A study on correlations between precipitation ETCCDI and airborne pollen/fungal spore parameters in the NE Iberian Peninsula.

Precipitation is one of the meteorological variables usually involved in the aerobiological studies, which presents a complex relationship with atmospheric levels of pollen and fungal spores and the temporal characteristics of their seasons. This complexity is due in a large part to rainfall's twofold impact of having, prior to pollination, a positive influence on subsequent pollen production and of contributing, during pollination, to pollen removal from the air through a wash-out effect. To better explore this impact, we place particular emphasis on extreme rainfall by calculating the correlation between airborne pollen and fungal spore parameters and the precipitation indices that the Expert Team on Climate Change Detection and Indices (ETCCDI) proposed for characterising climate extremes. Parameters for twenty-seven pollen and fungal spore taxa measured in six aerobiological stations in the NE Iberian Peninsula have been considered. We have distinguished between annual and winter ETCCDI in order to compare the correlations between extreme rainfall and airborne pollen concentrations and to avoid the wash-out effect as far as possible. Results show a positive influence from an increase in moderately extreme winter rainfall, specifically on subsequent pollen/fungal spore production: the percentage of all possible significant correlations is higher for winter than for annual rainfall. Furthermore, while annual rainfall in this region has nearly the same number of positive as negative correlations, the positive correlations for winter rainfall are more than twice that of the negative ones. The seasonal consideration on rainfall ETCCDI made with the aim to avoid the confounding overlapping of different rainfall impacts has led to more sharpened observations of its positive and negative effects on airborne pollen and fungal spore concentrations.

Multifractal structure of the monthly rainfall regime in Catalonia (NE Spain): Evaluation of the non-linear structural complexity.

The complex non-linear regime of the monthly rainfall in Catalonia (NE Spain) is analyzed by means of the reconstruction fractal theorem and the multifractal detrended fluctuation analysis algorithm. Areas with a notable degree of complex physical mechanisms are detected by using the concepts of persistence (Hurst exponent), complexity (embedding dimension), predictive uncertainty (Lyapunov exponents), loss of memory of the mechanism (Kolmogorov exponent), and the set of multifractal parameters (Hölder exponents, spectral asymmetry, spectral width, and complexity index). Besides these analyses permitting a detailed description of monthly rainfall pattern characteristics, the obtained results should also be relevant for new research studies concerning monthly amounts forecasting at a monthly scale. On one hand, the number of necessary monthly data for autoregressive processes could change with the complexity of the multifractal structure of the monthly rainfall regime. On the other hand, the discrepancies between real monthly amounts and those generated by some autoregressive algorithms could be related to some parameters of the reconstruction fractal theorem, such as the Lyapunov and Kolmogorov exponents.

Detection of mitochondrial single nucleotide polymorphisms using a primer elongation reaction on oligonucleotide microarrays.

We have developed a novel allele-specific primer elongation protocol using a DNA polymerase on oligonucleotide chips. Oligonucleotide primers carrying polymorphic sites at their free 3'end were covalently bound to glass slides. The generation of single-stranded targets of genomic DNA containing single nuclotide polymorphisms (SNPs) to be typed was achieved by an asymmetric PCR reaction or exonuclease treatment of phosphothioate (PTO)-modified PCR products. In the presence of DNA polymerase and all four dNTPs, with Cy3-dUTP replacing dTTP, allele-specific extension of the immobilized primers took place along a stretch of target DNA sequence. The yield of elongated products was increased by repeated reaction cycles. We performed multiplexed assays with many small DNA targets, or used single targets of up to 4.4 kb mitochondrial DNA (mtDNA) sequence to detect multiple SNPs in one reaction. The latter approach greatly simplifies preamplification of SNP-containing regions, thereby providing a framework for typing hundreds of mtDNA polymorphisms.

Mutations of the ret protooncogene in German multiple endocrine neoplasia families: relation between genotype and phenotype. German Medullary Thyroid Carcinoma Study Group.

