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This study explores the belief-attitude-performance chain, which is based on Davis's technology acceptance model (TAM). The aim of this study is to develop an extended TAM model which examines the influence of the nature of collaborative tasks (interdependence and task non-routineness) on the effective use of collaboration technologies in project based work contexts. The theoretical model was tested using Partial Least Squares (PLS) on a sample of 75 project team members who were making full use of collaborative technologies in their project work context. The empirical results not only confirmed TAM, but also demonstrate that the nature of the performed tasks positively influence perceived benefits and user attitudes towards the use of collaboration technologies in project teams. More importantly, users with a high intention to adopt a collaboration technology in their work context, showed increased performance in decision making or problem solving. Finally, this study also presents managerial implications and limitations as well as avenues for future research.

ABSTRACTCarbapenemase-producing Klebsiella pneumoniaestrains (CP-Kps) are currently among the most important nosocomial pathogens. An observational study was conducted during 2009 to 2010 in two hospitals located in a high-prevalence area (Athens, Greece). The aims were (i) to evaluate the clinical outcome of patients with CP-Kp bloodstream infections (BSIs), (ii) to identify predictors of mortality, and (iii) to evaluate the various antibiotic schemes employed. A total of 205 patients with CP-Kp BSIs were identified: 163 (79.5%) were infected with KPC or KPC and VIM, and 42 were infected with VIM producers. For definitive treatment, 103 patients received combination therapy (two or more active drugs), 72 received monotherapy (one active drug), and 12 received therapy with no active drug. The remaining 18 patients died within 48 h after the onset of bacteremia. The all-cause 28-day mortality was 40%. A significantly higher mortality rate was observed in patients treated with monotherapy than in those treated with combination therapy (44.4% versus 27.2%; P= 0.018). The lowest mortality rate (19.3%) was observed in patients treated with carbapenem-containing combinations. In the Cox proportion hazards model, ultimately fatal disease (hazards ratio [HR], 3.25; 95% confidence interval [CI], 1.51 to 7.03; P= 0.003), the presence of rapidly fatal underlying diseases (HR, 4.20; 95% CI, 2.19 to 8.08; P< 0.001), and septic shock (HR, 2.15; 95% CI, 1.16 to 3.96; P= 0.015) were independent predictors of death. Combination therapy was strongly associated with survival (HR of death for monotherapy versus combination, 2.08; 95% CI, 1.23 to 3.51; P= 0.006), mostly due to the effectiveness of the carbapenem-containing regimens.

Abiotic and biotic components of a serpentine Mediterranean soil were studied in terms of heavy metal and nutrient concentrations, microbial biomass, and structural and functional characteristics of the soil nematode community. We explored differentiations of the soil environment imposed by vegetation, sampling the bare soil and soil under Buxus sempervirens, Juniperus oxycedrus, Cistus creticus and Thymus sibthorpii. Organic matter, microbial biomass, nutrient availability and calcium/magnesium (Ca/Mg) ratio of the serpentine site were similar to those of degraded, non-serpentine Mediterranean ecosystems; the serpentine site showed potassium deficiency and high heavy metal load. Soil nematode abundance, especially of phytoparasites, was very low. Low enrichment and structure indices and high channel index values indicated a degraded, low-resource, stressful environment where fungal decomposition predominates. There was no differentiation of heavy metal concentrations among microsites. Bare soil exhibited high pH, low water content, low Ca/Mg (0.68), low nutrient concentrations, low abundance of most nematode groups, low values of maturity and plant parasitic indices, low nematode diversity and a distinct generic composition. Rhizosphere soil was differentiated according to the evergreen–sclerophyllous or seasonal–dimorphic habit of shrubs. This was reflected in soil nutrients and in all parameters of the soil nematode community.

