The effect of cooling rate on the precision of measurement of glow peak 5 in the thermoluminescence of LiF:Mg,Ti (TLD-100).

The effect of natural rapid cooling and oven slow cooling on the precision of thermoluminescence measurements of LiF:Mg,Ti is investigated. Three separate series of measurements resulted in average precisions of 5.1 and 5.0%, respectively. However, the highest precision of 1.7% (1 SD) was achieved for an oven-cooled material.

SEARCH FOR EXPERIMENTAL EVIDENCE OF DOSE-RATE AND WALL SCATTERING EFFECTS IN THE THERMOLUMINESCENCE RESPONSE OF LIF:MG,TI (TLD-100).

An experimental investigation into the possibility of dose-rate effects and wall scatter in the thermoluminescent response of LiF:Mg,Ti (TLD-100) was carried out. The investigation was motivated by theoretical simulations predicting the possible presence of dose-rate effects coupled with the lack of detailed experimental studies. The dose rate was varied by changing the source to sample distance, by the use of attenuators, sources of 137Cs of various activities, filtration and the construction of identical geometrical irradiators of Teflon and stainless steel. Four levels of dose in the linear dose response region were studied at 10-2 Gy, 1.5 × 10-2 Gy, 0.1 Gy and 0.5 Gy to avoid complications in interpretation due to supralinearity above 1 Gy. At the dose of 1.5 × 10-2 Gy, the dose rate was varied by five orders of magnitude from 4.9 × 10-3 Gy s-1 to 4.9 × 10-8 Gy s-1. At the other levels of dose, a one to two orders of magnitude in dose rate was achieved. Within the measurement uncertainty of 5-10%, no dose-rate effects were observed in any of the experimental measurements and no changes in the shape of the glow curve were observed. The maximum wall scatter effect (Teflon to stainless steel) was measured at ~8% within the experimental uncertainty and well below expectations. The results are encouraging with respect to the accurate and reproducible use of LiF:Mg,Ti under various experimental conditions of irradiation.

INVESTIGATION OF THE TL CHARACTERISTICS OF COMPOSITE PEAK 5 IN THE GLOW CURVE OF LIF:MG,TI (TLD-100) USING NATURALLY AND FURNACE-COOLED SAMPLES FOLLOWING THE 400°C PRE-IRRADIATION ANNEAL.

The cooling rate to room temperature following the 400°C pre-irradiation anneal is known to affect the thermoluminescent properties of LiF:Mg,Ti (TLD-100) as a result of migration and clustering of defects during the cooling down process. In this investigation the dose response over an extended dose range from 0.01 to 7000 Gy in both naturally cooled and the much slower furnace-cooled samples has been measured. Glow curve deconvolution based on first-order kinetics is employed to extract the dose response of the various glow peaks. Of especial interest is the behaviour of glow peaks 4, 5a and 5 as a function of dose. The idea is to modify the supralinear dose response of peak 5 from 1 to 30 Gy to a linear behaviour. This dose range is important for clinical therapy and a linear dose response is of substantial advantage leading to both improved accuracy and precision.

Pediatric Epinephrine Auto-injector Accident Without Digital Ischemia.

Accidental finger sticks with EpiPens and EpiPen Jr (epinephrine auto-injectors) are a very real hazard in those who carry them and their families. The most feared complications are digital ischemia and necrosis; however, long-term adverse effects are extremely rare. Treatment for a finger stick is controversial, ranging from intra-arterial inj--ections of vasodilating agents to topical vasodilators to conservative management. We report a pediatric patient suffering from an EpiPen Jr accidental stick to the distal first digit who was successfully managed in a conservative fashion.

Obliterative Versus Reconstructive Prolapse Repair for Women Older than 70: Is There an Optimal Approach?

OBJECTIVES: This study aimed to evaluate outcomes among women 70 years and older who underwent obliterative compared with reconstructive procedures for pelvic organ prolapse. METHODS: This was a retrospective cohort study of patients 70 years and older who underwent surgical prolapse repair at our institution from January 2004 through June 2010. Only patients with at least 4 weeks of follow-up were included. Patient characteristics and relevant pre, intra, and postoperative information were abstracted from medical records. Severity of postoperative complications was classified using the Dindo surgical classification system. RESULTS: We analyzed 143 (97.3%) patients. Fifty-four (37.8%) women underwent an obliterative procedure, whereas 89 (62.2%) underwent a reconstructive procedure. Twenty-eight (31.5%) women who had a reconstructive surgery met our criteria for recurrent prolapse compared with only 5 (9.3%) women in the obliterative group (P = 0.002).The incidence of intraoperative complication was 4.9%, and the incidence of any postoperative complication was 62.9%. Similar proportions of women who underwent each type of procedure experienced a postoperative complication. However, the severity of the complications differed between the groups (P = 0.02). In particular, 16.9% of women who had a reconstructive procedure experienced a grade III complication according to the Dindo scale compared with 13.0% of women who had an obliterative procedure. CONCLUSIONS: The majority of women 70 years and older do not have high-grade complications after pelvic organ prolapse repair, but women who undergo reconstructive procedures are more likely to experience high-grade complications and recurrent prolapse compared with women who undergo obliterative procedures.