It has been suggested that not only the position but also the nature of the mutations of the ret protooncogene strongly correlate with the clinical manifestation of the multiple endocrine neoplasm type 2 (MEN 2) syndrome. In particular, individuals with a Cys634-Arg substitution should have a greater risk of developing parathyroid disease. We, therefore, analyzed 94 unrelated families from Germany with inherited medullary thyroid carcinoma (MTC) for mutation of the ret protooncogene. In all but 1 of 59 families with MEN 2A, germline mutations in the extracellular domain of the ret protein were found. Some 81% of the MEN 2A mutations affected codon 634. Phenotype-genotype correlations suggested that the prevalence of pheochromocytoma and hyperparathyroidism is significantly higher in families with codon 634 mutations, but there was no correlation with the nature of the mutation. In all but 1 of 27 familial MTC (FMTC) families, mutations were detected in 1 of 4 cysteines in the extracellular domain of the ret protooncogene. Half of the FMTC mutations affected codon 634. Mutations outside of codon 634 occurred more often in FMTC families than in MEN 2A families. In all but 1 of 8 MEN 2B patients, de novo mutations in codon 918 were found. These data confirm the preferential localization of MEN 2-associated mutations and the correlation between disease phenotype and the position of the ret mutation, but there was no correlation between the occurrence of hyperparathyroidism or pheochromocytoma and the nature of the mutation.

Dimerization of double-stranded RNA possessing a 3'-overhanging single-stranded end.

A simple system derived from the acceptor stem of tRNA(Ala) is presented which undergoes a pH-dependent dimerization. This is brought about by formation of C+-G-C base triples of the pyrimidine motif type between protonated cytidines of the 3' single-stranded end and regularly paired G-C pairs in the double-helical stem. In addition, an unusual interaction between a protonated adenine and a regular G-C pair is suggested. The equilibrium between monomer and dimer forms can be monitored via NMR spectroscopy and UV melting curve analysis. A dimerization enthalpy of 159 kJ mol(-1) was found at pH 5.0. The system could serve as a model for inter- and intra-molecular association, respectively, of single-stranded and double-helical regions to enable optimal packing of large RNA molecules.

Cystic neoplasms of the pancreas.

Cystic neoplasms of the pancreas can be easily misdiagnosed and mistreated by the surgeon unfamiliar with the pathology, natural history, and operative strategy specific to these uncommon tumors. The authors have treated nine patients over a seven-year period involving four cystadenocarcinomas, two mucinous cystadenomas, two serous cystadenomas, and one solid and papillary epithelial tumor. Our experience illustrates the inaccuracies in both clinical and pathologic diagnosis. Suspected cystic neoplasms are optimally managed by resection. Their slow growth and late metastasis permits curative surgery after a previous drainage or bypass procedure. An aggressive surgical approach is therefore warranted, and multimodal treatment with radiation and chemotherapy may be clinically applicable to large, invasive cystadenocarcinomas.

Value of ultrasound in the diagnosis of acute appendicitis: interesting aspects.

OBJECTIVE: The value of ultrasound in the diagnosis of acute appendicitis is still unclear. Both, studies with excellent and such with disappointing results have been published. The aim of this investigation was to answer the question, whether the results of these studies depend on study design, the investigating clinical department, or the number of ultrasound investigators. METHODS: A systematic literature research (PubMed (NLM) database) was performed. Of 99 publications dealing with ultrasound in the diagnosis of acute appendicitis, 69 were relevant to investigate the value of ultrasound in suspected appendicitis. RESULTS: Results of single-center studies (sensitivity 81.6%, specificity 89.8%, accuracy 85.7%) are better then those of multi-center trials (38.3%, 87.6%, 62.9%). There are no distinct differences between the investigating departments (surgeons 78.9%, 88.9%, 86.0%; radiologists 83.1%, 88.1%, 83.5%; mixed 77.8%, 87.1%, 79.4%, no specification 73.8%, 87.1%, 80.45.9%). Less than 10 investigators showed better diagnostic values (84.3%, 86.8%, 85.6%) compared to studies with 10 or more investigators (64.7%, 88.6%, 67.7%). CONCLUSION: The results of multi-center trials are disappointing and the good results of single-center studies do not reflect surgical everyday life. However, excellent results can be obtained if the investigation is restricted to a few specialists irrespectively of the clinical department.