AbstractBackground:Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiologic entity characterized by headache, visual disturbances, seizures, and the presence of edema on MRI scan, predominantly in the posterior white matter. Regarding end-stage renal disease (ESRD) and PRES, only a few cases of children on peritoneal dialysis (PD) and adults on hemodialysis have been described in the literature. Cases:We report 4 cases of adult patients on PD who presented with PRES, all of which were due to hypertension and inadequate management of fluid balance. The patients expressed typical PRES symptoms such as headache, visual disorders, and tonic/clonic seizures. The patients recovered completely and the MRI lesions disappeared after strict control of volume status. Conclusion:Nephrologists should be aware of the syndrome, especially when they manage hypertensive ESRD patients not compliant with the fluid and diet restrictions. MRI scan is the only diagnostic tool for defining the syndrome. Early diagnosis is important, since complete remission is achieved after appropriate treatment.Copyright © 2013 S. Karger AG, Basel

A novel series of 3-C-ethynyl and 3-C-(1,4-disubstituted-1,2,3-triazolo) double-headed pyranonucleosides has been designed and synthesized. Reaction of 3-keto glucoside 1 with ethynyl magnesium bromide gave the desired precursor 3-C-ethynyl-1,2:5,6-di-O-isopropylidene--D-allofuranose (2). Hydrolysis followed by acetylation led to the 1,2,4,6-tetra-O-acetyl-3-C-ethynyl--D-allopyranose (3). Compound 3 was condensed with silylated 5-fluorouracil, uracil, thymine, N4-benzoylcytosine and N6-benzoyladenine, respectively and deacetylated to afford the target 1-(3-C-ethynyl--D-allopyranosyl)nucleosides 5a-c,f,g. Copper-Catalyzed Azide-Alkyne Cycloaddition (CuAAC) reaction was utilized to couple the 3-C-ethynyl pyranonucleoside derivatives with azidoethyl adenine, 5-fluorouracil and thymine, respectively to afford novel triazole double-headed nucleoside analogs 8a-h. 3-C-Ethynyl pyranonucleosides and the new double-headed analogues were evaluated for their antiviral and cytostatic activities. Although none of the compounds showed pronounced cytostatic activity and were devoid of a significant antiviral potential, the double-headed nucleoside derivatives 8a, 8c and 8e showed a moderate cytostatic activity against human cervix carcinoma HeLa cells which may be the basis for the synthesis of analogous derivatives with improved cytostatic potential.

Renin-angiotensin II-aldosterone axis has long been known as a regulator of blood pressure and fluid homeostasis. Yet, local renin-angiotensin II systems have been discovered and novel actions of angiotensin II (AngII) have emerged among which its ability to act as a immunomodulator and profibrotic molecule. The enzyme responsible for its synthesis, Angiotensin-converting-enzyme (ACE), is present in high concentrations in lung tissue. In the present paper, we review data from studies of the past decade that implicate AngII and functional polymorphisms of the ACE gene that increase ACE activity with increased susceptibility for asthma and chronic obstructive pulmonary disease (COPD) and for pulmonary hypertension. Moreover, drugs that inhibit the synthesis of AngII (ACE inhibitors) or that antagonize its actions on its receptors (Angiotensin II receptor blockers -ARBs) have been shown to provide beneficial effects. Another recent discovery reviewed is the presence of a homologue of ACE, ACE2, which cleaves a single amino acid from AngII and forms a heptapeptide with vasodilatory actions, Ang 1-7. The balance between ACE and ACE2 is crucial for controlling AngII levels. ACE and ACE2 also appear to modify the severity of Acute Respiratory Distress Syndrome (ARDS), with ACE2 playing a protective role. Finally, mention is made to the recent discovery of ACE2 as a receptor for the SARS Corona Virus.

ABSTRACTWe evaluated the pharmacokinetic profile of ciprofloxacin and its penetration into bronchial secretions of critically ill patients with chronic obstructive pulmonary disease (COPD). Twenty-five mechanically ventilated patients with severe COPD who were suffering from an acute, infectious exacerbation were included in this prospective, open-label study. All subjects received a 1-hour intravenous infusion of 400 mg ciprofloxacin every 8 h. Serial blood and bronchial secretion samples were obtained at steady state, and concentrations were determined using high-performance liquid chromatography. The pharmacodynamic parameters that are associated with the efficacy of fluoroquinolones against Gram-negative pathogens were also calculated. The mean peak (maximum) concentration (Cmax) and trough (minimum) concentration in plasma were 5.37 ± 1.57 and 1 ± 0.53 mg/liter, respectively. Mean values for volume of distribution, clearance, half-life, and area under the curve from 0 to 24 h (AUC0–24) were 169.87 ± 84.11 liters, 26.96 ± 8.86 liters/h, 5.35 ± 2.21 h, and 47.41 ± 17.02 mg · h/liter, respectively. In bronchial secretions, a mean Cmaxof 3.08 ± 1.21 mg/liter was achieved in 3.12 ± 1.01 h, and the penetration ratio was 1.16 ± 0.59. The target of AUC0–24/MIC of ≥125 was attained in all patients, in the majority of them (76%), and in none at MICs of 0.125, 0.25, and 1 μg/ml, respectively. Slightly better results were obtained for the ratio Cmax/MIC of ≥10. In conclusion, ciprofloxacin demonstrates excellent penetration into bronchial secretions. There is wide interindividual variability in its pharmacokinetic parameters in critically ill COPD patients and inadequate pharmacodynamic exposure against bacteria with MICs of ≥0.5 μg/ml.

