Saturn's dayside ultraviolet auroras: Evidence for morphological dependence on the direction of the upstream interplanetary magnetic field.

We examine a unique data set from seven Hubble Space Telescope (HST) "visits" that imaged Saturn's northern dayside ultraviolet emissions exhibiting usual circumpolar "auroral oval" morphologies, during which Cassini measured the interplanetary magnetic field (IMF) upstream of Saturn's bow shock over intervals of several hours. The auroras generally consist of a dawn arc extending toward noon centered near ∼15° colatitude, together with intermittent patchy forms at ∼10° colatitude and poleward thereof, located between noon and dusk. The dawn arc is a persistent feature, but exhibits variations in position, width, and intensity, which have no clear relationship with the concurrent IMF. However, the patchy postnoon auroras are found to relate to the (suitably lagged and averaged) IMF Bz , being present during all four visits with positive Bz and absent during all three visits with negative Bz . The most continuous such forms occur in the case of strongest positive Bz . These results suggest that the postnoon forms are associated with reconnection and open flux production at Saturn's magnetopause, related to the similarly interpreted bifurcated auroral arc structures previously observed in this local time sector in Cassini Ultraviolet Imaging Spectrograph data, whose details remain unresolved in these HST images. One of the intervals with negative IMF Bz however exhibits a prenoon patch of very high latitude emission extending poleward of the dawn arc to the magnetic/spin pole, suggestive of the occurrence of lobe reconnection. Overall, these data provide evidence of significant IMF dependence in the morphology of Saturn's dayside auroras. KEY POINTS: We examine seven cases of joint HST Saturn auroral images and Cassini IMF dataThe persistent but variable dawn arc shows no obvious IMF dependencePatchy postnoon auroras are present for northward IMF but not for southward IMF.

Randomized clinical trial of laparoscopic versus open donor nephrectomy.

BACKGROUND: This randomized controlled trial was designed to determine the safety and efficacy of laparoscopic donor nephrectomy (LDN) in comparison with short-incision open donor nephrectomy (ODN). METHODS: Eighty-four live kidney donors were randomized in a 2 : 1 ratio to LDN (56 patients) or short-incision ODN without rib resection (28). Primary endpoints were pain relief and duration of inpatient stay. RESULTS: There was no donor death or allograft thrombosis in either group. The first warm ischaemic time median (range) 4 (2-7) versus 2 (1-5) min; P = 0.001) and the duration of operation (160 (110-250) versus 150 (90-200); P = 0.004) were longer for LDN. LDN led to a reduction in parenteral morphine requirement 59 (6-136) versus 90 (35-312) mg; P = 0.001) and hospital stay (4 (2-6) versus 6 (2-9) days; P = 0.001), and earlier return to employment (42 (14-84) versus 66.5 (14-112) days; P = 0.004). Postoperative respiratory function was improved after LDN. There were more postoperative complications per donor in the ODN group (0.6(0.7) versus 0.3(0.5); P = 0.033). At a median follow-up of 74 months, there were no differences in renal function or allograft survival between the groups. CONCLUSION: LDN removes some of the disincentives to live donation without compromising the outcome of the recipient transplant.

The interaction of the atmosphere of Enceladus with Saturn's plasma.

During the 14 July 2005 encounter of Cassini with Enceladus, the Cassini Plasma Spectrometer measured strong deflections in the corotating ion flow, commencing at least 27 Enceladus radii (27 x 252.1 kilometers) from Enceladus. The Cassini Radio and Plasma Wave Science instrument inferred little plasma density increase near Enceladus. These data are consistent with ion formation via charge exchange and pickup by Saturn's magnetic field. The charge exchange occurs between neutrals in the Enceladus atmosphere and corotating ions in Saturn's inner magnetosphere. Pickup ions are observed near Enceladus, and a total mass loading rate of about 100 kilograms per second (3 x 10(27) H(2)O molecules per second) is inferred.

Composition and dynamics of plasma in Saturn's magnetosphere.

During Cassini's initial orbit, we observed a dynamic magnetosphere composed primarily of a complex mixture of water-derived atomic and molecular ions. We have identified four distinct regions characterized by differences in both bulk plasma properties and ion composition. Protons are the dominant species outside about 9 RS (where RS is the radial distance from the center of Saturn), whereas inside, the plasma consists primarily of a corotating comet-like mix of water-derived ions with approximately 3% N+. Over the A and B rings, we found an ionosphere in which O2+ and O+ are dominant, which suggests the possible existence of a layer of O2 gas similar to the atmospheres of Europa and Ganymede.

