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Es wird uber den Fall einer Kardiomyopathie bei einem 22-jahrigen Patienten mit langjahrigem Methamphetaminkonsum berichtet. Echokardiographisch zeigte sich eine dilatative Kardiomyopathie mit hochgradig eingeschrankter Pumpfunktion und hochgradiger Mitralklappeninsuffizienz. Durch Inotropika und Implantation zweier MitraClips® (Abbott Vascular, Santa Clara, CA, USA) konnte eine hamodynamische Stabilisierung erreicht werden. Die zunehmende Verbreitung des Methamphetaminkonsums sollte Anlass geben, in Fallen mit unklarer Kardiomyopathie bei jungen Patienten eine gezielte Anamnese und gegebenenfalls Urinanalyse durchzufuhren.

Microbial denitrification occurs in anaerobic soil microsites and aquatic environments leading to production of N 2 O and N 2 gases, which eventually escape to the atmosphere. Atmospheric concentrations of N 2 O have been on the rise since the beginning of the industrial revolution due to large-scale manipulations of the N cycle in managed ecosystems, especially the use of synthetic nitrogenous fertilizer. Here we document and test a microbial denitrification model identified as IMWJ and implemented as a submodel in the EPIC terrestrial ecosystem model. The IMWJ model is resolved on an hourly time step using the concept that C oxidation releases electrons that drive a demand for electron acceptors such as O 2 and oxides of N (NO 3 − , NO 2 − , and N 2 O). A spherical diffusion approach is used to describe O 2 transport to microbial surfaces while a cylindrical diffusion method is employed to depict O 2 transport to root surfaces. Oxygen uptake by microbes and roots is described with Michaelis-Menten kinetic equations. If insufficient O 2 is present to accept all electrons generated, the deficit for electron acceptors may be met by oxides of nitrogen, if available. The movement of O 2 , CO 2 and N 2 O through the soil profile is modeled using the gas transport equation solved on hourly or sub-hourly time steps. Bubbling equations also move N 2 O and N 2 through the liquid phase to the soil surface under highly anaerobic conditions. We used results from a 2-yr field experiment conducted in 2007 and 2008 at a field site in southwest Michigan to test the ability of EPIC, with the IMWJ option, to capture the non-linear response of N 2 O fluxes as a function of increasing rates of N application to maize [ Zea mays L.]. Nitrous oxide flux, soil inorganic N, and ancillary data from 2007 were used for EPIC calibration while 2008 data were used for independent model validation. Overall, EPIC reproduced well the timing and magnitude of N 2 O fluxes and NO 3 − mass in surficial soil layers after N fertilization. Although similar in magnitude, daily and cumulative simulated N 2 O fluxes followed a linear trend instead of the observed exponential trend. Further model testing of EPIC + IMWJ, alone or in ensembles with other models, using data from comprehensive experiments will be essential to discover areas of model improvement and increase the accuracy of N 2 O predictions under a wide range of environmental conditions.

Resume Les droits des personnes âgees residant en etablissement medicosocial (EMS) dependent en Suisse de dispositions legales relatives notamment au droit de la protection de l’adulte et aux droits des patients, ainsi que de conventions internationales sur les droits humains. Leur mise en œuvre est fortement liee a la maniere dont ils sont percus et compris par les differents acteurs concernes, a savoir : les residents, leurs proches, ainsi que les differents professionnels. Cet article vise a analyser les transformations historiques de ces droits – tant sur le plan formel que dans l’acception subjective qu’en ont les divers individus engages dans une interaction de soin –, et a s’interroger sur les facons dont ces prescriptions sont percues, comprises et mises en pratique par les acteurs sociaux. La prise en compte de la perspective des acteurs concernes revet un interet particulier du point de vue ethique. Il s’agit de mettre en lumiere les regards croises de chacun, en fonction des interets en jeu, et de se donner les moyens de rendre visibles les eventuels points de tension qui peuvent survenir entre les droits et devoirs des uns et des autres. La combinaison d’une methodologie historique et d’une methode de recherche qualitative par focus groups a permis de documenter et de contextualiser les changements principaux au niveau des textes de loi ou des chartres ethiques, tout en mettant en evidence la facon dont les residents, leurs proches ainsi que les professionnels d’EMS s’approprient de tels changements.

