A primary cutaneous carcinosarcoma of the retro auricular region, how to treat and literature review.

INTRODUCTION: Carcinosarcomas are malignant biphasic tumours of epithelial and mesenchymal tissue. They are most often found in visceral organs, but also appear on the skin. Older age, male sex and chronic sun exposure are risk factors for its development. In this article we report a case and provide a review of literature regarding primary cutaneous carcinosarcoma (CCS) with special regard to its management. MATERIAL AND METHODS: A manual electronic search of the PubMed Medline and Web of Science Core Collection databases was performed encompassing all included reports until 30th November 2022 to identify studies that reported primary CCS. RESULTS: CCS is a rare and aggressive tumour. Diagnosis requires histological examination and immunoreactivity of epithelial and mesenchymal components to specific markers. On its diagnosis, possibility of metastasis of a visceral carcinosarcoma should always be excluded. Surgical excision with clear margins, including the use of Mohs micrographic surgery (MMS), is the primary treatment for CCS. Reconstruction the excision defect should be performed. Regular follow-up for 5 to 10 years after initial treatment is advised. CONCLUSION: Awareness for CCS is necessary in the diagnostic evaluation of skin tumours. Further research is needed to better understand the underlying mechanisms of CCS and to establish optimal management strategies for this challenging malignancy. We recommend complete surgical excision using MMS as the treatment modality for this type of skin cancer. Dermatological follow-up for at least 5 years should be conducted to monitor for recurrence.

Emission factors of gaseous pollutants from recent kerosene space heaters and fuels available in France in 2010.

UNLABELLED: Laboratory measurements of the gaseous emission factors (EF) from two recent kerosene space heaters (wick and injector) with five different fuels have been conducted in an 8-m(3) environmental chamber. The two heaters tested were found to emit mainly CO(2), CO, NO, NO(2), and some volatile organic compounds (VOCs). NO(2) is continuously emitted during use, with an EF of 100-450 µg per g of consumed fuel. CO is normally emitted mainly during the first minutes of use (up to 3 mg/g). Formaldehyde and benzene EFs were quantified at 15 and 16 µg/g, respectively, for the wick heater. Some other VOCs, such as 1,3-butadiene, were detected with lower EFs. We demonstrated the unsuitability of a 'biofuel' containing fatty acid methyl esters for use with the wick heater, and that the accumulation of soot on the same heater, whatever the fuel, leads to a dramatic increase in the CO EF, up to 16 mg/g, which could be responsible for chronic and acute CO intoxications. PRACTICAL IMPLICATIONS: Our results show that in spite of new technologies and emission standards for unvented kerosene space heaters, as well as for the fuels, the use of these heaters in indoor environments still leads to NO(x) levels in excess of current health recommendations. Whereas injection heaters generate more nitrogen oxides than wick heaters, prolonged use of the latter leads to a soot buildup, concomitant with high CO emissions, which could be responsible for acute and chronic intoxications. The use of a biofuel in a wick heater is also of concern. Maintenance of the heaters and adequate ventilation of the room during use of kerosene space heaters are therefore of prime importance to reduce personal exposure.

Pyrene measurements in sooting low pressure methane flames by jet-cooled laser-induced fluorescence.

This paper presents in detail the study we carried out concerning the pyrene measurement by jet-cooled laser-induced fluorescence (JCLIF) in different sooting low pressure methane flames. The aim of this paper is both to demonstrate the potentialities of this technique for the measurement of such moderately sized polycyclic aromatic hydrocarbons under sooting flame conditions and to provide new experimental data for the understanding and the development of chemical models of the soot formation processes. Several concentration profiles of pyrene measured in different sooting flame (various pressure and equivalence ratio) are presented. The validation of the JCLIF method for pyrene measurements is explained in detail as well as the calibration procedure, based on the standard addition method, which has been implemented for the quantification of the concentration profiles. Sensitivity lower than 1 ppb was obtained for the measurement of this species under sooting flame conditions.

Measurement of the Neutron Lifetime by Counting Trapped Protons.

We measured the neutron decay lifetime by counting in-beam neutron decay recoil protons trapped in a quasi-Penning trap. The absolute neutron beam fluence was measured by capture in a thin (6)LiF foil detector with known efficiency. The combination of these measurements gives the neutron lifetime: τ n = (886.8 ± 1.2 ± 3.2) s, where the first (second) uncertainty is statistical (systematic) in nature. This is the most precise neutron lifetime determination to date using an in-beam method.

Cecal drop reflects the chickens' cecal microbiome, fecal drop does not.

