Effective energy exploitation from horse manure combustion.

We investigated the exploitation of horse manure for energy recovery by combustion. First, the impact of the waste origin and management (storage conditions) was evaluated in terms of elemental analysis, moisture content, heating value, and ash melting temperature. Besides some carbon loss over the time, horse manure origin and management policy do not impact its profitable exploitation by combustion. More relevant, the ignition tests disproved the current industrial opinion that combustion of manure alone is difficult, without the addition of auxiliary fuel, like wood shavings. It has been demonstrated through ignition tests that the major limitation in manure combustion is just the high moisture content (approx. 60% w.b.). The study focused on overcoming the detrimental effect of the large moisture content, and specifically its removal efficiency. The latter requires the understanding of manure permeability which is determined by the bedding material and the stable management. Here we provide indications of the impact of the manure composition and its sample size on the efficiency of moisture removal, whose energy impact must be minimized for an effective energy recovery. The energy balance confirms that the total removal of 62% w.b. moisture reduces by 23% the potential energy content of the manure; this drying penalty on energy is largely offset by the dramatic improvement in reactivity of the residual solid fuel.

[Clinical outcome and health related quality of life in patients undergoing coronary angioplasty with balloon or stent. A prospective multicenter study]. / Resultados clínicos y de calidad de vida de los pacientes tratados con angioplastia coronaria con balón o stent. Estudio multicéntrico prospectivo.

INTRODUCTION AND OBJECTIVES: Clinical outcome and health related quality of life after coronary angioplasty with stent or balloon are insufficiently studied in routine practice. The aim of the present study was to assess the impact of angioplasty on the clinical results and quality of life in real clinical practice. PATIENTS AND METHODS: All the consecutive patients undergoing angioplasty with stent or balloon attending two Spanish tertiary hospitals from October, 1997 to July, 1998 were evaluated at baseline and one year after discharge from hospital with a structured clinical questionnaire and the generic SF-36 quality of life questionnaire. RESULTS: Three hundred ninety-seven patients with a mean age of 63 years were included in the study. A stent (or stent plus balloon) was implanted in 342 patients and angioplasty with a single balloon was performed in 55 patients. More advanced coronary disease and suboptimal lesions for treatment were found in patients treated with only balloon. At one year of follow up the total mortality was 6% and 54% of the patients were free of angina. Mean baseline scores of the SF-36 questionnaire were remarkably low (35 for physical health and 45 for mental health). At one year the scores achieved levels similar to those of the general Spanish population matched for age and sex (45 for physical health and 52 for mental health). Independent predictors of quality of life at one year were the following: baseline quality of life, age, sex, comorbidity, previous hospitalizations, hospital where the patient was attended, symptoms at admission and late angina. CONCLUSIONS: a) After percutaneous myocardial revascularization the mean quality of life achieved was similar to that of the general population; b) different clinical subgroups did not achieve these levels, although improvement was similar to that of the remaining subgroups

[Outcomes of coronary artery surgery: determinants of quality of life related to postoperative health]. / Resultados después de cirugía coronaria: determinantes de calidad de vida relacionada con la salud postoperatoria.

BACKGROUND AND OBJECTIVES: Little is known of the clinical and nonclinical determinants of health related quality of life after coronary artery bypass graft in routine clinical practice. The aim of this study was to assess the quality of life and its determinants after a first coronary bypass in a representative population of Catalonia, Spain. PATIENTS AND METHOD: Clinical and quality of life questionnaires were given to all the patients (n = 710) undergoing a first coronary bypass in private and public Catalan hospitals, prior to surgery and at six months and one year of follow-up. Quality of life was assessed with the DASI and the SF-36. RESULTS: The rate of clinical events at one year was 23%. The mean quality of life improved to levels slightly below those in general population; with greater changes reported in physical than in mental condition although the latter was less impaired. In 24%, the quality of life scores at one year were below 1.5 standard deviations of those in the general population. Females, patients with comorbidity and those with public health care insurance showed lower quality of life scores. Independent predictors of one-year quality of life included initial quality of life scores, public insurance, comorbidity, gender, age and chronic disease. Postoperative angina and dyspnoea were also associated with quality of life. CONCLUSION: The mean quality of life improves after coronary bypass, although up to one fourth of the patients may have unsatisfactory one-year clinical or quality of life outcome. Female patients, public insurance and comorbidity predict a worse quality of life.