This article analyses and tests a novel framework for the evaluation of an ERP project. The framework incorporates specific performance measures, which are linked to a previously developed model, (the ‘six-imperatives’ framework) and are relevant to ERP implementation Two case studies illustrate the use of the framework in two Greek companies aiming to measure, in practical terms, the impact of the ERP project on their operations. The main results indicate that the “six-imperatives” provide a comprehensive methodology based on the profound exploration and understanding of specific business processes and objectives that should be met in order to assess an ERP project.

Corporate Governance (CG) and Enterprise Systems (ESs) have attracted a great deal of attention from academics and practitioners. Financial scandals (Enron, WorldCom, etc.) and information system breakdowns are common nowadays. This paper argues that these failures are closely correlated. It shows the correlation and makes some suggestions about how the information systems should be designed and implemented and how corporate governance can benefit from the new design approach. Regulation, voluntary codes and good practices as a motive for adopting new systems (organisational and informational) play a crucial role in selecting the course of action and strategy. The synergies between CG and ESs can lead to a more stable corporate environment and improved organisational performance.

To assess in patients with late-onset idiopathic restless legs syndrome (RLS) the brain iron content with magnetic resonance relaxometry, and brain activation during dorsiflexion and plantar flexion of both feet, using fMRI.

The adoption of ERP systems by Small and Medium-sized Enterprises (SMEs) is a major endeavour and a complex project with many potential difficulties concerning budget overruns and benefits reached. SMEs must apply contemporary performance measurement methodologies to ensure efficiency and effectiveness in their overall Information Technology (IT) and business strategy, which in most cases can lead to superior competitive positioning. This paper develops a novel framework for measuring the impact of ERP implementations at SMEs; it is based on the concept that success is achieved only when the organisation is capable of better performing every operation embedded within the ERP system, and when the integrated information platform can contribute to overall performance enhancements. We focus on key performance measures, which are linked to a previously developed model (the 'six-imperatives' framework) and are relevant to the ERP implementation.

Enterprise Resource Planning (ERP) adoption involves initiating the appropriate business process changes and information technology upgrades to enhance enterprise performance, quality, costs, flexibility and responsiveness. While the number of articles in ERP implementation is substantial, limited attention has been given to the ERP adoption by Small- and Medium-sized Enterprises (SMEs). Motivated by the organisation fit of the ERP concept, we propose a structured methodology for ERP system evaluation and selection which can be easily used by SMEs, as it provides the necessary information for their decision-making process. This article describes the ERP evaluation and selection methodology followed by an industrial Greek company. The proposed methodology consists of a framework built upon six imperatives, which generate a number of ERP objectives materialised through a set of levers. The analysis results in the identification of tailor-made ERP objectives, which, in turn, are used in a multiple criteria model as part of the decision-making process to select, from a list of alternatives, a suitable ERP vendor.

Background. Very few data are available on longitudinal renal growth in small for gestational age (SGA) infants born at term. The aim of this prospective study was to estimate comparatively the renal growth in SGA infants and in infants born appropriate for gestational age (AGA) during the first 2 years of life.Methods. The study comprised groups of SGA and AGA infants with a gestational age (GA) of 36–41 weeks. The SGA group was classified into two subgroups of symmetrical and asymmetrical neonates according to the ponderal index. Serial renal ultrasonography (US) was performed at the ages of 41 weeks corrected age [GA (in weeks) plus age after birth (in weeks)] and at 3, 6, 12 and 24 months of chronological age and kidney length (KL) was related to other anthropometric indices.Results. A total of 312 infants participated in the study out of which 197 were SGA, and a total number of 802 measurements were performed. The symmetrical SGA infants and, to a lesser degree, the asymmetrical SGA infants had smaller kidneys at birth compared with the AGA infants (P < 0.0001 and P < 0.001, respectively). The symmetrical SGA infants had a lower body weight (BW) (P < 0.001, P < 0.01) and crown-heel length (CHL) (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. The asymmetrical SGA infants had a lower BW (P < 0.01, P < 0.05) than controls at the ages of 12 and 24 months of chronological age. On the contrary, the KL in both SGA groups was not different from that of the AGA infants after the 41st week of corrected age and up to the 2nd year of life.Conclusion. SGA term infants had shorter KL at birth compared with AGA infants but a similar length from the 3rd to the 24th month of life. Early catch-up kidney growth was observed in both SGA groups and is more prominent in the symmetrical SGA infants. This observation may represent either an accelerated renal maturation process or early compensatory kidney hypertrophy in this group of infants.

