Acclimation potential of Arctic cod (Boreogadus saida) from the rapidly warming Arctic Ocean.

As a consequence of the growing concern about warming of the Arctic Ocean, this study quantified the thermal acclimation responses of Boreogadus saida, a key Arctic food web fish. Physiological rates for cardio-respiratory functions as well as critical maximum temperature (Tc,max) for loss of equilibrium (LOE) were measured. The transition temperatures for these events (LOE, the rate of oxygen uptake and maximum heart rate) during acute warming were used to gauge phenotypic plasticity after thermal acclimation from 0.5°C up to 6.5°C for 1 month (respiratory and Tc,max measurements) and 6 months (cardiac measurements). Tc,max increased significantly by 2.3°C from 14.9°C to 17.1°C with thermal acclimation, while the optimum temperature for absolute aerobic scope increased by 4.5°C over the same range of thermal acclimation. Warm acclimation reset the maximum heart rate to a statistically lower rate, but the first Arrhenius breakpoint temperature during acute warming was unchanged. The hierarchy of transition temperatures was quantified at three acclimation temperatures and was fitted inside a Fry temperature tolerance polygon to better define ecologically relevant thermal limits to performance of B. saida We conclude that B. saida can acclimate to 6.5°C water temperatures in the laboratory. However, at this acclimation temperature 50% of the fish were unable to recover from maximum swimming at the 8.5°C test temperature and their cardio-respiratory performance started to decline at water temperatures greater than 5.4°C. Such costs in performance may limit the ecological significance of B. saida acclimation potential.

Laboratory rearing of wild Arctic cod Boreogadus saida from egg to adulthood.

The techniques and protocols used to successfully capture, transport and breed Arctic cod Boreogadus saida, as well as to rear their larvae through to adulthood are summarized. Breeding B. saida will increase the opportunity to study this fish species, which is a critical part of the Arctic food web.

Upper thermal limits of the hearts of Arctic cod Boreogadus saida: adults compared with larvae.

Wild adult and reared larval Boreogadus saida were acclimated to 3·5° C before testing their cardiac response to acute warming. Heart rate transition temperatures during warming were similar for adult and larval hearts, except that the maximum temperature for heart rate was 3° C warmer for adults. Thus, in a rapidly warming Arctic Ocean, the upper temperature limit for larval rather than adult B. saida appears more likely to dictate the southern range of the species.

Upper thermal limits of cardiac function for Arctic cod Boreogadus saida, a key food web fish species in the Arctic Ocean.

The objective of this study was to determine the upper thermal limits of Arctic cod Boreogadus saida by measuring the response of maximum heart rate (f(Hmax)) to acute warming. One set of fish were tested in a field laboratory in Cambridge Bay (CB), Nunavut (north of the Arctic Circle), and a second set were tested after air transport to and 6 month temperature acclimation at the Vancouver Aquarium (VA) laboratory. In both sets of tests, with B. saida acclimated to 0° C, f(Hmax) increased during acute warming up to temperatures considerably higher than the acclimation temperature and the near-freezing Arctic temperatures in which they are routinely found. Indeed, f(Hmax) increased steadily between 0.5 and 5.5° C, with no significant difference between the CB and VA tests (P > 0.05) and with an overall mean ± s.e. Q10 of 2.4 ± 0.5. The first Arrhenius breakpoint temperature (T(AB)) for f(Hmax) was also statistically indistinguishable for the two sets of tests (mean ± s.e. 3.2 ± 0.3 and 3.6 ± 0.3° C), suggesting that the temperature optimum for B. saida could be reliably measured after live transport to a more southerly laboratory location. Continued warming above 5.5° C revealed a large variability among individuals in the upper thermal limits that triggered cardiac arrhythmia (T(arr)), ranging from 10.2 to 15.2° C with mean ± s.e. 12.4 ± 0.4° C (n = 11) for the field study. A difference did exist between the CB and VA breakpoint temperatures when the Q10 value decreased below 2 (the Q10 breakpoint temperature; T(QB)) at 8.0 and 5.5° C, respectively. These results suggest that factors, other than thermal tolerance and associated cardiac performance, may influence the realized distribution of B. saida within the Arctic Circle.

Angiographically assessed coronary arterial patency and reocclusion in patients with acute myocardial infarction treated with anistreplase: results of the anistreplase reocclusion multicenter study (ARMS).