[Therapeutic control and quality of life in coronary artery bypass surgery patients]. / Control terapéutico de los factores de riesgo y calidad de vida en los pacientes tratados mediante derivación aortocoronaria.

BACKGROUND: Description of measures of secondary prevention and of health related quality of life one year after the intervention in patients undergoing coronary artery bypass surgery. PATIENTS AND METHOD: One year follow up prospective study in patients undergoing first coronary bypass surgery without associated procedures and aged less than 80 in public and private hospitals in Cataluña, Spain. RESULTS: 710 patients were included, 85.4% were men, and mean age was of 63 years. When compared women and men, 74.8 vs 48.7% patients were diagnosed of hypertension, 70.2 vs 55% of hypercholesterolemia, and 42.3 vs 28.7% of diabetes (p < 0.01); on the other hand, 31.2% of men and 2.9% of women were active smokers (p < 0.01). After a year of follow-up, 7% of the total population remained smokers; a significant reduction of anti-anginal treatments and a significant improvement in health related quality of life were observed. Cholesterol lowering treatment in patients previously diagnosed of hypercholesterolemia increased significantly between hospital admission and one year after hospital discharged (from 44% at the beginning to a 58% at the year of follow up; p < 0.01). CONCLUSIONS: Patients undergoing coronary artery bypass surgery clinically improved one year after the intervention, improving also their health related quality of life. However, the percentage of smokers and the level of antihypertensive and lowering cholesterol treatment at the end of follow up suggest a suboptimal control of risk factor

Oligomerization of the plasma membrane calcium pump involves two regions with different thermal stability.

Ca(2+) pump dimerization was studied by using a combined approach of thermal denaturation and fluorescence resonance energy transfer. The measurement of calcium pump ability to dimerize after the unfolding of individual functional domains of the enzyme demonstrated the existence of two different regions involved in the self-association process. One of these regions is highly susceptible to thermal unfolding and was identified as the calmodulin (CaM)-binding domain. The other region whose thermal stability is higher than those of the catalytic and CaM-binding domains could be related with the previously found C28W-binding regions.

Factors involved in the biochemical etiology of human seminal plasma hyperviscosity.

Semen rheology was studied to elucidate the biochemical basis of seminal plasma hyperviscosity. Semen proved to fit in with a power law model, by presenting a pseudoplastic behavior. Apparent viscosity at 230 s(-1) and 25 degrees C (eta(a)) was 4.3 /- 0.2 cp and 5.4 +/- 0.4 cp in normal and high-consistency semen, respectively. The effect of enzymes and mucolytic agents on human seminal plasma viscosity were evaluated by incubating normal and hyperviscous semen pool aliquots with trypsin, dithiothreitol, EDTA, alpha-amylase and deoxyribonuclease I. After incubation, trypsin treatment reduced eta(a) by 36% in normal semen and by 44% in hyperviscous semen. There was a decrease in eta(a) following incubation of hyperviscous samples with dithiothreitol (33%) and alpha-amylase (44%) that was not observed in the normal consistency samples. No decrease was observed in eta(a) after EDTA or DNAse treatment of both groups. Comparison of normal and hyperviscous seminal plasmas revealed no difference in the concentration of total proteins, DNA, or in the percentage of water content. These findings indicate that the primary substances responsible for basic normal semen rheologic behavior are proteins. A comparison of rheological properties between normal and hyperviscous semen samples indicates the existence of a highly organized network in the latter group, in which disulfide bonds and oligosaccharide chains complexed to the peptide core may play a key role.

Thermal stability of the plasma membrane calcium pump. Quantitative analysis of its dependence on lipid-protein interactions.

