Immune suppression and isolated severe head injury: a significant clinical problem.

In the developed world, trauma is the principal cause of death under the age of 40 and is the third largest overall killer. In the UK, approximately 25,000 people die each year as a result of major injury, 25% as a result of head injuries alone. Despite improved diagnosis and management, infection remains the commonest complication in those patients surviving the initial injury. Some 5% are reported to die as a result of septic complications. Prolonged periods of intensive care and respiratory support predispose to infective respiratory complications. These patients in the absence of significant systemic injury and, as a result of severe head injury, are unable to mount an effective immune response. This literature review examines the changes that have been reported to occur in the immune system following isolated severe head injury and explores the relationship these changes may have to the increased development of infective complications.

Earth rotation measured by lunar laser ranging.

The estimated median accuracy of 194 single-day determinations of the earth's angular position in space is 0.7 millisecond (0.01 arc second). Comparison with classical astronomical results gives agreement to about the expected 2-millisecond uncertainty of the 5-day averages obtained by the Bureau International de l'Heure. Little evidence for very rapid variations in the earth's rotation is present in the data.

The Lunar Laser Ranging Experiment: Accurate ranges have given a large improvement in the lunar orbit and new selenophysical information.

The lunar ranging measurements now being made at the McDonald Observatory have an accuracy of 1 nsec in round-trip travel time. This corresponds to 15 cm in the one-way distance. The use of lasers with pulse-lengths of less than 1 nsec is expected to give an accuracy of 2 to 3 cm in the next few years. A new station is under construction in Hawaii, and additional stations in other countries are either in operation or under development. It is hoped that these stations will form the basis for a worldwide network to determine polar motion and earth rotation on a regular basis, and will assist in providing information about movement of the tectonic plates making up the earth's surface. Several mobile lunar ranging stations with telescopes having diameters of 1.0 m or less could, in the future, greatly extend the information obtainable about motions within and between the tectonic plates. The data obtained so far by the McDonald Observatory have been used to generate a new lunar ephemeris based on direct numerical integration of the equations of motion for the moon and planets. With this ephemeris, the range to the three Apollo retro-reflectors can be fit to an accuracy of 5 m by adjusting the differences in moments of inertia of the moon about its principal axes, the selenocentric coordinates of the reflectors, and the McDonald longitude. The accuracy of fitting the results is limited currently by errors of the order of an arc second in the angular orientation of the moon, as derived from the best available theory of how the moon rotates in response to the torques acting on it. Both a new calculation of the moon's orientation as a function of time based on direct numerical integration of the torque equations and a new analytic theory of the moon's orientation are expected to be available soon, and to improve considerably the accuracy of fitting the data. The accuracy already achieved routinely in lunar laser ranging represents a hundredfold improvement over any previously available knowledge of the distance to points on the lunar surface. Already, extremely complex structure has been observed in the lunar rotation and significant improvement has been achieved in our knowledge of lunar orbit. The selenocentric coordinates of the retroreflectors give improved reference points for use in lunar mapping, and new information on the lunar mass distribution has been obtained. Beyond the applications discussed in this article, however, the history of science shows many cases of previously unknown, phenomena discovered as a consequence of major improvements in the accuracy of measurements. It will be interesting to see whether this once again proves the case as we acquire an extended series of lunar distance observations with decimetric and then centimetric accuracy.

Laser ranging retro-reflector: continuing measurements and expected results.

After successful acquisition in August of reflected ruby laser pulses from the Apollo 11 laser ranging retro-reflector (LRRR) with the telescopes at the Lick and McDonald observatories, repeated measurements of the round-trip travel time of light have been made from the McDonald Observatory in September with an equivalent range precision of +/-2.5 meters. These acquisition period observations demonstrated the performance of the LRRR through lunar night and during sunlit conditions on the moon. Instrumentation activated at the McDonald Observatory in October has yielded a precision of +/-0.3 meter, and improvement to +/-0.15 meter is expected shortly. Continued monitoring of the changes in the earth-moon distance as measured by the round-trip travel time of light from suitably distributed earth stations is expected to contribute to our knowledge of the earth-moon system.