria is defined as a urticarial and/or angioedematous reaction of the skin to contact with cold objects, water or air. Types of urticaria associated with infectious diseases, such as mononucleosis, rubeola, varicella, syphilis, hepatitis, and HIV infection have been reported. We present the case of a patient who developed cold urticaria associated with acute serologic toxoplasmosis. The patient was a 34-year-old man who for the previous 2 months had presented cutaneous pruritus accompanied by several papular lesions in parts of the skin exposed to cold as well as those in contact with cold water. The result of an "ice-cube test" was positive. Serologic tests for Toxoplasma gondii showed an IgG level of 68 UI/ml and were positive for IgM, while a test for cryoglobulins was positive. One month later cryoglobulins were negative and a serologic test for T. gondii showed an IgG concentration of 75 UI/ml and positive IgM. Three months later cryoglobulins were still negative, IgG for T. gondii was 84 UI/ml, and IgM was positive. After 6 months cryoglobulins were still negative, IgG level was 68 UI/ml and IgM was still slightly positive. In the final evaluation, 14 months later, IgG level was 32 UI/ml and IgM was negative. The patient continues to present clinical manifestations of cold urticaria, although he has experienced some improvement and his tolerance to cold has increased after treatment with cetirizine.

We have previously shown that macrophages from interleukin (IL)-12p40 gene knockout (IL-12/IL-23-/-) mice have a bias towards the M2 activation profile, spontaneously secreting large quantities of transforming growth factor-beta1 (TGF-beta1) and producing low levels of nitric oxide (NO) in response to lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma). To verify whether the activation profile of dendritic cells (DCs) is also influenced by the absence of IL-12/IL-23, bone marrow-derived DCs from IL-12/IL-23-/- and C57BL/6 mice were evaluated. At first we noticed that approximately 50% of the C57BL/6 DCs were dead after LPS-induced maturation, whereas the mortality of IL-12/IL-23-/- DCs was < 10%, a protective effect that diminished when recombinant IL-12 (rIL-12) was added during maturation. Similarly to macrophages, mature IL-12/IL-23-/- DCs (mDCs) produced higher levels of TGF-beta1 and lower levels of NO than C57BL/6 mDCs. NO release was IFN-gamma-dependent, as evidenced by the poor response of IFN-gamma-/- and IL-12/IL-23-/-IFN-gamma-/- mDCs. Nevertheless, IFN-gamma deficiency was not the sole reason for the weak NO response observed in the absence of IL-12/IL-23. The high level of TGF-beta1 secretion by IL-12/IL-23-/- mDCs could explain why exogenous IFN-gamma partially restored the NO production of IFN-gamma-/- mDCs, while IL-12/IL-23-/- IFN-gamma-/- mDCs remained unresponsive. We also showed that CD4+ T-cell proliferation was inhibited by C57BL/6 mDCs, but not by IL-12/IL-23-/- mDCs. IFN-gamma and NO appear to mediate this antiproliferative effect because this effect was not observed in the presence of mDCs from IFN-gamma-/- or IL-12/IL-23-/- IFN-gamma-/- mice and it was attenuated by aminoguanidine. We conclude that the presence of IL-12/IL-23 during LPS-induced maturation influences the activation profile of DCs by a mechanism that is, only in part, IFN-gamma dependent.

Protein interactions in the budding yeast have been shown to form a scale-free network, a feature of other organized networks such as bacterial and archaeal metabolism and the World Wide Web. Here, we study the connections established by yeast proteins and discover a preferential attachment between essential proteins. The essential-essential connections are long ranged and form a subnetwork where the giant component includes 97% of these proteins. Unexpectedly, this subnetwork displays an exponential connectivity distribution, in sharp contrast to the scale-free topology of the complete network. Furthermore, the wide phylogenetic extent of these core proteins and interactions provides evidence that they represent the ancestral state of the yeast protein interaction network. Finally, we propose that this core exponential network may represent a generic scaffold around which organism-specific and taxon-specific proteins and interactions coalesce.