The assessment of osteoporosis regarding bone mass and microarchitecture “quality” contributes in determining fracture risk. Therefore, the crystalline structure of hydroxyapatite may indicate the quality of trabecular bones through the identification of crystallite sizes, microhardness and microdeformation values and calcium and phosphorous proportions in the three types of bones: normal, osteopenic, and osteoporotic. Nine L1 vertebrae-dried trabecular bones from human cadavers were used. The characterization of the three types of bones was made through scanning electron microscopy, EDS, microhardness, and X-ray diffractometry with the Rietveld refinement method. The results show that the microstructural characterization possibilities the identification of the three types of bones: normal, osteopenic, and osteoporotic, allowing the detection of osteoporosis based on bone quality.

This article presents the case of a 22-year-old male patient with cardiomyopathy associated with a long history of methamphetamine abuse. Echocardiography revealed a dilated cardiomyopathy with highly reduced systolic pump function and severe mitral valve regurgitation. Inotropic treatment and MitraClip® (Abbott Vascular, Santa Clara, CA, USA) implantation resulted in enhancement of hemodynamics. The rising prevalence of methamphetamine abuse should give reason to raise awareness for the diagnostic work-up and patient history particularly in cases of unexplained cardiomyopathy in young patients.

The Senior Living Lab has run a number of participatory workshops with seniors with a view to brainstorming and developing products and services to improve the quality of life of ageing populations in Switzerland. This project aims to combine and adapt design thinking and living lab methodologies to be suitable with elderly participants. It gathers various qualitative techniques and deploys an interdisciplinary methodology based on community-based participatory research. This living lab project highlights the key success factors and the challenges in order to successfully involve seniors during complex innovation processes, such as time essential to tackle logistic issues and the ability to adapt participatory initiatives to an elderly public.

The term crystal structure is understood as a set of atoms periodically distributed in space, forming a lattice. The composite material, bone, contains an organic part consisted of collagen and an inorganic part consisted predominantly of hydroxyapatite crystals, having the molecular formula Ca10(PO4)6(OH)2 in its unit cell. The crystal structure of hydroxyapatite can indicate the trabecular bone quality, by the identification of crystallite size, microhardness, microstrain and ratio of calcium and phosphorus in bones of three types: normal, osteopenic or osteoporotic. Osteoporosis is defined by the National Institute of Health as a skeletal disorder characterized by compromised bone strength and increased risk of fracture. Dried trabecular bones of vertebrae L1 columns of nine human cadavers from the São Paulo City Morgue were used. Before sample collection, they were pre-divided into three groups: normal, osteopenic or osteoporotic, through quantitative ultrasound of the calcaneus. The characterization of the three types of bones was made by electron microscopy scanning, microanalysis by energy dispersive spectrometry, microhardness and powder X-ray diffraction with application of the Rietveld method. The results showed a decrease of the crystallite size, hardness, ratio of calcium and phosphorus, trabecular number and bone density and an increase in microstrain values suggesting greater fragility and disruption in the crystalline structure of hydroxyapatite in osteopenic and osteoporotic bone. Microstructural characterization of hydroxyapatite crystals in dry trabecular bone could differentiate the three types of bones (normal, osteopenic and osteoporotic) and supplement assessment of osteoporosis, with an emphasis on bone quality.

The downregulation of β-adrenergic receptors (β-AR) and decreased cAMP-dependent protein kinase activity in failing hearts results in decreased phosphorylation and inactivation of phosphatase-inhibitor-1 (I-1), a distal amplifier element of β-adrenergic signaling, leading to increased protein phosphatase 1 activity and dephosphorylation of key phosphoproteins, including phospholamban. Downregulated and hypophosphorylated I-1 likely contributes to β-AR desensitization; therefore its modulation is a promising approach in heart failure treatment. Aim of our study was to assess the effects of adeno-associated virus serotype 9 (AAV9) - mediated cardiac-specific expression of constitutively active inhibitor-1 (I-1c) and to investigate whether I-1c is able to attenuate the development of heart failure in mice subjected to transverse aortic constriction (TAC). 6-8 week old C57BL/6 N wild-type mice were subjected to banding of the transverse aorta (TAC). Two days later 2.8 × 1012 AAV-9 vector particles harbouring I-1c cDNA under transcriptional control of a human troponin T-promoter (AAV9/I-1c) were intravenously injected into the tail vein of these mice (n=12). AAV9 containing a Renilla luciferase reporter (AAV9/hRluc) was used as a control vector (n=12). Echocardiographic analyses were performed weekly to evaluate cardiac morphology and function. 4 weeks after TAC pressure- volume measurements were performed and animals were sacrificed for histological and molecular analyses. Both groups exhibited progressive contractile dysfunction and myocardial remodeling. Surprisingly, echocardiographic assessment and histological analyses showed significantly increased left ventricular hypertrophy in AAV9/I-1c treated mice compared to AAV9/hRluc treated controls as well as reduced contractility. Pressure-volume loops revealed significantly impaired contractility after AAV9/I-1c treatment. At the molecular level, hearts of AAV9/I-1c treated TAC mice showed a hyperphosphorylation of the SR Ca2+-ATPase inhibitor phospholamban. In contrast, expression of AAV9/I-1c in unchallenged animals resulted in selective enhancement of phospholamban phosphorylation and augmented cardiac contractility. Our data suggest that AAV9-mediated cardiac-specific overexpression of I-1c, previously associated with enhanced calcium cycling, improves cardiac contractile function in unchallenged animals but failed to protect against cardiac remodeling induced by hemodynamic stress questioning the use of I-1c as a potential strategy to treat heart failure in conditions with increased afterload.