Thermal stability of plasma membrane Ca(2+) pump was systematically studied in three micellar systems of different composition, and related with the interactions amphiphile-protein measured by fluorescence resonance energy transfer. Thermal denaturation was characterized as an irreversible process that is well described by a first order kinetic with an activation energy of 222 +/- 12 kJ/mol in the range 33-45 degrees C. Upon increasing the mole fraction of phospholipid in the mixed micelles where the Ca(2+) pump was reconstituted, the kinetic coefficient for the inactivation process diminished until it reached a constant value, different for each phospholipid species. We propose a model in which thermal stability of the pump depends on the composition of the amphiphile monolayer directly in contact with the transmembrane protein surface. Application of this model shows that the maximal pump stability is attained when 80% of this surface is covered by phospholipids. This analysis provides an indirect measure of the relative affinity phospholipid/detergent for the hydrophobic transmembrane surface of the protein (K(LD)) showing that those phospholipids with higher affinity provide greater stability to the Ca(2+) pump. We developed a method for directly measure K(LD) by using fluorescence resonance energy transfer from the membrane protein tryptophan residues to a pyrene-labeled phospholipid. K(LD) values obtained by this procedure agree with those obtained from the model, providing a strong evidence to support its validity.

[Adaptation of the MacNew QLMI quality of life questionnaire after myocardial infarction to be used in the Spanish population]. / Adaptación del cuestionario de calidad de vida postinfarto MacNew QLMI para su uso en la población española.

BACKGROUND: The advantage of specific quality of life instruments is its ability to evaluate specific issues related to the illness of interest. The aim of the present study is to develope a Spanish version of the self-administered questionnaire MacNew QLMI, specific for patients after myocardial infarction (MI). MATERIAL AND METHOD: Forward and back-translation method by bilinguals was performed; once the test for feasibility and comprehension was carried out. 143 patients with a first MI completed the Spanish version of the MacNew QLMI and principal components factor analysis was performed. Reliability was assessed in 50 patients with stable MI that completed twice the questionnaire (with an interval of two weeks), measuring reproducibility and internal consistency with Student t test, intraclass correlation and Cronbach's alpha. RESULTS: Factor analysis showed a similar three dimensional structure as the original version. Intraclass correlation coeficient were 0.83, 0.87 and 0.83, and Cronbach's alpha coeficients were 0.85, 0.88 and 0.83 for the emotional, physical and social dimensions respectively. CONCLUSIONS: The Spanish version of the MacNew QLMI questionnaire has a good equivalence with the original version, a good internal consistency and a good reproducibility; it can be used in the Spanish population to study its validity.

Molecular characterization of the glycated plasma membrane calcium pump.

We have previously demonstrated (Diabetes 39:707-711, 1990) that in vitro glycation of the red cell Ca(2+) pump diminishes the Ca(2+)-ATPase activity of the enzyme up to 50%. Such effect is due to the reaction of glucose with lysine residues of the Ca(2+) pump (Biochem. J. 293:369-375, 1993). The aim of this work was to determine whether the effect of glucose is due to a full inactivation of a fraction of the total population of Ca(2+) pump, or to a partial inactivation of all the molecules. Glycation decreased the V(max) for the ATPase activity leaving unaffected the apparent affinities for Ca(2+), calmodulin or ATP. The apparent turnover was identical in both, the glycated and the native enzyme. Glycation decreased the V(max) for the ATP-dependent but not for the calmodulin-activated phosphatase activities. Concomitantly with the inhibition, up to 6.5% of the lysine residues were randomly glycated. The probabilistic analysis of the relation between the enzyme activity and the fraction of nonmodified residues indicates that only one Lys residue is responsible for the inhibition. We suggest that glucose decreases the Ca(2+)-ATPase activity by reacting with one essential Lys residue probably located in the vicinity of the catalytic site, which results in the full inactivation of the enzyme. Thus, Ca(2+)-ATPase activity measured in erythrocyte membranes or purified enzyme preparations preincubated with glucose depends on the remaining enzyme molecules in which the essential Lys residue stays unglycated.

Identification of Bordetella pertussis virulence-associated outer membrane proteins.

