Random lasing from optical fibers with phase separated glass cores.

A novel random laser, integrating a passive optical fiber with a phase separated aluminosilicate core-silica cladding as the feedback medium, is proposed and presented. The core exhibits greatly enhanced Rayleigh scattering, therefore requiring a significantly reduced length of scattering fiber (4 m) for lasing. With a Yb-doped fiber as the gain medium, the fiber laser operates at 1050 nm with low threshold power and possesses an output that can be amplified through conventional means. Furthermore, the laser was found to have a high degree of spatial coherence, spectral broadening with increasing input power, and temporal spectral variation. The facile setup and results herein pave the way for further study and applications based on low threshold random fiber lasers.

Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma.

BACKGROUND AND PURPOSE: MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. MATERIALS AND METHODS: A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma. All patients received noncontrast head CT, ultrafast brain MR imaging without sedation, and standard MR imaging with general anesthesia or an immobilizer, sequentially. Two pediatric neuroradiologists independently reviewed each technique blinded to other modalities for intracranial trauma. We performed interreader agreement and consensus interpretation for standard MR imaging as the criterion standard. Diagnostic accuracy was calculated for ultrafast MR imaging, noncontrast head CT, and combined ultrafast MR imaging and noncontrast head CT. RESULTS: Interreader agreement was moderate for ultrafast MR imaging (κ = 0.42), substantial for noncontrast head CT (κ = 0.63), and nearly perfect for standard MR imaging (κ = 0.86). Forty-two percent of patients had discrepancies between ultrafast MR imaging and standard MR imaging, which included detection of subarachnoid hemorrhage and subdural hemorrhage. Sensitivity, specificity, and positive and negative predictive values were obtained for any traumatic pathology for each examination: ultrafast MR imaging (50%, 100%, 100%, 31%), noncontrast head CT (25%, 100%, 100%, 21%), and a combination of ultrafast MR imaging and noncontrast head CT (60%, 100%, 100%, 33%). Ultrafast MR imaging was more sensitive than noncontrast head CT for the detection of intraparenchymal hemorrhage (P = .03), and the combination of ultrafast MR imaging and noncontrast head CT was more sensitive than noncontrast head CT alone for intracranial trauma (P = .02). CONCLUSIONS: In abusive head trauma, ultrafast MR imaging, even combined with noncontrast head CT, demonstrated low sensitivity compared with standard MR imaging for intracranial traumatic pathology, which may limit its utility in this patient population.

Paediatric necrolytic migratory erythema as a presenting sign of glucagonoma syndrome.

Glucagonoma syndrome is an extremely rare pancreatic neuroendocrine tumour often associated with necrolytic migratory erythema. While glucagonomas are neoplasms of adulthood, we report the first case in a paediatric patient. We present the case of a 15-year-old girl with a 4-year history of a rash, consistent with necrolytic migratory erythema, found to have a localized glucagonoma. Immediately following resection of the tumour, there was complete resolution of her rash and systemic symptoms. Detection of the cutaneous rash of necrolytic migratory erythema can aid in the early diagnosis of a glucagonoma, as well as the prevention of metastatic disease. To our knowledge, this is the first reported paediatric patient with glucagonoma syndrome.

Disseminated cutaneous mycobacterium avium complex in a person with AIDS.

A cutaneous Mycobacterium avium complex (MAC) infection is a rare infection that can occur through direct inoculation or via dissemination to the skin. We report an interesting case of disseminated cutaneous MAC infection in a 45-year-old man with acquired immunodeficiency syndrome (AIDS), currently treated with highly active antiretroviral therapy (HAART) and MAC prophylaxis.

Non-visible print set-off of photoinitiators in food packaging: detection by ambient ionisation mass spectrometry.