Resume La maltraitance des personnes âgees reste unsujet tabou, malgre l′interet manifeste pourcette problematique par les scientifiques et les politiques desante publique depuis le debut des annees 80.Definie comme atteinte a l′integrite de la personne, elle prend des formes multiples, allant des coups, des humiliationset des exactions financieres aux expressions plus subtiles de la negligence. Elle s′exprime souvent dans le cadre d′unesituation d′abus de pouvoir, marquee d′enjeux relationnelscomplexes. Afin de saisir la complexite de ce processus etd′elaborer des pistes pour la prevention, l′UNIGER arealise une recherche-action dans quelques etablissement smedico-sociaux accueillant des personnes âgees. Constituee d′une intervention systemique aupres d′equipes de professionnels confrontees a dessituations d′impasse et d′une analyse des processus de changement,cette recherche-action a mis en evidence les difficultes rencontrees et les ressources mobilisees par ces professionnels pour imaginer et mettre en œuvre des solutions positives, avec le soutiendes intervenantes. Seuls quelques elements du rapport de recherche-action sont repris dans le present article, a savoir les etapes et les resultats de l′intervention. Quanta l′esprit de la demarche, il releve d′une ethique de l′accompagnement : nous avons voulu susciter, dansle respect et la reconnaissance reciproque, un espace qui ouvre le champ des possibles, donc favorise le processus d′autonomisation a lafois des professionnels et des residents dont ils s′occupent.Reconnaitre l′autre dans ses potentiels et ses limites, respecteret faciliter sa liberte de choix apparaissent en effet comme les ingredients essentiels d′un accompagnement bientraitant.

We have developed a cDNA-dependent scintillation proximity assay (SPA) for rabbit apolipoprotein A-I that follows a classic radioimmunoassay scheme, in that antiserum and radiolabeled ligand are used in a process to quantify a source containing unlabeled ligand. To synthesize radiolabeled ligand we isolated a full-length rabbit apolipoprotein A-I (apoA-I) cDNA, transcribed the corresponding RNA in vitro, and synthesized radiolabeled apoA-I by including tritiated leucine in an in vitro translation reaction. Assay conditions were established which allowed quantification of unlabeled apoA-I over a range of 0.2 to 4 nanograms with intra- and interassay coefficients of variation of 5% and 10%, respectively. Purified rabbit apoA-I, apoA-I in rabbit liver parenchymal cell conditioned media, and apoA-I contained in rabbit plasma all generated parallel titration curves. Quantification of rabbit plasma apoA-I was not affected when sheep anti-rabbit apoA-I serum was mixed with sheep anti-rabbit apoB or apoE serum; thus, the antibody need not be specific to quantify the ligand of interest. To show utility of the assay, apoA-I mass was quantified in in vitro and in vivo models displaying altered apoA-I levels. In each model apoA-I values from the cDNA-dependent SPA and the established methodologies of Western blotting and electroimmunodiffusion were highly correlated. The approach outlined in this report should permit rapid development of scintillation proximity assays for other proteins given the widespread availability of full-length cDNAs.

The purpose of this study was to determine whether a polymer could be formed from relatively innocuous monomeric ingredients and, if so, if it might serve as a suitable embedding medium for maximizing antigen retention. Such a polymer, HACH, was made up from a mixture of 2-hydroxyhexanedial and carbohydrazide. It polymerized spontaneously at room temperature within 24 hr. Preservation of protein antigenicity and subsequent immunocytochemical localization were demonstrated by three methods. To determine whether protein antigens were retained up to the polymerization stage, we studied hemoagglutination of red blood cells using antibodies directed against their protein antigens. In these trials, HACH-treated cells exhibited the same agglutination responses as control, untreated cells. Second, a guinea pig antibody was used to immunodecorate insulin in β cells of the islets of Langerhans. The number of gold particles, indicating sites where the antibody was bound, was several-fold greater in HACH- than in Lowicryl K4M-embedded pancreatic β cells. To assess the limit of detection of protein antigens in thin sections, an example of a protein present in mitochondria, lipoamide dehydrogenase, was also studied. An indirect procedure for immunodecoration, employing rabbit immunoglobulin G followed by gold-tagged secondary antibody, indicated that the enzyme was present at several sites within cross-sectioned mitochondria. The results suggest that the HACH polymer will be useful for the localization of antigens that are present in relatively few copies.