Bordetella pertussis virulence-associated 30-, 32-, 90- and 95-kDa outer membrane proteins were purified and their N-terminal amino acid sequences were determined. The 30- and 32-kDa outer membrane proteins showed identity to the C-terminal region of the precursors of the serum resistance protein (BrkA) and the tracheal colonization factor, respectively. We confirmed the cleavage site of these precursors after N731 for BrkA and after N393 for tracheal colonization factor. Associated with the 32-kDa outer membrane protein, we found a new group of 36-kDa virulence-associated peptides. The 95-kDa outer membrane protein showed identity to Vag8. The 90-kDa outer membrane protein did not show homology with the described proteins. We report the N-termini sequence of Vir-90, a novel potential virulence factor.

[The unequal clinical profile, quality of life and hospital mortality in patients undergoing aortocoronary bypass in the public and private centers of Catalonia. The CIRCORCA Study]. / Desigual perfil clínico, calidad de vida y mortalidad hospitalaria en pacientes operados de injerto aortocoronario en centros públicos y privados de Cataluña. El estudio CIRCORCA.

INTRODUCTION AND AIMS: The influence of the type of health care funding and management of hospital centres on hospital mortality in coronary artery bypass surgery (CABG) has not been analyzed in detail. We therefore assessed clinical and quality of life preoperative profiles and in-hospital mortality in public and private patients undergoing coronary bypass surgery in Catalonia. METHODS: Clinical questionnaires, Duke Activity Status Index (DASI) and SF-36 were preoperatively administered to all patients undergoing first coronary bypass surgery without associated procedures in Catalonia between November 1996-June 1997. In-hospital morbidity and mortality were recorded. RESULTS: Predictors of in-hospital death, including DASI, SF-36 and comorbidity scores, were significantly worse in public than in private patients. In-hospital mortality rate was more than ten times greater in public than in private patients (8.2% vs 0.7%; p < 0.001). Multivariate analysis identified private funding of health care, among others, as an independent predictor of in-hospital survival. Non evidence-based indications for surgery were significantly more common in private than in public patients (6% vs 0.7%, p < 0.001). CONCLUSIONS: a) In catalonia, the risk profile of public patients undergoing coronary bypass surgery was significantly higher than that of private patients, accounting, at least in part, for a remarkable mortality difference; b) non evidence-based indications for surgery were more common in private than in public patients; c) these unequal patterns raise questions about the adequacy of care and referral patterns in both private and public sectors.

[Impact of biomedical publications on the incorporation of new therapeutic attitudes in cardiovascular pathology]. / Impacto de las publicaciones biomédicas en la incorporación de nuevas actitudes terapéuticas en patología cardiovascular.

OBJECTIVE: To evaluate the application degree of results from three clinical trials on cardiovascular pathology in clinical practice: SOLVD trial (in patients with congestive heart failure), SAVE trial (in patients with acute myocardial infarction) and SPINAF trial (in patients with chronic atrial fibrillation). DESIGN: Retrospective cross-sectional study performed in the first six months in 1990 and 1992 (SOLVD trial) and in the first six months in 1991 and 1993 (SAVE trial) admitted to the Consorci Hospitalari del Parc Taulí, and a cross-sectional study in a single randomized sample of all patients with the discharge diagnosis of atrial fibrillation at Hospital Vall d'Hebron during 1994. An absolute increase of 23% and 19% in the prescription of ACEI agents was observed for patients with heart failure and myocardial infarction, respectively. Forty-eight percent of patients with atrial fibrillation received antithrombotic therapy, which included aspirin and acenocoumarine for 51% and 49% of cases, respectively.

The membrane topology of the amino-terminal domain of the red cell calcium pump.