Direct analysis in real time coupled to time-of-flight mass spectrometry (DART/TOF-MS) was used to detect the non-visible set-off of photoinitiators on the food contact surface of three different packages. The samples were intentionally under-cured to provoke set-off. Twelve commercially available photoinitiators were included in the ink formulations including α-amino-, morpholino, and α-hydroxy benzophenones, thioxanthones, aryl-phosphine oxide and three polymeric versions of these. Major colours of the packages' prints were analysed, as well as the specific areas of the inner surface in contact with them. Larger quantities of photoinitiators were detected on the food contact areas in contact with the darker colours of the images. Speed-cure 7005 and 4-phenylbenzophenone were the compounds most susceptible to set-off in each of the samples by DART response. An identification protocol for unknown set-off compounds was tested, resulting in the set-off detection of diethylene glycol ethers, erucamide and acrylates, and confirmed by solvent extraction GC-MS analysis. Finally, DART/TOF-MS was scanned across transects of the food contact side of packages to map the presence of photoinitiators. Higher photoinitiator signals were observed in patterns corresponding to the printed image, suggesting DART/TOF-MS might "image" print set-off.

Assessing direct analysis in real-time-mass spectrometry (DART-MS) for the rapid identification of additives in food packaging.

The ambient ionization technique direct analysis in real time (DART) was characterized and evaluated for the screening of food packaging for the presence of packaging additives using a benchtop mass spectrometer (MS). Approximate optimum conditions were determined for 13 common food-packaging additives, including plasticizers, anti-oxidants, colorants, grease-proofers, and ultraviolet light stabilizers. Method sensitivity and linearity were evaluated using solutions and characterized polymer samples. Additionally, the response of a model additive (di-ethyl-hexyl-phthalate) was examined across a range of sample positions, DART, and MS conditions (temperature, voltage and helium flow). Under optimal conditions, molecular ion (M+H+) was the major ion for most additives. Additive responses were highly sensitive to sample and DART source orientation, as well as to DART flow rates, temperatures, and MS inlet voltages, respectively. DART-MS response was neither consistently linear nor quantitative in this setting, and sensitivity varied by additive. All additives studied were rapidly identified in multiple food-packaging materials by DART-MS/MS, suggesting this technique can be used to screen food packaging rapidly. However, method sensitivity and quantitation requires further study and improvement.

The subchronic oral toxicity of ethane, 1,2-bis(pentabromophenyl) (Saytex 8010) in rats.

Ethane, 1,2-bis(pentabromophenyl) (EBP; CAS no. 8452-53-9) dose levels of 0, 100, 320 and 1000 mg/kg/day administered to rats by gavage in corn oil for 90 consecutive days produced no compound-related clinical signs of systemic toxicity, ocular lesions, or alterations in urinalysis, clinical chemistry, and hematology values in the treated or recovery groups. No biologically or toxicologically significant differences were observed in body weights, body weight gains, and food consumption. Statistically significant differences were found between control and high-dose animals in mean absolute or relative liver weights. Histomorphological evaluation showed in male rats low-grade liver changes consisting of minimal to slight hepatocellular vacuolation (high-dose males) and minimal to slight centrilobular hepatocytomegaly (high- and possibly mid-dose males). These changes had resolved by the end of the 28-day recovery period. No treatment-related changes were found in the livers of female rats. No treatment-related histomorphologic changes were present in any of the other tissues examined in either sex, except for evidence of aspirated test article in individual rats. The 90-day EBP no-adverse-effect level in the rat was > or = 1000 mg/kg/day, and was consistent with that of the preceding 28-day study (no-effect level > or = 1250 mg/kg/day). EBP's lack of toxicity is likely related to poor bioavailability due to its high molecular weight and low solubility.

Remarkable spectator ligand effect on the rate constant of ligand substitution of (aqua)ruthenium(II) complexes.

The influence of two different di(1-pyrazolyl)alkane ligands on the rate constant of aqua ligand substitution of ruthenium(II) complexes with the formula [Ru(H2O)(L2)(tpmm)]2+ (L2 = di(1-pyrazolyl)methane (DPMet) or 2,2-di(1-pyrazolyl)propane (DPPro)) was investigated. A 9.4 x 10(5)-fold increase in the rate constant of ligand substitution at pH = 6.86 was observed when DPMet was replaced with DPPro. This remarkable increase was unexpected, considering that these bidentate ligands appear quite similar. To help lend insight into this dramatic spectator ligand effect, the activation parameters for the ligand substitution reactions were determined, and single-crystal X-ray data were collected on the structurally analogous (chloro)ruthenium(II) complexes, [Ru(Cl)(L2)(tpmm)]+. These results are discussed in the context of a heteroscorpionate effect exerted by the DPPro ligand.