In this open multicenter study, 156 patients with acute myocardial infarction received 30 U of anistreplase intravenously over 5 minutes within 4 hours of the onset of chest pain. The patency of the infarct-related vessel was determined by coronary angiography 90 minutes after anistreplase treatment, and also 24 hours after treatment, in patients with a patent infarct-related vessel at 90 minutes, to assess the reocclusion rate. The investigators categorized the infarct-related vessel as patent or occluded, and 2 independent cardiologists graded the infarct-related vessel according to the Thrombolysis in Myocardial Infarction (TIMI) perfusion criteria. At the 90-minute assessment, 106 of 145 evaluable patients (73%) had patent infarct-related vessels, and 39 of 145 (27%) had occluded infarct-related vessels. Of the 139 independently assessed patients, 98 (71%) had TIMI grades 2 or 3 and 41 (29%) had TIMI grades 0 or 1. At the 24-hour assessment, 98 of 102 patients (96%) had a patent infarct-related vessel, and reocclusion had occurred in 4 of 102 patients (4%). Of the 94 independently assessed patients 90 (96%) had TIMI grades 2 or 3, and 4 (4%) had TIMI grades 0 or 1. The reliability of noninvasive parameters as indicators of achieved patency of the infarct-related vessel was estimated by means of correlation with patency assessed by coronary angiography. A significant correlation of 0.62 was found. The patency rate of 71 to 73% after use of anistreplase in patients with acute myocardial infarction corresponds with findings in earlier studies. The low reocclusion rate of 4% after use of anistreplase probably reflects the prolonged action of anistreplase.

Blood amine acid levels in patients with insulin excess (functioning insulinoma) and insulin deficiency (diabetic ketosis).

Blood amino acid concentrations were determined in the postabsorptive state in nine patients with insulin excess (functioning insulinomas), nine juvenile-type diabetics with insulin deficiency (diabetic ketosis due to insulin withdrawal), six juvenile diabetics in moderate metabolic control, and five healthy control subjects. Blood branched-chain amino acid (BCAA) levels were elevated in diabetic ketosis and decreased in patients with insulinomas. Blood concentrations of BCAA were significantly correlated to blood glucose levels, and in diabetics they were also correlated to blood ketone bodies, serum free fatty acids, and glycerol levels. These data indicate an inverse relationship between circulating effective insulin levels and blood BCAA concentrations. It is suggested that blood levels of BCAA might represent an indicator of insulin-dependent alterations of protein metabolism.

A causal analysis of diet composition in free ranging cattle in reed-dominated vegetation.

Theoretical and observed diets of free-ranging yearling cattle in an area of reed-dominated vegetation were related to constraints inherent to ruminants (rumination time as reflected in the zone of acceptable crude fibre content of the ration; rumen fill) and in more general terms, to requirements for minerals (Na, Ca, Mg, P), for protein and for metabolisable energy in order to balance the growth rate achieved by experimental animals. Theoretical diets in spring were mainly limited by feeding time; theoretical diets in summer and autumn were mainly limited by rumen capacity. The high proteinto-energy ratio in the forage species caused protein intake to exceed the animals' demands. Mineral intake was in excess of requirements except for sodium. Yearling cattle in our study area maximized their energy intake, with feeding time, rumen capacity and crude fibre content of the forage as important constraints.

If functional sinus surgery fails: a radical approach to sinus surgery.

Radical surgery of the nose and paranasal sinuses was performed in 56 patients as a last resort for severe recurrent treatment-resistant rhinosinusitis. Surgery consists of removal of all walls between the nasal fossa and the paranasal sinuses, creating one cavity. All patients were permanently relieved of sinusitis and nasal obstruction, and other symptoms were greatly reduced. Morbidity is low in relation to preoperative symptoms. We conclude that radical sinus surgery is an effective last resort if functional sinus surgery repeatedly falls.

Unilateral versus bilateral botulinum toxin injections in adductor spasmodic dysphonia.

Thyroarytenoid injection of botulinum toxin is the therapy of choice in spasmodic dysphonia. However, there is no convincing evidence as to whether unilateral or bilateral injections are to be preferred. For this reason, a prospective study was designed in which voice quality, duration of effect, and side effects were assessed. Twenty-seven patients with adductor spasmodic dysphonia were treated with percutaneous injections of botulinum toxin. The first treatment consisted of injection of 5 units in the left thyroarytenoid muscle. The second treatment, 2.5 units in both sides, took place when the effect of the first procedure had completely ceased. All patients underwent both procedures. By means of self-rating scales, effects and side effects were assessed over at least 3 months. There was no difference between the procedures in duration of voice improvement, nor in the occurrence of breathy dysphonia. After a bilateral injection, statistically more patients reported swallowing problems. However, most patients preferred the bilateral injection, in spite of more and longer-lasting side effects.

Adductor spasmodic dysphonia and botulinum toxin treatment: the effect on well-being.

Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were used to assess the personality characteristics and psychological and somatic well-being of 46 patients with AdSD. Moreover, the effect of botulinum toxin (Botox) treatment on their well-being was evaluated. No significant differences could be detected between patients and a representative norm group concerning 7 personality characteristics. Nevertheless, before treatment, there were significantly more psychological and somatic complaints. After establishment of a normal to near-normal voice with Botox injections, these complaints were reduced to normal levels--a finding suggesting these phenomena to be secondary to the voice disorder. These findings, and the normal personality characteristics, do not support a psychogenic cause of AdSD.

Perceptual characteristics of adductor spasmodic dysphonia.

The evaluation of perceptual symptoms is one of the mainstays in the diagnostic workup of adductor spasmodic dysphonia (ADSD). The most widely used perceptual rating system is the GRBAS scale. However, with this system, not all audible features of ADSD can be described. Therefore, we extended the GRBAS system by 6 parameters. The aim of this study was assessment of the perceptual characteristics of ADSD with the "extended" GRBAS system and evaluation of its reproducibility. Seventy-seven patients were scored independently by 3 experienced observers quantifying the voice sound profile. Cluster analysis distinguished 4 different voice types. Intraobserver and interobserver agreement among 8 less-experienced observers appeared fair-to-good. This study demonstrates that the "extended" GRBAS system is suitable for perceptual characterization of ADSD. On the grounds of the fair-to-good interobserver variability, it is appropriate for clinical use. Moreover, 4 different voice clusters of ADSD were identified, with significant differences in voice and demographic parameters.

Human health effects of dust exposure in animal confinement buildings.

Work in swine and poultry units is associated with exposure to significant levels of organic dust and endotoxins with the highest concentrations found in poultry houses, whereas values found in dairy and in cattle farming are much lower. Corresponding to this is an excess of work-related respiratory symptoms in swine farmers. A dose-response relationship exists between symptoms and number of working hours. Longitudinal studies have demonstrated an accelerated decline of lung function in swine farmers large enough to cause clinically significant disease in some farmers. Because of the large number of people needed in swine farming and the long working hours, swine farming has emerged as the major respiratory problem in farming. Experimental studies indicate that exposure has to be lowered substantially to avoid acute effects and longitudinal studies demonstrate that loss of lung function occurs in non-smoking swine farmers without respiratory symptoms and that accelerated decline in lung function occurs below endotoxin concentrations in dust (100 ng/m3) proposed as a safe threshold.

Cholesterol embolism as a complication of left heart catheterisation. Report of seven cases.

Cholesterol embolism after left heart catheterisation by the femoral approach was diagnosed in seven men (mean age 59.6 years) out of a total of 4587 catheterisations. Diabetes was present in four patients, systemic hypertension in three, and signs of extensive atherosclerosis in six; five patients were taking anticoagulant drugs. Acute pain in the legs or abdomen occurred in six patients, two of whom had abdominal angina; renal failure was present in six patients, cutaneous manifestations in five, and a cholesterol embolus was seen in the retina in one. Six out of six patients had an appreciable increase in the erythrocyte sedimentation rate and five out of five had eosinophilia within a week of catheterisation. Renal failure was progressive in five patients, one of whom required haemodialysis. Three patients required amputation of the toes because of gangrene. Four patients died within four and a half months of catheterisation from causes not directly related to cholesterol embolism. At necropsy cholesterol emboli were found in all four patients. Cholesterol embolism is a rare but serious complication of left heart catheterisation.

[A beta ray applicator (106Ru/106Rh) in the treatment of ciliary body melanomas]. / Ein Betastrahlenapplikator (106Ru/106Rh) zur Behandlung von Ziliarkörpermelanomen.

A new form of 106Ru/106Rh applicator is described, with which it is possible to treat ciliary body tumors while preserving the cornea. Radiotherapy with this applicator may be regarded as an alternative to local excision and radiation of ciliary body melanomas with protons or helium ions.

[Granulomatous allergic reaction of the delayed type to surfen]. / Granulomatöse allergische Reaktion vom verzögerten Typ auf Surfen.

In the last five years, a distinct increase of allergic reactions to surfen, a constituent of various insulin preparations, was observed. The allergic reactions were tuberculoid granulomas of the delayed type (type IV of Gell and Coombs). Intracutaneous tests with surfen or surfen-containing insulin preparations confirmed the diagnosis. Dermal infiltrates and mild erythema developed 24 to 96 hours after the injection of insulin. In some patients a post-inflammatory pigmentation was noted. Histological examination of the lesions and the intracutaneous test sites revealed a granulomatous inflammation without signs of foreign body reaction. At present, the cause of the increased incidence of allergic reactions to surfen remains hypothetical.