A systematic study of the membrane-associated regions in the plasma membrane Ca2+ pump of erythrocytes has been performed by hydrophobic photolabeling. Purified Ca2+ pump was labeled with 3-(trifluoromethyl)-3-(m-[125I]iodophenyl)-diazirine ([125I]TID), a generic photoactivatable hydrophobic probe. These results were compared with the enzyme labeled with a strictly membrane-bound probe, [3H]bis-phosphatidylethanolamine (trifluoromethyl) phenyldiazirine. A significant light-dependent labeling of an M(r) 135,000-140,000 peptide, corresponding to the full Ca2+ pump, was observed with both probes. After proteolysis of the pump labeled with each probe and isolation of fragments by SDS-PAGE, a common pattern of labeled peptides was observed. Similarly, labeling of the Ca2+ pump with [125I]TID, either in isolated red blood cell membranes or after the enzyme was purified, yields a similar pattern of labeled peptides. Taken together, these results validate the use of either probe to study the lipid interface of the membrane-embedded region of this protein, and sustain the notion that the conformation of the pump is maintained throughout the procedures of solubilization, affinity purification, and reconstitution into proteoliposomes. In this work, we put special emphasis on a detailed analysis of the N-terminal domain of the Ca2+ pump. A labeled peptide of M(r) 40,000 belonging to this region was purified and further digested with V8 protease. The specific incorporation of [125I]TID to proteolytic fragments pertaining to the amino-terminal region indicates the existence of two transmembrane stretches in this domain. A theoretical analysis based on the amino acid sequence 1-322 predicts two segments with high probability of membrane insertion, in agreement with the experimental data. Each segment shows a periodicity pattern of hydrophobicity and variability compatible with alpha-helical structure. These results strongly suggest the existence of a transmembrane helical hairpin motif near the N-terminus of the Ca2+ pump.

Analysis of prostate and seminal vesicle motion: implications for treatment planning.

PURPOSE: To quantify prostate and seminal vesicle positional changes (target motion) between treatment planning and delivery, and to identify the factors contributing to target motion. METHODS AND MATERIALS: Thirty patients with adenocarcinoma of the prostate were prospectively evaluated by analyzing two sequential planning computerized tomography (CT) scans (S1, obtained prior to treatment, and S2, obtained during the fourth week of treatment) for each patient. All anatomical volumes of interest (soft tissue and bony) were reconstructed from transverse CT images and projected onto anterior and lateral beam's-eye view projections. Positional changes between S1 and S2 were eliminated by applying a rigid body translation and rotation. Target motion was then measured by recording the positional change between S1 and S2 at the edges (right, left, superior, inferior). Potential correlation of target motion with bladder volume, rectal volume, and rectal diameter changes were evaluated by linear regression analysis. RESULTS: Neither the prostate nor seminal vesicles remained fixed with respect to bony anatomy between S1 and S2. The distribution of positional changes were generally small (< 0.5 cm), but maximum displacements of 1.5-2.2 cm did occur, particularly in the lateral view. In this study, bladder volume changes between the scans were small and did not correlate with target motion (P = 0.67). Both rectal volume and rectal diameter changes correlated with target motion for both the prostate (p = 0.004 and 0.005, respectively) and seminal vesicles (p < 0.001 and < 0.001, respectively). However, neither the initial rectal volume nor the initial rectal diameter could be used to predict subsequent target motion when evaluated either singly or as part of a multiple regression model. CONCLUSIONS: Target motion occurs during the course of treatment planning and delivery and should be considered when designing conformal radiation fields. Although the target position at the time of planning CT may differ substantially from the mean treatment position, target motion cannot be predicted by evaluating simply measured parameters from a single scan, or double scan sequence.

Quantification of lumbar nerve root decompression using somatosensory-evoked potentials.

Intraoperative somatosensory-evoked potential (SSEP) data were collected prospectively in a consecutive series of patients with an acute lumbar herniated nucleus pulposus (HNP). Each patient underwent an open limited diskectomy, hemilaminotomy, and partial foraminotomy. The sequence of diskectomy and bony decompression was randomized, and the extent of foraminotomy was standardized. SSEP data were recorded after each operative procedure and were coded for blind interpretation. SSEP tracings were compared with each patient's baseline for changes in latency and amplitude. In the overall study, changes in amplitude and latency produced by diskectomy versus bony decompression were not statistically significant. In the six patients with lateral recess stenosis (LRS), a statistically significant reduction in latency was observed after bony decompression (averaging -2.05 ms) compared with diskectomy (-0.62 ms). In patients with underlying LRS and a HNP, minimally invasive techniques addressing the disc only may be inadequate to decompress a lumbar nerve root.

The hrp gene locus of Pseudomonas solanacearum, which controls the production of a type III secretion system, encodes eight proteins related to components of the bacterial flagellar biogenesis complex.