Microbiota in the gastro-intestinal tract are closely related to both the intestinal and overall health of the host. Experimental chickens have always been euthanized in order to identify and quantify the bacteria in cecal content. In this study, quantification and identification of the microbial populations in cecal drop, cecal content and fecal drop samples from chickens showed that cecal drop contains a bacterial community that is very similar (concerning bacterial diversity, richness and species composition) to cecal content, as opposed to the bacterial community found in fecal drop. Cecal drop analysis thus allows for longitudinal experiments on chickens' cecal bacteria. The varying results in the analysis of fecal samples question the method's reliability in reflecting the true cecal microbiota in chickens.

Release of cardiac troponin I in antegrade crystalloid versus cold blood cardioplegia.

OBJECTIVE: The purpose of this study was to assess the efficacy of myocardial protection, comparing antegrade crystalloid cardioplegia with cold blood cardioplegia, in patients with preserved left ventricular function who were undergoing elective first coronary artery bypass grafting. Release of cardiac troponin I was used as a marker for the effectiveness of myocardial protection. METHODS: A consecutive series of 62 patients were randomly assigned to receive crystalloid or blood cardioplegia. Cardiac troponin I concentrations were determined in venous blood samples before the operation, immediately after unclamping, at 6, 9, 12, and 24 hours, and daily thereafter for 5 days. RESULTS: Rising levels of troponin I were found in all patients. The time course and peak release were similar in the crystalloid cardioplegia and the blood cardioplegia groups. No patients in either group had electrocardiographic evidence of perioperative myocardial infarction. Cardiac troponin I was able to detect small areas of myocardial damage, not revealed by electrocardiography or creatine kinase MB release. Aprotinin administration was associated with lower cardiac troponin I release in both groups. Cardiac troponin I was lower in patients whose conditions did not require electrical defibrillation after aortic unclamping, irrespective of cardioplegia type. The presence of a main stem lesion was associated with higher cardiac troponin I release only in the crystalloid cardioplegia group. CONCLUSIONS: Antegrade cold blood cardioplegia is equally effective as antegrade crystalloid cardioplegia in a randomized group of patients with preserved left ventricular function who were undergoing elective first coronary artery bypass grafting. Aprotinin administration resulted in lower cardiac troponin I release, whereas electrical defibrillation was related to a higher release irrespective of cardioplegia type. The presence of a main stem lesion resulted in higher cardiac troponin I release in the crystalloid cardioplegia group.

The effectiveness of preterm-birth prevention educational programs for high-risk women: a meta-analysis.

OBJECTIVE: To evaluate whether preterm-birth prevention educational programs are effective at reducing neonatal mortality, low birth weight (LBW), and preterm delivery. DATA SOURCES: A MEDLINE literature search of English-language studies was performed, supplemented by a bibliography search of original research and review articles to locate studies assessing preterm-birth prevention programs. METHOD OF STUDY SELECTION: We identified 31 studies that reported results from trials evaluating preterm-birth prevention programs. From this group, only the six randomized controlled trials evaluating preterm-birth prevention education programs satisfied criteria of homogeneity to be included in a meta-analysis. One of these six studies was a subset of another study and was excluded except when reporting outcomes that were not included in the larger report. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers assessed study methodology and identified the following outcomes: LBW frequency, preterm birth frequency, neonatal survival, birth weight, gestational age at delivery, and preterm labor diagnosis rates. When data were combined using meta-analytic techniques, no significant benefits were found for preterm-birth education programs in preventing neonatal death (cumulative relative risk [RR] 1.00, 95% confidence interval [CI] 0.99-1.01), LBW rates (RR 0.99, 95% CI 0.88-1.11), or preterm delivery rates (RR 1.08, 95% CI 0.92-1.27). The only statistically significant effect of preterm birth education programs appears to be an increase in the frequency at which preterm labor is diagnosed (RR 1.71, 95% CI 1.41-2.08). CONCLUSION: Preterm-birth prevention educational programs appear to have little benefit in reducing preterm birth and may result in an increased rate of diagnosis of preterm labor.

Pharmacological analysis of wild-type alpha, gamma and delta subtypes of the human peroxisome proliferator-activated receptor.