The cytotoxicity of symmetrical and unsymmetrical bis(thiosemicarbazones) and their metal complexes in murine and human tumor cells.

A number of thiosemicarbazones have been tested previously and herein are included three bis(thiosemicarbazones) for comparison to the previous derivatives. In general the uncomplexed thiosemicarbazones were more potent in the cytotoxic screens than the bis(thiosemicarbazone) except in the murine L1210 and the human colon SW480 screens. Mode of action studies have only demonstrated slight differences in the effects of the two types of compounds on nucleic acid metabolism. The symmetrical and unsymmetrical bis(thiosemicarbazones) complexes of copper, nickel, zinc, and cadmium have been examined to compare them to the heterocyclic N(4)-substituted thiosemicarbazones metal complexes. These new derivatives demonstrated excellent activity against the growth of suspended lymphomas and leukemias although it should be pointed out that generally they were not as active as the copper complexes of N(4)-substituted thiosemicarbazones. Nevertheless, selected bis(thiosemicarbazones) complexes were active against the growth of human lung MB9812, KB nasopharynx, epidermoid A431, glioma UM-86, colon SW480, ovary 1-A9, breast MCK-7, and osteosarcoma Saos-2. In human HL-60 promyelocytic leukemia cells the complexes preferentially inhibited DNA and purine syntheses over 60 min. The regulatory enzyme of the de novo purine pathway, IMP dehydrogenase, appeared to be a major target of the complexes. However, minor inhibition of the activities of DNA polymerase alpha, PRPP-amido transferase, ribonucleotide reductase, and nucleoside kinases occurred over the same time period. No doubt these effects of the complexes on nucleic acid metabolism were additive since the d[NTP] pool levels were reduced after 60 min as was DNA synthesis. The symmetrical and unsymmetrical bis(thiosemicarbazones) and their metal complexes did not cause as severe DNA fragmentation as the heterocyclic N(4)-substituted thiosemicarbazone metal complexes; furthermore, their metabolic effects in the tumor cell were more focused on a single synthetic pathway.

Family practice training in Nepal.

BACKGROUND: This article describes the health care system in Nepal and the only existing family practice (general practice) training program in that country. The majority of doctors in Nepal still have no residency training, and a specialist focus pervades. The efforts of some leading educators in Nepal led to establishment of a family practice training program in 1982, and the program now enrolls 12 residents per year, half of whom are from India. Major obstacles in education, financing, and policy must be addressed before family practice can have a meaningful presence or effect on the health care in Nepal.

Management of the patient with congestive heart failure using outpatient, home, and palliative care.

Congestive heart failure is a chronic, debilitating illness, with increasing prevalence in the elderly. It is one of the most common causes for hospital admission, and associated treatment costs are estimated at $20.2 billion. Despite improved survival with medical therapy, beneficial effects on quality of life have not been consistently reported. In addition, optimum medical therapy, as recommended by evidence-based guidelines, are not always implemented. Counseling and education involving dietary modifications, activity recommendations, medication management, self-monitoring, prognosis, coping skills, social support, caregiver stress, and spiritual needs are critical components in the management of heart failure through initial diagnosis to end of life. Within the last decade, close follow-up for congestive heart failure has been associated with decreased hospitalizations, reduced hospital length of stay, improved functional status, better compliance, lower costs, and improved survival. Research trials have mainly been observational and small, and they have used different interventions. Little has been written regarding outpatient management of the patient with advanced congestive heart failure, and none of the current published guidelines addresses recommendations for the New York Heart Association class IV (other than for transplant candidacy). New models of close follow-up for chronic and advanced congestive heart failure should be investigated. These models could be implemented in urban and rural settings and be supported by private insurance or Medicare.

Synthesis and evaluation of copper radiopharmaceuticals with mixed bis(thiosemicarbazone) ligands.