Comparison of renal allograft fibrosis after transplantation from heart-beating and non-heart-beating donors.

BACKGROUND: Renal transplants from non-heart-beating donors (NHBDs) yield acceptable function and allograft survival rates in the medium term. However, the long-term results are less certain and there is a paucity of information relating to the development of chronic allograft nephropathy. The aim of this study was to compare allograft fibrosis in kidneys transplanted from NHBDs and conventional heart-beating donors (HBDs). METHODS: A series of 37 NHBD and 75 HBD renal transplants were studied. Protocol renal transplant biopsies were performed at 6 and 12 months after transplantation. Biopsy sections were stained with Sirius red to demonstrate interstitial extracellular matrix. Renal allograft fibrosis was quantified using a computerized image analysis system. RESULTS: The mean first warm ischaemia time for kidneys from NHBDs was 24 min. A significant delay in graft function occurred in eight of 75 recipients in the HBD group and 31 of 37 in the NHBD group (P < 0.001). There were no significant differences in the level of allograft fibrosis between the two groups at any time point. CONCLUSION: Despite high rates of delayed graft function secondary to a prolonged warm ischaemia time, NHBD kidneys do not appear to be more susceptible to the development of renal allograft fibrosis. This study supports the growing body of evidence that kidneys from NHBDs are an acceptable alternative to those from HBDs.

A comparison of traditional open, minimal-incision donor nephrectomy and laparoscopic donor nephrectomy.

Laparoscopic donor nephrectomy (LDN) and minimal-incision donor nephrectomy (MILD) are less invasive procedures than the traditional open donor nephrectomy approach (ODN). This study compares donor and recipient outcome following those three different procedures. Sixty consecutive donor nephrectomies were studied (n = 20 in each group). Intra-operative variables, analgesic requirements, donor recovery, donor/recipient complications and allograft function were recorded prospectively. Operating and first warm ischaemia times were longer for LDN than for ODN and MILD (232+/-35 vs 121+/-24 vs 147+/-27 min, P < 0.001; 4+/-1 vs 2+/-2 vs 2+/-1 min, P < 0.01). Postoperative morphine requirements were significantly higher after ODN than after MILD and LDN (182+/-113 vs 86+/-48 vs 71+/-45 mg; P < 0.0001). There was no episode of delayed graft function in this study. Donors returned to work quicker after LDN than after ODN and MILD (6+/-2 vs 11+/-5 vs 10+/-7; P = 0.055). Donor and recipient complication rates and recipient allograft function were comparable. We concluded that MILD and LDN reduce postoperative pain and allow a faster recovery without compromising recipient outcome.

Mu-peroxo-bis[trans-chloro(1,4,8,11-tetraazacyclotetradecane)cobalt(III)] bis(tetraphenylborate) diacetone solvate.

The title complex, [Co(2)Cl(2)(mu-O(2))(cyclam)(2)](C(24)H(20)B)(2).2Me(2)CO, was obtained when [Co(cyclam)Cl(2)](BPh(4))(2) was crystallized from acetone in air; cyclam is 1,4,8,11-tetraazacyclotetradecane, C(10)H(24)N(4). The peroxo O-O moiety straddles a crystallographic centre of inversion (the two octahedral Co atoms are symmetrically bridged by the O(2) moiety), hence only half of the complex cation is in the asymmetric unit. A comparison of the O-O [1.483 (3) A], Co-Cl [2.2647 (8) A] and Co-O [1.894 (2) A] bond lengths with similar bonds in previously determined structures indicates the oxidation of Co(II) to Co(III) during the crystallization process. In the crystal lattice, cation dimers are encapsulated by six [BPh(4)](-) anions, with C-H...pi hydrogen bonds between the cyclam methylene groups and the phenyl rings of the anion.

Mandibular positioning skills with respect to age.

Control of neuromuscular activity is essential for the execution of normal oral functions. Although the mechanisms that control mandibular movement and generation of force are understood, few reports address such skills in relation to age. This study aimed to determine the effect of age upon functional skills in the perception of mandibular position in healthy dentate people. A static task examined subjects' skill in the perception of size differences between objects placed between the incisor teeth, and a dynamic task examined subjects' skill in the reproduction of mandibular positions unaided by tooth contact. The results revealed that, with increasing age, a small but significant decline occurred in both static and dynamic oral skills. Irrespective of age, skill was greatly improved when tooth contact assisted in the determination of mandibular position. Consideration of these findings explores some possible clinical implications in the management of dental care for seniors.