Proteins often function as components of multi-subunit complexes. Despite its long history as a model organism, no large-scale analysis of protein complexes in Escherichia coli has yet been reported. To this end, we have targeted DNA cassettes into the E. coli chromosome to create carboxy-terminal, affinity-tagged alleles of 1,000 open reading frames (approximately 23% of the genome). A total of 857 proteins, including 198 of the most highly conserved, soluble non-ribosomal proteins essential in at least one bacterial species, were tagged successfully, whereas 648 could be purified to homogeneity and their interacting protein partners identified by mass spectrometry. An interaction network of protein complexes involved in diverse biological processes was uncovered and validated by sequential rounds of tagging and purification. This network includes many new interactions as well as interactions predicted based solely on genomic inference or limited phenotypic data. This study provides insight into the function of previously uncharacterized bacterial proteins and the overall topology of a microbial interaction network, the core components of which are broadly conserved across Prokaryota.

The role of B7/CD28 costimulatory pathway in the polyclonal and specific lymphocyte activation induced by blood stages of Plasmodium chabaudi AS was investigated in CD28 gene knockout (CD28(-/-)) and C57BL/6 (CD28(+/+)) mice. Analysis of the spleen during the acute infection revealed a similar increase in T and B cell populations in both groups of mice. Moreover, CD28(-/-) mice were able to develop a polyclonal IgM response to P. chabaudi. On the contrary, the polyclonal IgG2a response was markedly reduced in the absence of CD28. Production of IFN-gamma; up-regulation of CD69, CD40L, CD95 (Fas), and CD95L (Fas ligand); and induction of apoptosis were also affected by the lack of CD28. Interestingly, the ability to control the first parasitemia peak was not compromised in acutely infected CD28(-/-) mice, but CD28(-/-) mice failed to eradicate the parasites that persisted in the blood for >3 mo after infection. In addition, drug-cured CD28(-/-) mice were unable to generate memory T cells, develop an anamnesic IgG response, or eliminate the parasites from a secondary challenge. The incapacity of CD28(-/-) mice to acquire a full protective immunity to P. chabaudi correlated with an impaired production of specific IgG2a. Moreover, reinfected CD28(-/-) mice were protected by the adoptive transfer of serum from reinfected CD28(+/+) mice containing specific IgG2a. Our results demonstrate that the polyclonal lymphocyte response is only partially affected by the absence of CD28, but this coreceptor is essential to generate specific T and B cell responses required for complete protection against P. chabaudi malaria.

Owing to the high costs involved, only 28 eukaryotic genomes have been fully sequenced to date. On the other hand, an increasing number of projects have been initiated to generate survey sequence data for a large number of other eukaryotic organisms. For the most part, these data are poorly organized and difficult to analyse. Here, we present PartiGeneDB (http://www.partigenedb.org), a publicly available database resource, which collates and processes these sequence datasets on a species-specific basis to form non-redundant sets of gene objects-which we term partial genomes. Users may query the database to identify particular genes of interest either on the basis of sequence similarity or via the use of simple text searches for specific patterns of BLAST annotation. Alternatively, users can examine entire partial genome datasets on the basis of relative expression of gene objects or by the use of an interactive Java-based tool (SimiTri), which displays sequence similarity relationships for a large number of sequence objects in a single graphic. PartiGeneDB facilitates regular incremental updates of new sequence datasets associated with both new and exisitng species. PartiGeneDB currently contains the assembled partial genomes derived from 1.83 million sequences associated with 247 different eukaryotes.

Malignant pleural mesothelioma is an aggressive malignancy which is almost always fatal; median survival is usually < 1 year. Most patients present with symptoms including pain, dyspnoea, pleural effusions and chest wall masses. Until recently, there has been no effective treatment which can improve symptoms and prolong survival. This article reviews recent developments in the treatment of mesothelioma, particularly advances in drug therapy and the use of the current most active drug combination: pemetrexed and cisplatin. Pemetrexed is a novel antifolate drug with multiple enzyme targets. The combination of pemetrexed and cisplatin demonstrated a survival advantage over cisplatin alone in patients with pleural mesothelioma, and can give symptomatic benefits. This combination has become the standard of care in mesothelioma treatment.