Early surgical intervention in acute small bowel obstruction (SBO) has long been recognized as an important factor in preventing morbidity and mortality. Factors associated with surgically managed acute SBO were analyzed for delay in intervention and impact on outcome. A retrospective review of all patients evaluated for SBO on the surgical teaching service of the Greenville Hospital System from July 1, 1997 to June 30, 2000 was performed. Data were collected on patient demographics, admission information (date, admitting service, physical examination, and laboratory values), comorbidity, diagnostic studies, surgery date, operative findings, postoperative complications, operative mortality, and discharge date. Analysis of the data revealed 157 cases of presumed SBO of which 61 were managed nonoperatively and 96 required surgery. Acute SBO was diagnosed in 65 patients who constitute the basis for this review. Of these 65 patients 43 (66%) were admitted to the surgical service, 25 (38%) required small bowel resection, and 17 (26%) developed morbidity and/or mortality. When analyzed for morbidity and mortality the only characteristics that were statistically significant were the admitting service (P = 0.003) and length of stay (P = 0.003). On further analysis of admitting service and patient outcomes several factors were significant when we compared medical service admissions to surgical service admissions. These included days from admission to surgery (P = 0.003), length of stay (P = 0.019), morbidity (P = 0.004), mortality (P = 0.005), and combined morbidity and mortality (P = 0.003). Mortality of patients admitted to the medical service was 27 per cent compared with 2 per cent for the surgical service. There were no differences in morbidity and mortality when analyzed by the need for small bowel resection, patient age, etiology of obstruction, or presence of comorbidities. None of the factors studied were useful in predicting the need for small bowel resection. Our findings agree with those of previous investigators with regard to 1) lack of association between the preoperative evaluation and the need for small bowel resection and 2) the association between delay in diagnosis and increased morbidity and mortality. In addition we have found that one of the primary causes of delay in treatment for SBO was admission to the medical service. This delay led to significantly higher mortality in these patients. We recommend early surgical evaluation for any patient admitted with SBO as a differential diagnosis.

Golf is a different sport from all others discussed in this issue in one important aspect: Almost all of its practitioners play more, rather than less, as they mature. A great many of them play better, too. This additional play and skill can be highly satisfying to the participants; however, it puts them at risk for a number of overuse syndromes directly caused by the motion requirements of golf. In addition, the repetitive nature of the activity can exacerbate pre-existing and age-related orthopedic pathology as well. There is no substitute for attention to the preplay aspects of golf (warm-up, flexibility, and strengthening).

NOAA CoastWatch satellite imagery from early 1996 captured the initiation, development, and decay of a recurrent coastal plume in southern Lake Michigan (Figure 1). For the past 4 years intermittent satellite coverage has revealed a late winter-early spring plume in the lake, a feature also observed by Mortimer [1988]. In 1996, clear weather conditions allowed researchers to observe the plume's development for the first time and they also collected water samples from helicopter and a small boat.

The precision, accuracy, and other performance characteristics of the MS-2 (Abbott Laboratories, Diagnostic Division, Dallas, Tex.) system for the identification of Enterobacteriaceae were evaluated in a collaborative study involving three clinical laboratories. When identifying 150 unknown, coded organisms, the MS-2 system was 97%, 98%, and 93% accurate, respectively, in three laboratories. The system showed an overall accuracy of 94% when compared with conventional manual tube methods in identifying 1,154 clinical isolates of 26 species of Enterobacteriaceae. Discrepancies between automated and conventional methods were chiefly caused by biochemical variants, especially among Enterobacter species. The MS-2 system was rapid and simple to operate and produced printed results of bacterial identification in 5 h. The cost of disposable components compared favorably with commercial, visually read systems for identifying Enterobacteriaceae.

The complete amino acid sequence of the catalytic domain of rat brain hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) has been deduced from the nucleotide sequence of cloned cDNA. Extensive similarity in sequence, taken to indicate similarity in secondary and tertiary structure, is seen between the mammalian enzyme and yeast hexokinase isozymes A and B. All residues critical for binding glucose to the yeast enzyme are conserved in brain hexokinase. A location for the substrate ATP binding site is proposed based on relation of structural features in the yeast enzyme to characteristics commonly observed in other nucleotide binding enzymes; sequences in regions proposed to be important for binding of ATP to the yeast enzyme are highly conserved in brain hexokinase.