[Use of alloplastic material on the extrahepatic bile ducts]. / Verwendung von alloplastischem Material an den extrahepatischen Gallenwegen

Dogs (20 kg body weight) were laparotomized and the choledochous duct was ligated. Pre- and postoperative laboratory-parameters such as bilirubin, GOT, GPT, and alcaline phosphatase were controlled. Then, 8 days later, a patch-widening-plasty was performed after incision of the stenosis in 10 dogs. In the 10 other dogs the stenosis was resected and the defect was bridged over with a Teflon prosthesis. A few days later laboratory parameters became normal. Histologic investigation showed that after 4 weeks the Teflon prosthesis was covered with a bile duct-epithelial layer. In one of 3 patients with normal laboratory findings who have a Teflon patch, the operation took place 2 years ago.

[Selection of procedure in the management of recurrent juvenile and aneurismatic bone cysts]. / Verfahrenswahl bei der Behandlung des Rezidivs von juvenilen und aneurysmatischen Knochencysten.

Aneurysmal and juvenile bone cysts are characterized by frequent recurrence and pathological fractures caused by such bone cysts also recur frequently. Curettage of the cyst and spongiosaplasty is often unsuccessful. According to our experience, excochleation must be followed by drilling the cyst wall and fraising off the compact substance. Densely packed homologous spongiosa must then be implanted. In case of recurrence or if the cyst increases in size, radical en-bloc resection is indicated and the defect must be bridged by osteoplastic and osteosynthetic methods. We have treated four difficult cases successfully with this procedure. In one case, resection with limb shortening lead to full recovery.

The applicability of a helicopter patrol procedure to diverse areas: A cost-benefit evaluation.

The residential burglary deterrent effects of a helicopter patrol procedure were investigated in four separate areas with a multiple baseline technology. The helicopter was flown during an 8:00 a.m. to 4:00 p.m. period in two high density population areas of approximately 9.82 and 14.71 square miles and two low density population areas of 117.49 and 89.97 square miles. The helicopter patrol reduced residential burglaries without crime displacement in the two high density areas but had no deterrent effects in the low density areas. The costs of the helicopter patrol were justified by the benefits that resulted from the reduced home burglaries in the two high density areas. Because the helicopter patrol program is funded by general tax revenues, there is a disparity between those people paying for the procedure (all residents of Nashville) and those citizens that receive the burglary deterrent benefits (only residents of high-density areas). This distribution of benefit limitation suggests two courses of action: (1) The helicopter should be flown only in high population density areas even though the low population density areas are also victimized by high burglary rates. (2) A more comprehensive burglary reduction program must be developed so that effective deterrence can be realized in low density areas. These latter techniques would supplement helicopter patrol strategies and thus form a comprehensive burglary deterrent package that has an equitable benefit distribution.

Reduction of police vehicle accidents through mechaniically aided supervision.

Tachograph recorders were installed in 224 vehicles of a metropolitan police department to monitor vehicle operation in an attempt to reduce the rate of accidents. Police sergeants reviewed each tachograph chart and provided feedback to officers regarding their driving performance. Reliability checks and additional feedback procedures were implemented so that upper level supervisors monitored and controlled the performance of field sergeants. The tachograph intervention and components of the feedback system nearly eliminated personal injury accidents and sharply reduced accidents caused by officer negligence. A cost-benefit analysis revealed that the savings in vehicle repair and injury claims outweighed the equipment and operating costs.

Program evaluation research: an experimental cost-effectiveness analysis of an armed robbery intervention program.

An armed robbery alarm system was implemented in 48 different stores in two separate geographical areas for 6 months and 12 months, respectively. The alarms were placed in the two separate areas at different times and all alarms were eventually removed. Thus, multiple baseline and reversal strategies were used to evaluate program impact. A device planted in a cash drawer was triggered whenever "bait" money was removed from the drawer sending an alarm signal directly to police cars and headquarters. On-scene apprehensions of armed robbers within target stores were greatly increased even though the armed robbery systems did not deter robbery incidents nor influence the court disposition of the cases. There was also no crime deterrence, crime displacement, or increased apprehensions in either the immediate neighborhoods of target stores or on a city-wide basis. The cost effectiveness of the program was calculated to be poor even though the program is being maintained because of the absence of an alternative robbery apprehension technology.

Social evaluation research: the evaluation of two police patrolling strategies.