Botulinum toxin type A (BOTOX) for refractory myofascial pelvic pain.

OBJECTIVE: To assess intralevator botulinum toxin type A (Botox) injections for refractory myofascial pelvic pain with short tight pelvic floor. METHODS: Retrospective cohort study of all women with intralevator Botox injection (100-300 Units) from 2005 through 2010 for refractory myofascial pelvic pain. Primary outcomes were self-reported pain on palpation and symptom improvement. Secondary outcomes included postinjection complications and a second injection. Pain was assessed during digital palpation of the pelvic floor muscles using a scale of 0 to 10, with 10 being the worst possible pain. Follow-up occurred at less than 6 weeks after injection and again at 6 weeks or more. Data are presented as median (interquartile range) or proportion. RESULTS: Thirty-one patients met eligibility criteria; 2 patients were lostto follow-up and excluded. The median age was 55.0 years (38.0-62.0 years). Before Botox injection, the median pain score was 9.5 (8.0-10.0). Twenty-nine patients (93.5%) returned for the first follow-up visit; 79.3% reported improvement in pain, whereas 20.7% reported no improvement. The median pain with levator palpation was significantly lower than before injection (P<0.0001). Eighteen women (58.0%) had a second follow-up visit with a median pain score that remained lower than before injection (P<0.0001). Fifteen (51.7%) women elected to have a second Botox injection; the median time to the second injection was 4.0 months (3.0-7.0 months). Three (10.3%) women developed de novo urinary retention, 2 patients (6.9%) reported fecal incontinence, and 3 patients (10.3%) reported constipation and/or rectal pain; all adverse effects resolved spontaneously. CONCLUSIONS: Intralevator injection of Botox demonstrates effectiveness in women with refractory myofascial pelvic pain with few self-limiting adverse effects.

Microlaparoscopy in urogynecology: LSH and sacrocervicopexy.

STUDY OBJECTIVE: To determine the feasibility of using only microlaparoscopic (3.5 mm) accessory instruments for performing laparoscopic supracervical hysterectomy (LSH) and sacrocervicopexy with the aid of a transcervically placed cannula for introduction of mesh and needles. DESIGN: Retrospective evaluation of the first five cases of microlaparoscopic LSH with sacrocervicopexy (Canadian Task Force classification III). SETTING: Community teaching hospital affiliated with a major teaching hospital. PATIENTS: Five women with symptomatic uterovaginal prolapse of stage II or higher. INTERVENTIONS: LSH with transcervical morcellation followed by sacrocervicopexy with all 3.5 mm instruments using synthetic mesh with anterior and posterior extensions. MEASUREMENTS AND MAIN RESULTS: Four ports were made in all patients: a 5-mm infraumbilical port for the laparoscope and three 3.5-mm ports (right and left paraumbilical and suprapubic). LSH was performed using a 3-mm bipolar grasping device and reusable monopolar scissors. Resection of the uterus was also performed using monopolar scissors. Transcervical coring through the vagina was performed using a 15-mm serrated cylindrical blade with a central rod placed upward through the cervix, and transcervical morcellation was performed using an electromechanical morcellator. In all patients, sacrocervicopexy was performed successfully using Y-shaped polypropylene mesh, with PTFE sutures on the vagina and the sacral promontory. Reperitonealization over the mesh was performed using a running barbed absorbable suture. There were no intraoperative or postoperative complications in this group of patients. CONCLUSION: LSH and sacrocervicopexy using 3.5-mm accessory ports is a feasible procedure with the use of transcervical morcellation and a transcervical access cannula.

Do patient goals vary with stage of prolapse?