Three distinct peroxisome proliferator-activated receptor (PPAR) cDNAs were isolated from human brain RNA. Whereas the PPARdelta subtype perfectly matched the amino acid sequences reported in the Genbank database, several differences were found for the PPARalpha (Lys(123)Met, Ala(268)Val, Gly(296)Ala and Val(444)Ala) and PPARgamma2 (Met(8)Ile, Pro(9)Ala, Met(186)Ile, Pro(187)Ala and the deletion of a Gln(213) residue) subtypes. A pharmacological analysis was undertaken by co-expressing each PPAR subtype with a reporter plasmid containing a luciferase gene under the transcriptional control of a synthetic, triplicated PPAR response element in either HepG2 or Cos-7 cells. Whereas fenofibrate unselectively activated the PPARalpha and PPARdelta subtypes, the related BM-17.0744 compound was more potent and selective for PPARalpha. The thiazolidine dione derivatives rosiglitazone and pioglitazone were potent and selective PPARgamma2 agonists. L-165041, reported as a selective and potent PPARdelta ligand, displayed in this specified transactivation system, apart from its highly efficacious PPARdelta agonist activity, partial and full agonism at, respectively, PPARalpha and PPARgamma2 subtypes. In conclusion, transcriptional control of a luciferase gene by wild-type PPAR subtypes provides powerful recombinant assays to evaluate ligand's efficacy at these nuclear receptors.

Aerosolized furosemide in wheezy infants: a negative report.

We investigated the effects of 10 mg aerosolized furosemide on clinical score in 28 acutely wheezing infants (Part A) and in a second group of 20 intermittently wheezing babies on airway resistance and functional residual capacity during a symptomfree period (Part B), using a double-blind, placebo-controlled design. In both parts of the study no therapeutic effects were observed during and following aerosol inhalation of 10 mg furosemide.

Frontal absences in children.

In a cohort of 59 consecutive children referred for staring spells, we analysed clinical and electroencephalogram (EEG) characteristics in 23 children with both a history of absence seizures and a generalized spike and wave pattern during long-term video EEG monitoring. In 10 children, a frontal spike preceded the generalized spike and wave pattern. In the remaining 13 children, primary generalized spikes and waves were found. The frontal onset absences were clinically not different from primary generalized absences. The most striking difference between the two groups was the difficulty in controlling the absences in the frontal onset group and the high incidence of learning and behavioural problems in that group. The EEG analysis showed interictal, isolated epileptic discharges in 80% of the children with frontal onset absences. We believe that frontal onset absences should be considered as a secondarily generalized epilepsy syndrome, originating in the frontal regions.

The assessment of motor recovery: A new look at an old problem.

After nervous system damage, functional recovery usually occurs. It is of great clinical importance to follow the course of recovery and, when possible, predict the extent. This measurement and prediction of recovery is one of the main challenges facing clinicians today. The majority of assessment procedures currently employed, however, are impairment-oriented; that is, these procedures are oriented primarily at the disease or organ level. Until now, few procedures have been available that focus at the disability or behavioural level. This lack of disability-oriented assessment procedures hinders the development and evaluation of rehabilitation programmes, as impairment-oriented assessment scores have little relevance for the prediction of daily functioning. In this paper, a preliminary task-set is presented that may function as an impetus for the development of novel disability-oriented assessment procedures in neurological rehabilitation. Motor behaviour is not assessed in vacuo, rather as the end result of a continuous interaction between motor, sensory and cognitive processes. With this task set, it is possible to evaluate the changing influence of sensory and cognitive factors on the quality of motor performance over time. These changes, it is argued, are a crucial component of functional recovery.

Certification of the European reference soil set (IRMM-443--EUROSOILS). Part I. Adsorption coefficients for atrazine, 2,4-D and lindane.

The European Commission has characterised and certified a set of six European soils (the EUROSOILS) under the number IRMM-443. After a successful validation and trial period with a preliminary batch it was decided to produce a new batch of certified reference materials. Part I of this paper describes the certification of adsorption coefficients for atrazine, 2,4-D and lindane in these soils. The adsorption coefficients were determined according to OECD Test Guideline 106. Additionally, the underlying principles for the value assignment process according to the GUM and their practical application to the numerical data obtained during the certification exercise according to ISO Guide 34 and 35 are discussed.

Certification of the European Reference Soil Set (IRMM-443--EUROSOILS). Part II. Soil-pH in suspensions of water and CaCl2.

IRMM-443 re-groups a set of six European Reference Soils (EUROSOILS), which had been certified for their adsorption coefficients for atrazine, 2,4-D and lindane (Certification of the European Reference Soil Set (IRMM-443-EUROSOILS)-Part I. Adsorption coefficients for atrazine, 2,4-D and lindane. Sci Total Environ, in press). The certification of these parameters was complemented by an additional certification of pH in suspension as well by the determination of indicative values for total nitrogen, organic and total carbon content. While Part I explained the principles of the value assignment process and discussed their application to the adsorption coefficients, Part II presents the certified values for pH as well as the indicative values for N(tot), C(tot) and C(org). In addition, the assessment of uncertainty components for stability and homogeneity, which have been included in the final uncertainty budget, is discussed.