Analyses of treatment outcomes for complete dentures provided in an undergraduate teaching programme.

Identifying the source of difficulties some patients experience after replacement dentures are made is an essential part of improving quality care should further treatment to assist the patient be considered necessary. This report examines the findings of a retrospective review of 181 patients' records following the provision of complete dentures by undergraduate dental students at the University of Otago School of Dentistry. Treatment was provided in 1998; the audit commenced in August 1999 to allow sufficient time for the records to include review appointments. Forty-eight patients (26.5 percent) were recommended to receive further replacement dentures to correct errors identified by the supervising clinician. Causation was broadly attributed to dissimilarities from patients' previous dentures (42 percent), occlusal factors (33 percent), and difficulties in establishing a functional denture-bearing area (11 percent). These findings were compared with a published analysis of denture faults identified during the clinical examination of patients referred to a specialist in dental prosthetics. Evidence suggests that the use of a clinical technique which incorporates information from previously successful dentures may be appropriate in the construction of replacement dentures.

Advances in partial denture ceramics.

Two techniques for incorporating bonded porcelain facings within metal partial dentures are described. In the first technique, porcelain is bonded to a metal framework constructed of bonding alloy. In the second technique, separate components are combined in a cast-on procedure to incorporate the mechanical properties of both bonding and framework alloys in one prosthesis. These techniques have enabled the successful treatment of patients in whom limited interocclusal space or parafunctional activity had led to failure of previous prostheses.

A denture replication technique following partial maxillectomy: a case report.

A variety of problems faces the prosthodontist attempting reconstruction of maxillary defects. There are various treatment options for patients requiring a partial maxillectomy and an obturator prosthesis. Reduced adaptability makes it difficult for the patient to learn to use a new appliance, unless existing skills can be employed. It is therefore helpful to reproduce familiar features of a patient's existing obturator, especially if this has been used successfully over a transition period.

Treatment of primary hypercholesterolaemia with simvastatin. New Zealand multicentre evaluation.

OBJECTIVE: To assess the efficacy of simvastatin in a large patient cohort. DESIGN: In an open multicentre study, after a four week placebo phase, patients were treated with simvastatin for 24 weeks; a subgroup continued therapy for a further 24 weeks. Efficacy of simvastatin (a) with prolonged use over three years, and (b) in combination with bezafibrate was assessed in an open single site study. SETTING: Lipid or cardiology specialist hospital outpatient clinics. PATIENTS: For the open multicentre study, 228 patients with primary hypercholesterolaemia (total cholesterol level greater than 6.5 mmol/L) were recruited, of whom 224 met entry criteria and completed the study. Forty-seven of these patients continued therapy for one year. In the open single site study, 22 patients (with low density lipoprotein [LDL] cholesterol levels greater than 4.3 mmol/L) participated in studies of long term use (n = 9) or of combined therapy (n = 13). INTERVENTION: Therapy in the open multicentre study began with 10 mg of simvastatin per day, doubling to 20 mg after six weeks and then 40 mg after 12 weeks of therapy if total cholesterol levels persisted above 5.2 mmol/L. In the study of long term use, simvastatin (40 mg daily) was taken continuously over three years. In the study of combination therapy, bezafibrate (600 mg daily) was taken in addition to simvastatin (40 mg daily) for 10 months. MAIN OUTCOME MEASURES: Plasma lipid and lipoprotein concentrations. RESULTS: In the multicentre study, total plasma cholesterol levels were reduced by 32.8% from 9.11 +/- 1.84 (in mmol/L, mean +/- SD) to 6.12 +/- 1.25 (P less than 0.001), and LDL cholesterol levels by 41.4% from 6.90 +/- 1.92 to 4.04 +/- 0.31 (P less than 0.001). The effect of therapy was sustained in those patients continuing therapy to 48 weeks. The study of long term use found no significant attenuation of effect over three years of monotherapy. Combined simvastatin/bezafibrate therapy reduced the LDL cholesterol concentration by a further 19.9% (P less than 0.001) from levels achieved on simvastatin alone. CONCLUSIONS: Simvastatin is an effective, well tolerated lipid lowering drug, without significant attenuation of effect with prolonged use. Simvastatin plus bezafibrate appears to be a potentially useful drug combination.

Comparison of lisinopril versus placebo for congestive heart failure.