In most social evaluation research it is difficult to achieve the degree of experimental rigor possible in an applied behavioral study. This study illustrates how the evaluation researcher can increase experimental rigor in the analysis of social interventions. In the first evaluation, a variation of the time-series design that offered maximum experimental control given the limitations of the situation, was employed to evaluate the effects of a specialized home-burglary police patrol. This design revealed that no effects could be attributed to the patrol. In the second evaluation, a multiple baseline-like design was possible in determining the effects of a police walking patrol. This design revealed that the patrol produced an increase in crime reporting but not in arrests. Social interventions often occur in a manner that allows varying degrees of experimental analysis. The evaluation researcher must attain optimal experimental analysis given the limitations of each social intervention.

Patrol evaluation research: a multiple-baseline analysis of saturation police patrolling during day and night hours.

The effects of a carefully monitored and increased police patrol on the report of crime were examined in four patrol zones. Overall patrol movement was increased to four times normal levels and slow patrol movement (under 20 mph) to around 30 times normal levels for 10 days. The patrol was active in two zones between 9:00 a.m. and 5:00 p.m. and in the other two zones between 7:00 p.m. and 3:00 a.m. A multiple-baseline design and time-series statistical analyses showed statistically reliable changes in reported levels of Part I crime (such as robbery, burglary, and aggravated assault) during both night patrols, but not in the day patrols. In both night-patrol zones, there were also reliable increases from saturation patrol to postsaturation patrol in report of Part I crime after the night patrol was terminated. Neither of the day patrols showed significant crime report changes on termination. Despite statistically reliable decreases in report of crime during nighttime hours, the value of saturation patrolling as a crime-prevention technique was questioned on cost/benefit grounds.

Police and prosecution systems: An evaluation of a police criminal case preparation program.

Program evaluation can provide objective information relevant to decisions on program maintenance. A program to address problems in the preparation of criminal investigation reports in a metropolitan police department was evaluated. The program permanently altered environmental conditions under which reports were prepared to facilitate performance. Police officers, who had previously prepared reports without assistance, visited the Case Preparation Room to prepare reports with assistance from office personnel. Compared to reports prepared without assistance, reports prepared in the Case Preparation Room documented more case elements required by the state legal code for criminal prosecution, were completed in fewer days following arrests, and received higher ratings from Assistant District Attorneys. Operation of a permanent program available to approximately 945 officers proved a practical solution to improving the preparation of criminal investigation reports.

Police evaluation research: an experimental and cost-benefit analysis of a helicopter patrol in a high crime area.

The significance of a helicopter patrol procedure directed toward prevention of home burglaries was evaluated from experimental and cost-benefit perspectives. The helicopter patrolled one city zone from 9 a.m. to 5 p.m. for two 12-day periods. Each 12-day period was separated by a baseline period in which only normal patrol-car levels were maintained. Significantly reduced burglary levels during the intervention periods, compared to baseline periods, documented the experimental significance of the helicopter procedure. The cash costs of implementing the patrol procedure were compared to two estimates of the resulting cash benefits. This latter cost-benefit analysis was supplemented by a discussion of the intangible costs and benefits of the helicopter procedure. Taken together, these analyses documented that the marginal costs of the helicopter intervention were exceeded by all estimates of benefits.

[Stomach carcinoma: surgical strategy and therapy results 1992]. / Magenkarzinom: chirurgische Strategien und Therapieresultate 1992.

Surgical strategy for gastric carcinoma consists in total gastrectomy as a rule combined with extended lymphadenectomy. In small tumors of the intestinal type located in the distal stomach distal gastric resection can be taken into consideration. In case of high risk patients endoscopic polypectomy of a polypoid early gastric carcinoma can be sufficient. If the operation is done for cure we perform intraoperative radiotherapy within a prospective trial. For palliative situations procedures including removal of the tumor have better results with regard to quality of life and survival than bypass methods.

[Acute appendicitis mimicking cholecystitis. Case reports and review with focus on medicolegal aspects]. / Akute Appendizitis unter dem klinischen Bild einer Cholezystitis. Falldarstellungen und Review aus Sicht der MDK-Behandlungsfehlerbegutachtung.

Since 1955 simultaneous presentation of acute appendicitis und acute cholecystitis have been described. These cases are understood as concomitance on the one hand and as imitation or induction of acute cholecystitis due to acute appendicitis. In laparoscopic surgery for inflammatory diseases, in particular acute cholecystitis, exploration of the entire abdomen should be more than cursory. In remarkable postoperative courses after cholecystectomy in acute cholecystitis, acute appendicitis should be taken into account if it could not be excluded intraoperatively.