Preparation and certification of a reference material on PCBs in pig fat and its application in quality control in monitoring laboratories during the Belgian "PCB-crisis".

In this article, the production and validation of a new certified reference material "PCBs in animal fat" for the control of the maximum level of 200 ng/g setup by the European Communities for veterinary products from Belgium is described. Three materials are established: a blank, one material with about 100 ng/g and one with about 200 ng/g (sum of seven PCBs). Data on the production and certification are given. Additionally, this material was used as an unknown test material in the quality assurance program of the Belgium meat monitoring system (before the certification of the material). While the certification was performed with an uncertainty of less than 10%, the round robin exhibited larger deviations. However, these deviations were less than 20% for most of the 30 participating laboratories. Only two had significantly higher deviations.

IUPAC collaborative trial study of a method to detect genetically modified soy beans and maize in dried powder.

This paper presents results of a collaborative trial study (IUPAC project No. 650/93/97) involving 29 laboratories in 13 countries applying a method for detecting genetically modified organisms (GMOs) in food. The method is based on using the polymerase chain reaction to determine the 35S promotor and the NOS terminator for detection of GMOs. reference materials were produced that were derived from genetically modified soy beans and maize. Correct identification of samples containing 2% GMOs is achievable for both soy beans and maize. For samples containing 0.5% genetically modified soy beans, analysis of the 35S promotor resulted also in a 100% correct classification. However, 3 false-negative results (out of 105 samples analyzed) were reported for analysis of the NOS terminator, which is due to the lower sensitivity of this method. Because of the bigger genomic DNA of maize, the probability of encountering false-negative results for samples containing 0.5% GMOs is greater for maize than for soy beans. For blank samples (0% GMO), only 2 false-positive results for soy beans and one for maize were reported. These results appeared as very weak signals and were most probably due to contamination of laboratory equipment.

Experimental study and detailed modeling of toluene degradation in a low-pressure stoichiometric premixed CH4/O2/N2 flame.

Temperature and mole fraction profiles have been measured in laminar stoichiometric premixed CH4/O2/N2 and CH4/1.5%C6H5CH3/O2/N2 flames at low pressure (0.0519 bar) by using thermocouple, molecular beam/mass spectrometry (MB/MS), and gas chromatography/mass spectrometry (GC/MS) techniques. The present study completes our previous work performed on the thermal degradation of benzene in CH4/O2/N2 operating at similar conditions. Mole fraction profiles of reactants, final products, and reactive and stable intermediate species have been analyzed. The main intermediate aromatic species analyzed in the methane-toluene flame were benzene, phenol, ethylbenzene, benzylalcohol, styrene, and benzaldehyde. These new experimental results have been modeled with our previous model including submechanisms for aromatics (benzene up to p-xylene) and aliphatic (C1 up to C7) oxidation. Good agreement has been observed for the main species analyzed. The main reaction paths governing the degradation of toluene in the methane flame were identified, and it occurs mainly via the formation of benzene (C6H5CH3 + H = C6H6 + CH3) and benzyl radical (C6H5CH3 + H = C6H5CH2 + H2). Due to the abundance of methyl radicals, it was observed that recombination of benzyl and methyl is responsible for main monosubstitute aromatic species analyzed in the methane-toluene flame. The oxidation of these substitute species led to cyclopentadienyl radical as observed in a methane-benzene flame.

Effect of simulator training on driving after stroke: a randomized controlled trial.

BACKGROUND: Neurologically impaired persons seem to benefit from driving-training programs, but there is no convincing evidence to support this notion. The authors therefore investigated the effect of simulator-based training on driving after stroke. METHODS: Eighty-three first-ever subacute stroke patients entered a 5-week 15-hour training program in which they were randomly allocated to either an experimental (simulator-based training) or control (driving-related cognitive tasks) group. Performance in off-road evaluations and an on-road test were used to assess the driving ability of subjects pre- and post-training. Outcome of an official predriving assessment administered 6 to 9 months poststroke was also considered. RESULTS: Both groups significantly improved in a visual and many neuropsychological evaluations and in the on-road test after training. There were no significant differences between both groups in improvements from pre- to post-training except in the "road sign recognition test" in which the experimental subjects improved more. Significant improvements in the three-class decision ("fit to drive," "temporarily unfit to drive," and "unfit to drive") were found in favor of the experimental group post-training. Academic qualification and overall disability together determined subjects that benefited most from the simulator-based driving training. Significantly more experimental subjects (73%) than control subjects (42%) passed the follow-up official predriving assessment and were legally allowed to resume driving. CONCLUSIONS: Simulator-based driving training improved driving ability, especially for well educated and less disabled stroke patients. However, the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training.