Five transcription units of the Pseudomonas solanacearum hrp gene cluster are required for the secretion of the HR-inducing PopA1 protein. The nucleotide sequences of two of these, units 1 and 3, have been reported. Here, we present the nucleotide sequence of the three other transcription units, units 2, 4 and 7, which are together predicted to code for 15 hrp genes. This brings the total number of Hrp proteins encoded by these five transcription units to 20, including HrpB, the positive regulatory protein, and HpaP, which is apparently not required for plant interactions. Among the 18 other proteins, eight belong to protein families regrouping proteins involved in type III secretion pathways in animal and plant bacterial pathogens and in flagellum biogenesis, while two are related solely to proteins involved in secretion systems. For the various proteins found to be related to P. solanacearum Hrp proteins, those in plant-pathogenic bacteria include proteins encoded by hrp genes. For Hrp-related proteins of animal pathogens, those encoded by the spa and mxi genes of Shigella flexneri and of Salmonella typhimurium and by the ysc genes of Yersinia are involved in type III secretion pathways. Proteins involved in flagellum biogenesis, which are related to Hrp proteins of P. solancearum, include proteins encoded by fli and flh genes of S. typhimurium, Bacillus subtilis and Escherichia coli and by mop genes of Erwinia carotovora. P. solanacearum Hrp proteins were also found to be related to proteins of Rhizobium fredii involved in nodulation specificity.

Identification of transmembrane domains of the red cell calcium pump with a new photoactivatable phospholipidic probe.

The membrane-associated regions of the human erythrocyte Ca2+ pump were investigated by hydrophobic photolabeling. Purified Ca2+ pump was reconstituted in asolectin vesicles loaded with [3H]DIPETPD, a photochemical probe designed to label deeply into the hydrophobic core of the lipid bilayer (Delfino et al. J. Am. Chem. Soc. 115, 3458-3474, 1993). After photolysis and SDS-PAGE analysis, a significant light-dependent labeling of the Ca2+ pump was found. Controlled proteolysis of the photoadduct with trypsin or protease V8 followed by SDS-PAGE and immunoblotting yielded individual labeled fragments. The labeling pattern indicated the existence of three sequential clusters of transmembrane regions, consistent with the current model for the topography of this enzyme.

The erythrocyte calcium pump is inhibited by non-enzymic glycation: studies in situ and with the purified enzyme.

In a previous paper we demonstrated that incubation of either intact erythrocytes or erythrocytes membranes with glucose decreases the activity of the membrane Ca(2+)-ATPase [González Flecha, Bermúdez, Cédola, Gagliardino and Rossi (1990) Diabetes 39, 707-711]. The aim of the present work was to obtain information about the mechanism of this inhibition. For this purpose, experiments were carried out with purified Ca(2+)-ATPase, inside-out vesicles and membranes from human erythrocytes. Incubation of the purified Ca(2+)-ATPase with glucose led to a decay in the enzyme activity of up to 50% of the control activity under the conditions used. The decrease in ATPase activity was concomitant with labelling by [6-3H]glucose of the purified Ca2+ pump; the kinetic properties of both processes were almost identical, suggesting that inhibition is a consequence of the incorporation of glucose into the Ca(2+)-ATPase molecule. In inside-out vesicles, glucose also promoted inhibition of Ca(2+)-ATPase activity as well as of active Ca2+ transport. Arabinose, xylose, mannose, ribose, fructose and glucose 6-phosphate (but not mannitol) were also able to inactive the ATPase. The activation energy for both the decrease in ATPase activity by glucose and the labelling of the pump with [6-3H]glucose was about 65 kJ/mol. Furthermore, inorganic phosphate enhanced the inactivation of the Ca(2+)-ATPase by glucose. This evidence strongly suggests that inhibition is a non-enzymically catalysed process. Inactivation of the Ca(2+)-ATPase by glucose was enhanced by reductive alkylation with sodium borohydride. Aminoguanidine, an inhibitor of the formation of the advanced end products of glycosylation, did not prevent the deleterious effect of glucose on the enzyme activity. Therefore it is concluded that inactivation of the Ca2+ pump is a consequence of the glycation of this protein.