Four "mixed" bis(thiosemicarbazone) derivatives of pyruvaldehyde were synthesized that incorporate two dissimilar thiosemicarbazone functions. The corresponding [67Cu]copper(II) complexes were prepared and evaluated as possible copper radiopharmaceuticals. The pyruvaldehyde-based mixed bis(thiosemicarbazone) ligands, CH3C[=NNHC(S)NHMe]CH[=NNHC(S)NHEt] (1), CH3C[=NNHC(S)NHMe] CH[=NNHC(S)NEt2] (2), CH3C[=NNHC(S)NHMe]CH[=NNHC(S)-cyclo-N(CH2)5] (3), and CH3C [=NNHC(S)NHMe]CH[=NNHC(S)-cyclo-N(CH2)6] (4), were obtained by reaction of the appropriate thiosemicarbazide derivative with pyruvaldehyde-2-N4-methylthiosemicarbazone (CH3C[=NNHC(S) NHMe]CHO). The 67Cu-labeled copper(II) complexes of ligands 1-4 were prepared and screened in a rat model to assess the potential of each chelate as a 62Cu-radiopharmaceutical for imaging with positron emission tomography. The 67Cu-complexes of ligands 1-4 exhibit significant uptake into the brain and heart 1 min following intravenous administration to rats. For the 67Cu-complexes of ligands 2, 3, and 4, the cerebral and myocardial uptake of 67Cu is two-to-threefold lower at 2 h than at 1 min postinjection, due to significant biological clearance of these 67Cu-chelates. However, the 67Cu-complex of 1 affords cerebral and myocardial uptake and retention comparable to that of [67Cu]Cu-PTSM in this model. Although the kinetics of this new agent appear attractive, ultrafiltration studies using solutions of dog and human serum albumin reveal that the 67Cu-complex of ligand 1, like Cu-PTSM, interacts more strongly with human albumin than dog albumin. Thus, this new agent would appear to offer no advantage over Cu-PTSM as a 62Cu-labeled tracer for evaluation of regional tissue perfusion.

Pediatric dermatology.

There are a great many disorders that can affect young animals in addition to those with a hereditary component. Still, it is important to consider genodermatoses whenever a young animal presents with dermatological lesions. Fortunately, most dermatological conditions that affect young pups and kittens carry a good prognosis for diagnosis and full recovery. It is, however, important to correctly identify those animals with a poor prognosis if for no other reason than to offer supportive genetic counseling to minimize the risk of the trait being perpetuated.

Modes of protein movement that lead to the asymmetric localization of partner of Numb during Drosophila neuroblast division.

Partner of Numb (Pon) colocalizes with the determinant Numb and is required for its proper asymmetric localization in Drosophila. How the asymmetric localization of Pon is accomplished is not well understood. Here, we show that Pon localization takes place at the protein level and that its C-terminal region is necessary and sufficient for asymmetric localization. Fusion of the Pon localization domain with green fluorescent protein (GFP) allowed monitoring of the localization process in living embryos. Upon a neuroblast's entry into mitosis, Pon is recruited from the cytoplasm to the cortex. Cortically recruited Pon can move apically or basally within the two-dimensional confines of the cortex. This movement can occur when myosin motor activity is inhibited. However, the restriction of Pon to the basal cortex requires both actomyosin and Inscuteable.

Increased height in patients with medulloblastomas.

OBJECTIVE: Medulloblastomas demonstrate histological features similar to neuroendocrine tumors. Expression of various receptors for growth factors and production of growth hormones have been identified to occur with medulloblastomas. We studied the preoperative height of patients with medulloblastomas. METHODS: We studied 85 patients (64 children and 21 adults) with medulloblastomas and 42 patients (27 children and 15 adults) with cerebellar astrocytomas who served as a control group. All of the patients had their height and weight documented on standardized growth charts. In addition, age, sex, symptoms, radiographic findings, treatment, and survival were examined. RESULTS: Preoperatively, 22.4% of the patients with medulloblastomas were above the 95% curve in height and 80.0% were above the 50% curve for height. Compared with patients with cerebellar astrocytomas, 7.1% were above the 95% curve for height and 54.8% were above the 50% curve for height. The distribution of patients along the weight curves for both tumor types demonstrated a slight prevalence for lower weights but was not significantly different from the national average. A significant number of patients presenting with medulloblastomas attained increased height, which was disproportionate to the weight loss generally observed with neoplasms. To our knowledge, the disproportionate number of patients with medulloblastomas and increased height has not been reported before. A similar deviation in height distribution from the normal population could not be identified in patients with cerebellar astrocytomas. CONCLUSION: This study suggests that medulloblastomas may be influenced by growth hormone production or may produce growth factors in vivo.