The synthesis, characterization, and surface properties of soap‐type amphiphiles comprising alkyl chains of 10–16 carbon atoms linked through an ether group to a glycerol–amino acid hydrophilic head group is described. The surface properties of members of this series derived from histidine and tyrosine were compared with those of phenylalanine and tryptophan derivatives described previously and with those of conventional soaps. In all cases, the amino acid derivatives showed superior surface properties, and an interesting differentiation was discovered regarding the orientation of tryptophan derivatives.

Achilles tendon xanthomas are associated with increased cardiovascular risk in patients with familial hypercholesterolemia (FH). Oxidized low density lipoprotein (OxLDL), the antibodies against OxLDL, and the LDL-associated phospholipase A2 (Lp-PLA2) may play important roles in atherogenesis. We investigated the possible association between plasma levels of OxLDL, Lp-PLA2 activity, and autoantibody titers against various types of mildly OxLDL with Achilles tendon thickness (ATT). ATT was determined by sonography in 80 unrelated heterozygous FH patients. Three different types of mildly OxLDL were prepared: OxLDLL, OxLDLP, and OxLDLD, at the end of the lag, propagation, and decomposition phases of oxidation, respectively. Similar types of OxLDL were also prepared after inactivation of the LDL-associated Lp-PLA2. These types were denoted OxLDL(–)L, OxLDL(–)P, and OxLDL(–)D. FH patients exhibited significantly higher plasma OxLDL levels and serum IgG titers against OxLDLP and OxLDLD compared with 40 normolipidemic apparently healthy controls. ATT values were positively correlated with autoantibody titers against OxLDLP and OxLDLD; however, in multiple regression analysis, ATT was independently associated only with the autoantibody titers against OxLDLD. We conclude that the IgG autoantibody titers against OxLDLD but not OxLDL or Lp-PLA2 may play an important role in the pathogenesis of Achilles tendon xanthomas in FH patients.

OBJECTIVE: To investigate the clinical response and to evaluate by magnetic resonance imaging (MRI) the inflammatory tissue changes in patients with refractory rheumatoid arthritis (RA) treated with adalimumab. METHODS: Thirteen patients with refractory RA who were treated with adalimumab (40 mg every 2 weeks subcutaneously) were examined with MRI of the dominant affected wrist and hand before treatment and one year after therapy. The volume of the enhanced inflammatory tissue (VEIT) was evaluated in fat-suppressed contrast-enhanced T1-weighted MRI images using the Analyse 4.0 software. Disease activity was evaluated using the Disease Activity Score 28-joint (DAS-28). Clinical improvement was evaluated according to the American College of Rheumatology 20% response criteria (ACR20%). RESULTS: We studied 12 women and one man, with mean age 52.0 ± 10.9 years and mean disease duration 13.0 ± 8.5 years. Eight patients had positive IgM rheumatoid factor. One year after treatment, 11 (84.6%) patients showed a decrease of the VEIT. Moreover the values of C-reactive protein (CRP; 4.3 ± 6.6 mg/l), the erythrocyte sedimentation rate (ESR; 26.3 ± 19.5 mm/h), the DAS-28 (3.5 ± 1.1), and the VEIT (21.6 ± 10.7 cm3) after treatment were significantly lower compared to the corresponding values before treatment (CRP 41.6 ± 39.2), (ESR 54.3 ± 28.6) (DAS-28 5.8 ± 0.8), and (VEIT 36.9 ± 16.8) (p < 0.01). All but 3 (76.9%) patients with RA achieved the ACR20% response, while 7 (53.8%) and 5 (38.5%) patients achieved ACR50% and ACR70% response, respectively. A positive correlation between VEIT, swollen joint count, and ESR was found before treatment (r = 0.59, r = 0.64, respectively; p < 0.05). CONCLUSION: In patients with refractory RA, treatment with adalimumab resulted in improvement of clinical, laboratory, and MRI findings. MRI assessment of the VEIT may represent an additional tool for investigation of joint disease activity and responsiveness to treatment.