OBJECTIVES: To assess the relationship between stage of pelvic organ prolapse and self-expressed patient goals at initial urogynecologic evaluation. STUDY DESIGN: From February to December of 2010, women presenting for evaluation of pelvic floor disorders were asked to identify up to 5 goals for treatment. Charts were reviewed for demographics. Patients were grouped according to stage of prolapse and goals were grouped into 9 categories. RESULTS: Two hundred twenty-six women completed the questionnaire. Relief of urinary symptoms were the most commonly stated goal regardless of prolapse stage, pelvic organ prolapse quantitative-0 (59%), pelvic organ prolapse quantitative-I (78%), pelvic organ prolapse quantitative-II (55%), and pelvic organ prolapse quantitative-III (58%). Lifestyle, daily activity, and sexual function goals were the second, third, and fourth most common goals in all stages, respectively. CONCLUSION: Resolution of urinary symptoms, ability to perform daily activities, and sexual function goals are at least as important as resolution of prolapse symptoms and may be the reason for seeking care.

GPS-Prot: a web-based visualization platform for integrating host-pathogen interaction data.

BACKGROUND: The increasing availability of HIV-host interaction datasets, including both physical and genetic interactions, has created a need for software tools to integrate and visualize the data. Because these host-pathogen interactions are extensive and interactions between human proteins are found within many different databases, it is difficult to generate integrated HIV-human interaction networks. RESULTS: We have developed a web-based platform, termed GPS-Prot http://www.gpsprot.org, that allows for facile integration of different HIV interaction data types as well as inclusion of interactions between human proteins derived from publicly-available databases, including MINT, BioGRID and HPRD. The software has the ability to group proteins into functional modules or protein complexes, generating more intuitive network representations and also allows for the uploading of user-generated data. CONCLUSIONS: GPS-Prot is a software tool that allows users to easily create comprehensive and integrated HIV-host networks. A major advantage of this platform compared to other visualization tools is its web-based format, which requires no software installation or data downloads. GPS-Prot allows novice users to quickly generate networks that combine both genetic and protein-protein interactions between HIV and its human host into a single representation. Ultimately, the platform is extendable to other host-pathogen systems.

Crystal structure and magnetism of a well isolated 2D-quantum Heisenberg antiferromagnet, (Quinolinium)(2)CuBr(4).2H(2)O, and its anhydrous form.

Reaction of quinoline with HBr and CuBr(2) generates a mixture of two compounds, (quinolinium)(2)CuBr(4).2H(2)O (1) and (quinolinium)(2)CuBr(4) (2) for which single-crystal X-ray structures have been solved. Compound 1 crystallizes in the monoclinic space group C2/c as layers of tetrabromocuprate ions which are separated by intervening layers of quinolinium ions. Compound 2 crystallizes in the triclinic space group P1. Magnetic data analysis reveals that 1 behaves as a 2D-quantum Heisenberg antiferromagnet with 2J/k(B) = -6.17(3) K within the layers. High field magnetization data at low temperatures suggests that T(N) must be less than 1.8 K for 1, yielding a figure of merit |k(B)T(N)/2J| < 0.29, which indicates excellent isolation between the layers. Magnetic exchange in compound 2 was much weaker and was fit to a linear chain antiferromagnet with 2J/k(B) = -1.59(3) K.

Biologic and synthetic graft use in pelvic surgery: a review.

UNLABELLED: Urinary incontinence and pelvic organ prolapse are some of the most commonly treated conditions in postmenopausal women. Surgical cure rates vary greatly depending on surgical technique and the type of materials used, if any, to supplement the native tissue. Traditional colporrhaphy relies on adequate tissue for a successful repair. The main concern associated with traditional plication or needle suspension type repairs is that the use of intrinsic attenuated tissue may provide a weak, constricted, or an anatomically incorrect result. Graft use allows for a broader base of support and eliminates the need to rely on the existing weakened fascia and musculature. A review of the existing literature on success rates and complications with various synthetic and biologic graft materials yielded the following conclusions. The superiority of graft use over traditional suture suspensions for abdominal sacrocolpopexy and suburethral sling procedures has clearly been shown in the literature. Macroporous monofilament synthetic grafts and non-cross-linked biologic grafts appear to have the best integration into native tissues. Solvent dehydration and irradiation of biologic grafts may weaken the integrity of the material and may prevent proper tissue integration. Technical factors related to surgical technique may impact success rates, such as tension on suture line or failure to use vaginal packing. The perfect graft material has not yet been created. Suggestions for further research include more prospective, randomized trials comparing synthetic and biologic grafts, tension-free versus secured mesh, and absorbable versus nonabsorbable mesh. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to recall how common urinary incontinence is, explain the historical considerations for diagnosis and treatment, and summarize the updated methods of treatment based upon anatomical structures and pathophysiology.