Two glutamic acid analogs, (+)-(S)- and (-)-(R)-4-(2,2-diphenyl-1,3,2-oxazaborolidin-5-oxo)propionic acid ((+)-(S)- and (-)-(R)-Trujillon, respectively), were prepared. The stereospecific activity of their pharmacological properties was studied. The median convulsant dose (CD(50)) and median lethal dose (LD(50)) were analyzed in female Swiss Webster mice and their effects in vivo on unitary electrical activity in globus pallidus neurons were elucidated in male Wistar rats. Compounds were characterized by (1)H, (13)C, and (11)B nuclear magnetic resonance. The LD(50) of (+)-(S)-Trujillon was 449.08 mg/kg and it increased spontaneous motor activity, while with (-)-(R)-Trujillon there was no mortality up to 1,000 mg/kg and it decreased spontaneous motor activity. The CD(50) in experiments with (+)-(S)-Trujillon was 199.34 mg/kg. Unitary recording in globus pallidus neurons showed i.v. administration (+)-(S)-Trujillon (50 mg/kg) increased frequency 79.0 +/- 23.0% in relation to basal response. (-)-(R)-Trujillon and (+)-(S)-glutamate (50 mg/kg each) did not provoke changes in spontaneous basal firing. Local infusion of (+)-(S)-Trujillon (1 nMol) increased spontaneous firing in most neurons tested by 269.0 +/- 83.0% in relation to basal values. Intrapallidal infusion of (-)-(R)-Trujillon (1 nMol) and saline solution did not cause statistically significant changes in globus pallidus spiking. Results showed that (+)-(S)-Trujillon crosses the blood-brain barrier and has stereospecific activity., ((c) 2004 Wiley-Liss, Inc.)

Protective immunity against lethal infection is developed when BALB/c or C57BL/6 mice are immunized with plasmids containing genes from the protozoan parasite Trypanosoma cruzi. However, genetic vaccination of the highly susceptible mouse strain A/Sn promoted limited survival after challenge. This observation questioned whether this type of vaccination would be appropriate for highly susceptible individuals. Here, we compared the protective efficacy and the immune response after individual or combined genetic vaccination of A/Sn mice with genes encoding trans-sialidase (TS) or the amastigote surface protein-2 (ASP-2). After challenge, a significant proportion of A/Sn mice immunized with either the asp-2 gene or simultaneously with asp-2 and ts genes, survived infection. In contrast, the vast majority of mice immunized with the ts gene or the vector alone died. Parasitological and histological studies performed in the surviving mice revealed that these mice harbored parasites; however, minimal inflammatory responses were seen in heart and striated muscle. We used this model to search for an in vitro correlation for protection. We found that protective immunity correlated with a higher secretion of interferon- by spleen cells on in vitro restimulation with ASP-2 and the presence of ASP-2-specific CD8 cells. Depletion of either CD4 or CD8 or both T-cell subpopulations prior to the challenge rendered the mice susceptible to infection demonstrating the critical contribution of both cell types in protective immunity. Our results reinforce the prophylactic potential of genetic vaccination with asp-2 and ts genes by describing protective immunity against lethal T. cruzi infection and chronic tissue pathology in a highly susceptible mouse strain.

Challenge of 1-yr Trypanosoma cruzi chronically infected mice with trypomastigotes results in a consistent reduction of parasite dissemination that correlates with spleen activation and increase in the anti-T. cruzi effector immune mechanisms. That is, parasite challenge results not only in elimination of the inoculum but also in a drastic decrease in basal subpatent parasitemia levels as revealed by transferring blood samples to immunosuppressed mice. Parasite elimination correlated with (1) a brief and intense burst in the ability of spleen cells to produce interferon-gamma, (2) an increase in total IgG2a-producing spleen cells, (3) higher parasite-specific IgG2a serum levels, and (4) an accumulation of non-B, non-T class II+ cells in the spleen. Furthermore, challenged, chronically infected mice had increased numbers of B, CD4+, and CD8+ large spleen cells. Besides reinforcing the activation of protective Th1 effector mechanisms, challenge with T. cruzi also induced Th2 effector molecules, such as interleukin (IL)-10 and IL-4, and IL-4-dependent IgG1. Our results are the first evidence that the immune system of T. cruzi chronically infected mice can be optimized in its ability to restrict parasite dissemination, opening the possibility that therapeutic vaccination could be used to reduce the parasite load and pathology of patients with chronic Chagas' disease.

The present review illustrates the current knowledge on the autocrine effect of IL-12, and the putative contribution of IL-23, on macrophages and dendritic cells, focusing on cell activation and microbicidal activity. Here, we present convincing evidence that IL-12 is not only a connective element between accessory cells and lymphocytes, but it is also a key molecule for programming the macrophage and dendritic cell functions.