OBJECTIVE: To investigate the frequency and the severity of radiological cervical spine involvement in patients with rheumatoid arthritis (RA). METHODS: We investigated 165 consecutive unselected patients with RA who fulfilled the revised American College of Rheumatology criteria for RA. All patients had a complete physical and laboratory evaluation. Patients had a radiological evaluation that included hand and wrist radiographs, as well as cervical spine radiographs in anteroposterior, lateral, and lateral in full flexion views. Hand radiographs were evaluated according to the Larsen criteria, while cervical radiographs were evaluated according to Winfield classification. RESULTS: There were 143 women and 22 men, with a mean age of 59.6 ± 12.5 and disease duration 12.3 ± 13.9 years. Positive rheumatoid factor was found in 63.6% of patients. One hundred forty-six patients presented radiological findings related to cervical spine involvement: atlantoaxial subluxations were found in 20.6% and erosions of the odontoid process in 2.4%; none presented vertical subluxation. Subaxial subluxations were found in 43.6%, disc space narrowing at C2–C3, C3–C4, C4–C5 levels in 66.1%, and vertebral plate sclerosis and erosions in 43.6%. CONCLUSION: Cervical spine radiological involvement is a frequent finding in our patients with RA, but the severity of the disease is rather mild, possibly related to the ethnic background.

OBJECTIVE: To identify the genetic defect in a neonate presented with prolonged jaundice and central hypothyroidism. DESIGN: Central hypothyroidism was detected in a neonate initially examined for prolonged jaundice, and levothyroxine therapy was initiated. Direct sequencing of the Prop1 gene was carried out and pituitary function and morphology were evaluated using hormonal testing and magnetic resonance imaging (MRI) respectively. METHODS: Dynamic hormonal testing was carried out using established methodologies. Hormones were determined by RIA or chemiluminescence immunoassays. Genomic analysis of the Prop1 gene was performed by direct sequencing. MRI protocol: sagittal spin echo T2-weighted scans 2500/90 (TR/TE), plain and contrast-enhanced sagittal and coronal spin echo T1-weighted scans 500/20 (TR/TE). RESULTS: Low thyroid hormones (coupled with lack of TSH rise), low GH, normal cortisol and normal prolactin values were detected. Direct sequencing revealed the presence of two mutations in the Prop1 gene: GA296del and Q83X. The Q83X was further confirmed by PvuII restriction digestion and represented a novel Prop1 gene mutation, which was not detected in 100 controls tested. Pituitary enlargement was detected, with respect to normal-for-age controls. CONCLUSIONS: (i) The Q83X mutation extends the spectrum of Prop1 gene mutations; (ii) central hypothyroidism in a neonate might constitute the initial sign of Prop1 gene defect; (iii) the patient is the youngest individual with Prop1 gene defect and pituitary enlargement presented to date; and (iv) early detection of Prop1 gene mutations facilitates genetic counseling and ensures prompt management of the anticipated hormonal insufficiencies.

To investigate possible effects of sildenafil on the cardiopulmonary responses during sexual intercourse we evaluated cardiopulmonary responses during exercise in a group of impotent patients.

