Self-organization threshold scaling for thermal atoms coupled to a cavity.

We make a detailed experimental study of the threshold for the self-organization of thermal 87Rb atoms coupled to a high-finesse cavity over a range of atom numbers and cavity detunings. We investigate the difference between probing with a traveling wave and a retroreflected lattice. These two scenarios lead to qualitatively different behavior in terms of the response of the system as a function of cavity detuning with respect to the probe. In both cases, we confirm a N(-1) scaling of the threshold with atom number.

Early identification of impaired myocardial reperfusion with serial assessment of ST segments after percutaneous transluminal coronary angioplasty during acute myocardial infarction.

To evaluate the relation between ST-segment analysis and microvascular reperfusion in patients with acute myocardial infarction (AMI), we studied 51 patients with first AMI who were successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The lead showing the greatest ST-segment elevation on the 12-lead electrocardiogram (ECG) was serially investigated until 24 hours after PTCA. Successful reperfusion was determined by technetium-99m tetrofosmin single-photon emission computed tomography. Impaired reperfusion (group 1: < 4 change in the sum of the defect score from before to immediately after PTCA) was observed in 24 patients, and successful reperfusion (group 2) was observed in 27 patients. Although ST-segment elevation was reduced significantly at 30 minutes after PTCA in group 2 (2.2 +/- 1.4 to 1.7 +/- 1.3 mm, p = 0.01), there was no significant change in group 1 (1.9 +/- 1.9 to 2.4 +/- 1.7 mm). Ten of 14 patients (71%) with persistent ST-segment elevation (DeltaST > 0 mm change in ST segment from before to 30 minutes after PTCA > 0) were in group 1, whereas 23 of 37 patients (62%) with ST-segment resolution (DeltaST < or = 0) were in group 2. The sensitivity and specificity of persistent ST-segment elevation for predicting impaired microvascular reperfusion were 42% and 85%, respectively. Thus, persistent ST-segment elevation 30 minutes after primary PTCA was a highly specific electrocardiographic marker of impaired reperfusion in patients with AMI.

Adjustable silicone gastric banding and band erosion: personal experience and hypotheses.

BACKGROUND: Adjustable silicone gastric banding (ASGB) has been advocated as a minimally invasive procedure that is completely reversible for the surgical treatment of morbid obesity. Band erosion (BE) is one of the possible complications of ASGB. The authors report their experience with BE and discuss its possible causes. METHODS: Between February 1993 and February 1998, the authors performed 122 ASGB: 51 open and 71 laparoscopic procedures. RESULTS: Two cases of BE occurred (1.6%). CONCLUSION: Band erosion is a possible complication of ASGB that is often not diagnosed immediately. Prevention is essential and consists primarily in correct placement of the band. There appears to be only one solution to BE: removal of the band. Placement of a new band after removal is possible; the minimum interval is not known.

The first year of the toxicology program.

The CAP Toxicology Survey Program's initial year is reviewed. Four series of samples, each consisting of five specimens with approximately 12 different drugs, were sent to almost 200 participants and as many as seven referees. They reported the presence or absence of more than 16 different compounds, and identified specific barbiturates when present. In each series, two serum samples were for qualitative identification and quantitative analysis. The remainder were urine samples for qualitative analysis. The aim of the survey is to enhance the "current state of the art" among participants. Drug-abuse toxicology and therapeutic monitoring of drugs were given priority. Clinically relevant samples reflecting current drug abuse, especially mixed-drug abuse, were provided, including serum for quantitative determination as is required in treatment of barbiturate overdose and for therapeutic drug monitoring. The Committee has interacted with participants by critiques of surveys, by questionnaires, and by responding to queries from participants.

Neuronal depletion in the globus pallidus of heroin addicts.

Decreased neuronal population densities are described in the globus pallidus of narcotic addicts. Toxicologic studies indicate mixed addiction to be frequent, but exposure to parenteral heroin is the only common factor. This permanent brain damage seems more likely to be caused by recurrent episodes of hypoxia during severe reactions to narcotics than to be related to direct neurotoxic effects of heroin. The lesion may account for some of the long term changes observed in addicts.

Identification of war victims from mass graves in Croatia, Bosnia, and Herzegovina by use of standard forensic methods and DNA typing.