A multicenter, randomized, double-blind assessment of 130 patients with congestive heart failure (New York Heart Association functional classes II to IV) was undertaken to assess the therapeutic efficacy of lisinopril, an angiotensin-converting enzyme inhibitor. All the subjects received concurrent therapy with digoxin and diuretics. Assessments performed periodically over 12 weeks revealed that the active treatment was associated with significant improvements in treadmill exercise time, cardiothoracic ratio, ejection fraction, functional status and clinical signs and symptoms of heart failure. Lisinopril exhibited a mild first-dose effect on blood pressure that was not significantly different from that observed with placebo. The incidence of adverse experiences was not markedly different in the 2 study groups, with only mild hypotension and dizziness occurring more frequently in association with the active medication.

Lisinopril versus placebo in older congestive heart failure patients.

This article reports the results of a multicenter international study of the use of lisinopril in patients with congestive heart failure also receiving digoxin, diuretics, or both. Two thirds of the 130 subjects enrolled in the study received lisinopril and one third received placebo. Lisinopril treatment led to a significant improvement in both bicycle and treadmill exercise tolerance, New York Heart Association classification status, cardiac function assessed noninvasively, and symptomatology. There was no age differentiation; the same improvement was achieved in the 35 patients over 65 years old as in the younger patients. There was a mild decrease in both systolic and diastolic blood pressure in patients receiving lisinopril, peaking at seven hours. These changes, however, were not significantly different from those seen with placebo. Apart from one patient in whom hypotension developed followed by reversible renal failure, there were no serious adverse effects, and the incidence of sudden death and biochemical abnormalities was no different from that seen with placebo. This study confirms that this agent is an effective, safe, well-tolerated agent in the treatment of congestive cardiac failure and is equally applicable to younger and older patients.

Transdermal clonidine (Catapres-TTS) monotherapy in the management of mild hypertension in general practice.

The efficacy and patient acceptance of transdermal clonidine applied once a week were assessed in 62 mild hypertensives previously controlled on a diuretic and/or beta-blocker in a general practice setting involving 18 general practitioners. Patients underwent 3-5 week wash-out period and those patients whose mean seated diastolic blood pressure returned to levels between 91-105 mmHg or increased by greater than 10 mmHg above the initial value, were titrated with transdermal clonidine (Catapres-TTS-1, 2, or 3) and maintained on the optimal dose for 3 months with monthly check-ups. Satisfactory response of blood pressure to levels below 90 mmHg or greater than 10 mmHg reduction from the wash-out level was obtained in 85% of patients who completed the titration phase; nine patients failed to achieve a satisfactory blood pressure control. There was no significant difference in blood pressure response between previous therapy and transdermal clonidine treatment. Systemic side effects were minimal. Eight patients withdrew because of local allergic contact dermatitis. This study confirms that transdermal clonidine is at least as effective in reducing blood pressure as diuretic and/or beta-blocker therapy.

Contact sensitivity by diisocyanates: potencies and cross-reactivities.

The dermal sensitizing potencies of four diisocyanates were investigated using the mouse ear-swelling test (MEST) with BALB/cBy mice. Mice were administered topical doses of diisocyanates to the abdomen and were challenged on the ear 4 days later with a nonirritating dose of chemical. The increase in ear thickness at 24 hr postchallenge indicated the extent of contact sensitivity. Ear thickness increase plotted against the log of the dose of diisocyanate indicated three regions of effects: a no-effect region, a dose-response region, and a region of reduced response at highest dosages. The potencies of the diisocyanates expressed as the SD50 (dose required to sensitize 50% of the animals in each group) were hexamethylene diisocyanate, 0.088 mg/kg; diphenylmethane-4,4'-diisocyanate, 0.73 mg/kg; and toluene diisocyanate, 5.3 mg/kg. For dicyclohexylmethane diisocyanate, the steep dose-response curve suggested a threshold-type response occurring at 0.24 mg/kg. The specificity of sensitization was evaluated by challenging sensitized animals with heterologous diisocyanates. The homologous reactions were always the most extensive. However, cross-reactions were noted between aryl and alkyl diisocyanates. Toluene diisocyanate, the weakest sensitizer, elicited the fewest cross-reactions. The MEST proved to be a simple and effective method for assessing delayed-type hypersensitivity without need of adjuvants, occlusive patches, abrasions, or other procedures which fail to mimic industrial exposures. The observation that very high exposures resulted in reduced response indicates that protocols which generate dose-response data must be utilized to accurately assess the sensitizing potencies of industrial chemicals.