Chagas' disease is a chronic infection caused by Trypanosoma cruzi and represents an important public health burden in Latin America. Frequently the disease evolves undetectable for decades, while in a significant fraction of the affected individuals it culminates in death by heart failure. Here, we describe a novel murine model of the chronic infection with T. cruzi using a stable clone isolated from a human patient (Sylvio X10/4). The infection in the C3H/HePAS mouse strain progresses chronically and is mainly characterized by intense cardiac inflammatory lesions that recapitulate the chronic cardiac pathology observed in the human disease. Moderate striated muscle lesions are also present in C3H/HePAS mice. Viable parasites are detected and recovered from the chronic heart lesions of C3H/HePAS mice, supporting the current notion that development of heart pathology in Chagas' disease is related to parasite persistence in the inflamed tissue. By contrast, in infected A/J mice, chronic inflammatory lesions are targeted to the liver and the skeletal muscle, while pathology and parasites are undetectable in the heart. The phenotypic analysis of F(1) (A/J x C3H/HePAS) and F(2) (A/J x C3H/HePAS) mice suggests that the genetic predisposition to develop the inflammatory lesions caused by T. cruzi (Sylvio X10/4 clone) is heterogeneous because the heart and liver pathology segregate in the F(2) generation. These findings raise the hypothesis that the pathology heterogeneity observed in humans with Chagas' disease (absence and presence of cardiac or digestive chronic lesions) may be attributable to host genetic factors.

The development of a flow-through solid-phase room temperature phosphorescence (RTP) method for the sensitive determination of orthophosphate in aqueous samples, based on the energy transfer from a phosphor molecule (acting as a donor) to an orthophosphate dye-indicator (acting as an acceptor) is described. The proposed method, to our knowledge the first RTP optosensor for orthophosphate developed so far, is based on the injection in a flow system of 1ml sample treated to form phosphomolybdenum blue from the orthophosphate. After injection, the phosphomolybdenum blue is on-line co-immobilised onto a polymeric resin containing adsorbed erythrosine B. This selected donor molecule exhibits strong RTP in a de-oxygenated aqueous media when retained on the surface of polymeric resin beads. Absorption spectra of the phosphomolybdenum blue possess a desirable spectral overlap with the emission spectra of the RTP donor and a non-radiative energy transfer occurs from the phosphor molecule to the acceptor dye. An increase in the concentration of orthophosphate of the solution causes an absorption increase of the acceptor (phosphomolybdenum blue) and, therefore, an increase in the energy transfer, which brings about a decrease of the RTP emission. After measurement, the active sensing phase can be regenerated by passing 2ml of 2M sodium hydroxide plus 2ml of methanol. After the injection of 1ml of 2x10(-6)M erythrosine B the system is prepared again for a new sample injection. Potential interferences by ions present in natural waters, which could affect the optosensor response, and analytical performance characteristics of the RTP method are discussed in detail. An orthophosphate detection limit of 0.5ngml(-1) (for 1ml sample injection volume) was achieved. Finally, the selected RTP flow-through optical sensor has been successfully tested for the determination of orthophosphate in different water samples at a very few ngml(-1) levels.

Background: To date there has been only one published report pertaining to the outcomes following open-heart surgery in Australian aboriginal patients., Methods: The records of 57 consecutive aboriginal patients who underwent open-heart surgery at our institution over a 6-year period were retrospectively reviewed. Attempts were made to contact the patient by telephone, by letter, through their listed next of kin, general practitioners, community nurse or through the aboriginal liaison officer., Results: There were 38 males and 19 females. Forty-five patients had coronary artery bypass grafting, 10 had isolated valve procedures while 2 had a combined operation. Mechanical prostheses were used for all valve replacements. There was a high incidence of diabetes, hypertension, hypercholesterolemia and smoking. There was one hospital death. Follow-up ranged from 6 months to 6 years with a mean of 3.09 years. Forty-four of the 56 (78.6%) hospital survivors were contactable while 21.4% were not contactable. There were two late deaths. Of the coronary patients who could be contacted, only 79% were taking Aspirin and a similar number Statin. 23% patients had recurrence of angina. There were five episodes of anticoagulation related complications in three patients. Only 44% of the patients were conversant with anticoagulation., Conclusions: The follow-up of the aboriginal patients was disappointing. The compliance with the medications was sub-optimal. There was a high incidence of recurrence of angina and anticoagulation related complications. The results raise concern about the use of mechanical prosthesis in these patients.

Complexes [Pd(3)(mu(3)-S)(mu(3)-X)(L)(3)] (L = orthometalated imine), obtained by an unusual reaction of mu(2)-OH dimeric complexes and CS(2), are an unprecedented type of asymmetrical bridges between metallatriangles, which force an all-cis arrangement of the three orthometalated ligands relative to the metallatriangle.