The purpose of this study was to evaluate the role of MRI in the assessment of hip joint involvement in clinical subtypes of juvenile idiopathic arthritis (JIA). 28 patients (mean age 12.5 years) with JIA (oligoarthritis 8, polyarthritis 13, systemic arthritis 7) were examined with T2weighted turbo spin echo and T1weighted spin echo (plain and contrast enhanced) sequences. The severity of joint involvement was evaluated using an MR grading score: grade 1=no contrast enhancement; grade 2=focal synovial contrast enhancement; grade 3=diffuse synovial contrast enhancement; grade 4=grade 3+diffuse synovial thickening; grade 5=grade 4+villonodular synovial thickening; and grade 6=grade 5+cartilage and subchondral bone erosions. MRI was abnormal in 57.1% of cases (25% of oligoarthritis, 53.8% of polyarthritis and 100% of systemic arthritis). Clinical examination was positive in 32.1% of cases and was associated with higher MR grades (mean 4.6, SD 1.34) compared with a negative clinical examination, which was associated with lower MR grades (mean 1.78, SD 1.13) (p<0.001). Patients with active disease (mean grade 3.9, SD 2) had higher MR grades than those with inactive disease (mean grade 2.1, SD 1.4) (p<0.01). The MR grades were different in the three clinical subtypes: oligoarticular (mean 1.5, SD 1.06); polyarticular (mean 2.38, SD 1.55); and systemic (mean 4.85, SD 1.21) (F:12.3, p<0.001), with a significant difference between systemic arthritis and oligoarthritis, and between systemic arthritis and polyarthritis (p<0.001). MRI of the hip might be considered for inclusion in the study protocol of patients with JIA since it reveals joint involvement at early stages and provides a detailed evaluation of the extent of joint disease.

In thalassaemic patients, neurophysiological disturbances have been associated with high serum ferritin levels and desferrioxamine therapy. In the presence of a magnetic field, ferritin, the main iron storage protein, induces a preferential decrease of the T(2) relaxation time. The purpose of this study was to evaluate thalassaemic patients for brain iron deposition by assessing the T(2) relaxation rate (1/T(2)) of the grey matter. 41 thalassaemic patients (age range 8.5-44 years, mean 24 years) and 58 age- and sex-matched controls were included in the study. Current serum ferritin levels were obtained. The 1/T(2) values of the cortex (motor and temporal) (mean 0.0122 ms(-1), SD 0.0004), putamen (mean 0.0137 ms(-1), SD 0.0004) and caudate nucleus (mean 0.0132 ms(-1), SD 0.0003) were higher in patients compared with the controls (mean 0.0110 ms(-1), SD 0.0004; mean 0.0120 ms(-1), SD 0.0005; mean 0.0117 ms(-1), SD 0.0003, respectively) (p<0.001 for all parameters). No statistically significant differences were found in the globus pallidus. No correlation was found between 1/T(2) and serum ferritin. The higher values of 1/T(2) in the cortex, putamen and caudate nucleus of thalassaemic patients probably reflect a higher iron deposition. The lack of differences in 1/T(2) of the globus pallidus might suggest that even in thalassaemic patients iron cannot exceed a saturation level.

In thalassaemic patients, neurophysiological disturbances have been associated with high serum ferritin levels and desferrioxamine therapy. In the presence of a magnetic field, ferritin, the main iron storage protein, induces a preferential decrease of the T2relaxation time. The purpose of this study was to evaluate thalassaemic patients for brain iron deposition by assessing the T2relaxation rate (1/T2) of the grey matter. 41 thalassaemic patients (age range 8.5–44 years, mean 24 years) and 58 age- and sex-matched controls were included in the study. Current serum ferritin levels were obtained. The 1/T2values of the cortex (motor and temporal) (mean 0.0122 ms-1, SD 0.0004), putamen (mean 0.0137 ms-1, SD 0.0004) and caudate nucleus (mean 0.0132 ms-1, SD 0.0003) were higher in patients compared with the controls (mean 0.0110 ms-1, SD 0.0004; mean 0.0120 ms-1, SD 0.0005; mean 0.0117 ms-1, SD 0.0003, respectively) (p<0.001 for all parameters). No statistically significant differences were found in the globus pallidus. No correlation was found between 1/T2and serum ferritin. The higher values of 1/T2in the cortex, putamen and caudate nucleus of thalassaemic patients probably reflect a higher iron deposition. The lack of differences in 1/T2of the globus pallidus might suggest that even in thalassaemic patients iron cannot exceed a saturation level.

Stable nitrile oxides are added stereospecifically and regioselectively to the carboncarbon double bond of 2‐phenyl‐4‐arylidene‐5(4H)‐oxazolones resulting spiro‐derivatives 3, 5. The spectral properties of the reaction products are discussed. The cycloadducts give several substituted isoxazolines viaan opening of the oxazolone ring with nucleophilic reagents.