A method for determining the free periods of oscillation of an arbitrary enclosed homogeneous water body on a rotating earth is considered. Bathymetry and shape of the water body are taken into account. The oscillations are quasi-static and horizontally two dimensional. Analytical foundation of the theory is based upon a method developed by Proudman (1916). The method requires the construction of two sets of orthogonal functions; one set satisfies a condition of vanishing normal derivative on the boundary and the other set of functions have a zero value on the boundary. These orthogonal functions are numerically constructed for two real water bodies. The numerical orthogonal functions are used as a basis for the expansion of velocity and height fields. The expansion coefficients are then determined so as to satisfy the dynamical equations. The coefficients appear as eigenvectors of a Hermitian matrix. The corresponding eigenvalues represent the frequencies of oscillation. Structures are determined by numerical evaluation of the velocity and height field expansions. Application of the above procedure to Lake Ontario gives for the lowest gravitational mode a period of 5.11 h and for Lake Superior, the period of the corresponding mode is 7.86 h. Periods of the lowest six gravitational modes and their structures in both lakes are presented. Comparison of Lake Superior calculations with the data analysis of Mortimer & Fee (1976, preceding paper) shows very good agreement. A few examples of rotational modes are also presented.

The digestive fluid of Dionaea muscipula has been studied with respect to its protein content as a function of time after entrapment of protein material and some enzymes of the secretion. Maximum secretion of enzyme occurs within the first 3 days of the digestive cycle and protein reaches its maximum at 4 days. Phosphatase, proteinase, nuclease and amylase have been observed in the secretion. The enzymes have acid pH optima and the proteinase has a molecular weight of about 40,000.

The primary fixative containing 2% acrolein, 2% glutaraldehyde in 50% aqueous dimethyl sulfoxide (DMSO) buffered at pH 7.4, was applied for 7 hr in the cold. After a short wash in 0.02 M s-collidine buffer, pH 7.4, containing 0.2 M sucrose and 0.001 M CaCl2, the yeast cells were postfixed in 3% OsO4 at pH 4.0 (veronal acetate buffer). This method preserves many cytoplasmic features such as lipid deposits and ribosomes which are usually destroyed by permanganate fixation. DMSO apparently acts as a permeating agent allowing maximum penetration of the cell wall by the fixative without disrupting cellular fine structure

INTRAVENOUS injection of the ergot alkaloid agroclavine, a member of the clavine group of alkaloids, elicits marked behavioural effects in several species1, which suggests that the substance acts on the central nervous system. In curarized rabbits intravenous injection brings about a continuous arousal pattern of the electrocorticogram, indistinguishable from that produced by external stimuli or by administration of lysergic acid diethylamide (LSD)2. A more specific test of a neuropharmacological action of agroclavine was suggested by the similarity between the structure of agroclavine and that of LSD and the reported ability of LSD to antagonize the depressant effect of topically applied noradrenaline (NA) on the response of the rat somatosensory cortex evoked by stimulation of the forepaw3.

The complete amino acid sequence of the catalytic domain of rat brain hexokinase (ATP:D-hexose 6-phosphotransferase, EC 2.7.1.1) has been deduced from the nucleotide sequence of cloned cDNA. Extensive similarity in sequence, taken to indicate similarity in secondary and tertiary structure, is seen between the mammalian enzyme and yeast hexokinase isozymes A and B. All residues critical for binding glucose to the yeast enzyme are conserved in brain hexokinase. A location for the substrate ATP binding site is proposed based on relation of structural features in the yeast enzyme to characteristics commonly observed in other nucleotide binding enzymes; sequences in regions proposed to be important for binding of ATP to the yeast enzyme are highly conserved in brain hexokinase.

BECAUSE sponges constitute an important part of many fossil records, their fine structure should be of interest to palaeontologists. Internal fine structure in spicule fossils would provide a valuable comparison with present day spicules. Furthermore, changes in the fine structure of spicule fossils may offer clues as to climatological or ecological conditions in that period.

THREE different kinds of plastids have been observed in Venus flytrap, each in cells which perform a unique function in the plant. In the same cells, however, there are other organelles (for example, mitochondria) which are the same in all cells of the plant and similar to those in cells of most other plants. We have compared the fine structure and its relationship to the respective function of three types of plastids: the chloroplasts of the leaf cells, the plastids of the cells of the digestive gland, and the plastids of the cells of the trigger hairs.