The postmortem remains of sixty-one war victims were excavated from 6 mass graves in Bosnia and Herzegovina one and a half years after interment Using standard identification methods, including the matching of medical and dental records, the recognition of distinguishing characteristics such as the use of clothing and belongings, and video superimposition, 35 persons were identified. For the remaining 26 persons identification efforts continue. DNA typing was performed at the HLA DQA1 locus and five PM system loci. Results from DNA typing were confirmed by other methods. DNA profiles of family members of 150 missing persons are now being developed using the 6 loci. These DNA profiles will then be compared with those generated from the bone and teeth remains of the unidentified victims.

[Intestinal by-pass for obesity (author's transl)]. / Intestinale kortsluiting voor obesitas

Obese people, more than 45 kg above their ideal weight, can be treated by an intestinal by-pass. This operation must be reserved for patients where conservative treatment failed, where there is no organic origin, and given the operative risk be not increased by underlying serious disease. Good pre- and postoperative collaboration of the patient together with clinical and biological controls are essential. The operation consists of an end-to-side jejuno-ileostomy with proximal suture of the blind loops; or an end-to-end jejuno-ileostomy with implantation of the blind loops in the colon. Loss of weight to near ideal plus improvement of diabetes, hypertension, gout and hyperlipaemia can be expected. Diarhea will occur for a few months or one year. Biochemical values usually remain stable: values for lipids decrease to lower normal if elevated before the operation. During fast weight loss, there are changes in the liver structure and hepatic tests; these are transient and reversible.

Laparoscopic transperitoneal mesh repair of inguinal hernia. A preliminary review of 120 cases.

From april 1992 to april 1994 we performed 120 laparoscopic transperitoneal hernia repairs using a polypropylene mesh. This paper is a preliminary review of the method we used and our results. We operated upon 105 patients including 40 direct, 79 indirect and 1 femoral hernias. The inguinal region is approached transperitoneally through 3 trocars placed in the lower abdominal region. A dissection of the pre-peritoneal inguinal space is performed and a 14 x 8 cm mesh is fixed using a stapling device. We have had some peroperative complications (injury to the epigastric vessels and the vas deferens, bowel injury), mainly in our early experience with this new technique. Postoperative complications consisted of minor problems (scrotal seroma and induration of the spermatic cord) 3 infections, 1 patient with prolonged pain and 1 recurrence. Some of these problems can be resolved by adjusting the technique. There seems to be less postoperative pain and a shorter convalescence period allowing active persons to return to work earlier than with classic herniorrhaphy. Since this is a new technique, no definite conclusions can be drawn at the moment.

Kind strangers? Physicians through the eyes of Tennessee Williams.

In Louisiana, Tennessee Williams is usually thought of as a famous denizen of the French Quarter or perhaps as our greatest playwright. Medicine rarely enters into it. Illness, however, particularly mental illness, shaped much of Williams' life and his work. The playwright had mixed feelings about physicians and their effect on his life and that of his close relations. These feelings worked their way into his plays. Through it all Williams gives a vivid, humorous, and deeply truthful image of the doctor-patient relationship in the first half of the twentieth century. Here we give a brief review of medicine in Williams' work.

Serum adiponectin level is not only decreased in metabolic syndrome but also in borderline metabolic abnormalities.

OBJECTIVE: Along with the increasing prevalence of obesity and related diseases, particularly atherosclerotic diseases, metabolic syndrome (MetS) is now a common and major public health issue in many countries around the world. Adiponectin, a protein secreted by the adipose tissue, has become recognized as a key player in the development of MetS. These days, not only MetS but also borderline metabolic/physiological abnormalities, such as impaired fasting glucose, high normal blood pressure and high normal plasma cholesterol, have been reported to be risk factors for atherosclerotic disease. Therefore, we undertook this study to determine the relationship between adiponectin and borderline metabolic/physiological abnormalities, as well as MetS. DESIGN: A cross-sectional study performed from April 2007 to November 2009. SUBJECTS: In 16 892 Japanese adults (10 008 men and 6884 women), we examined the relationship between the serum adiponectin concentration and borderline metabolic/physiological abnormalities or MetS by a questionnaire survey about medical treatment, body size measurement and measurement of laboratory parameters including the serum adiponectin concentration. RESULTS: Adiponectin showed a significant negative correlation with the number of MetS components. In subjects without overt diabetes mellitus, hypertension or dyslipidemia, the adiponectin concentration also showed a significant negative correlation with the number of borderline metabolic abnormalities. CONCLUSION: The decrease of circulating adiponectin may start before the development of diabetes mellitus, hypertension, dyslipidemia or MetS. Adiponectin is an important biomarker for reflecting the adverse influence of visceral fat in persons with MetS, and also in these subclinical states.