In normal conscious humans, when a brief hypoxic ventilatory stimulus is followed immediately by breathing 100% O2, ventilation during hyperoxia gradually declines to baseline prehypoxic levels without an undershoot. During the decline, ventilation is greater than baseline in the absence of hypoxia and hypercapnia. This has been interpreted as evidence of decay of short-term potentiation (STP) or afterdischarge. It is not known whether the intensity of the stimulus that activates STP influences the time course of its decay. Therefore we studied STP decay in nine normal adults after administration of placebo (P) and almitrine (A) in a single-blind manner on 2 separate days. On each day, three runs consisting of 45 s of isocapnic hypoxia (end-tidal PO2=55 mm Hg) followed by 2 min of hyperoxia were conducted while ventilation (V¨I) was measured breath by breath. Baseline VT did not differ between A and P, but at the end of hypoxia, V¨Iwith A was 169±14% (SE) of baseline while V¨Iwith P was 132±7% of baseline (p<0.05). Immediately after hyperoxia was instituted, V¨Ifell abruptly, the fall being 36% of baseline for A and 15% for P. This probably represented the withdrawal of peripheral chemoreceptor input. Thereafter, V¨Ideclined slowly toward baseline, and the time course of this decline did not differ between P and A. Our results indicate that within the limits we studied, the increase of the intensity of the discharge of the peripheral chemoreceptors during hypoxia does not influence STP decay.

To evaluate and compare in vivo the protective efficacy of unilamellar liposomal amphotericin B (L-AmB) with that of deoxycholate amphotericin B (D-AmB) in experimental endocarditis.

Cortical brain lesions were identified on MRI and CT in 14 patients with a variety of diseases. Each of these patients developed neurologic symptoms, the most prominent of which were seizures, depressed mental status, and blurred vision or cortical blindness. Both the imaging and the neurologic abnormalities resolved spontaneously within a period ranging from 5 to 30 days. Due to location and evolution of the lesions over time we hypothesize that they are secondary to small cortical venous thromboses.

The anodic oxidation of 6-hydroxydopamine and 5-hydroxydopamine and their chloride and bromide salts was studied in aqueous acidic solutions. The electrodes used were Pt and Pt/M (UPD) (M = Bi, Tl, Pb) modified surfaces. The electrochemical studies revealed that the first two-electron oxidation leads to formation of reactive quinoid intermediates. Reactions of these quinoid intermediates with nucleophiles yield substituted quinones that are not stable in solution. The reactions are initiated by the oxidation of the third hydroxyl group at more positive potentials. Cyclic voltammetry and rotating ring-disc electrode voltammetry were used to elucidate the reaction mechanisms. These techniques provide powerful tools to generate and detect transient intermediates and products and give valuable information regarding the pathways and mechanisms of the redox reactions. Keywords: 6-hydroxydopamine, 5-hydroxydopamine, voltammetry, electrolysis, oxidation mechanism, nucleophilic attack.

The surgical intervention and adjuvant locally applied measures to reduce the impact of a severe cutaneous hand infection caused by Mycobacterium marinumin a 48-year-old diver, receiving anti-TNFa (anti-tumor necrosis factor αlpha) treatment are presented herein.

Background: Transfusion of blood products has been associated with the long term engraftment of donor cell-derived genetic material in the recipient (microchimerism: MC), whose clinical implications have not been sufficiently studied. The manifestation of post-transfusion MC has mainly been studied among severe trauma injured patients, heavily transfused at short term periods of time.

Intracranial hydatidosis is more common in children than in adults. The most severe complication is anaphylactic response after direct rupture into the subarachnoid spaces. We report a case of brain hydatid cyst that was accidentally drained into the peritoneal cavity and was not complicated by an anaphylactic response or dissemination.

Miller-Fisher syndrome (MFS) is considered as a variant of the Guillain-Barre syndrome (GBS) and its characteristic clinical features are ophthalmoplegia, ataxia, and areflexia. Typically, it is associated with anti-GQ1b antibodies; however, a significant percentage (>10%) of these patients are seronegative. Here, we report a 67-year-old female patient who presented with the typical clinical features of MFS. Workup revealed antibodies against glutamic acid decarboxylase (GAD) in relatively high titers while GQ1b antibodies were negative. Neurological improvement was observed after intravenous gamma globulin and follow-up examinations showed a continuous clinical amelioration with simultaneous decline of anti-GAD levels which finally returned to normal values. This case indicates that anti-GAD antibodies may be associated with a broader clinical spectrum and future studies in GQ1b-seronegative patients could determine ultimately their clinical and pathogenetic significance in this syndrome.