[Innovative laser technologies in the treatment of urolithiasis : A change to more gentle methods with increased patient safety]. / Innovative Lasertechnologien in der Harnsteintherapie : Ein Wandel zu schonenderen Methoden mit hoher Patientensicherheit.

Management of urolithiasis has undergone fundamental changes with the introduction of extracorporeal shock wave lithotripsy (ESWL) and percutaneous and ureterorenoscopic techniques in the 1980s. Since then, these minimally invasive techniques have been continuously optimized and specific laser techniques for stone disintegration have emerged. Besides the established holmium laser, other types of lasers are also emerging. Especially the thulium fiber laser is the subject of promising research due to its variable adjustment options. In terms of patient safety, both holmium and thulium techniques seem to be similar . While serious direct physical lesions are rare, there is increasing evidence of clinically relevant secondary thermal injury due to increased temperatures in the upper urinary tract during treatment. Our research group has recently demonstrated in both in vitro and in vivo (porcine animal model) experiments that monitoring the fluorescence spectra of calculi allows precise target differentiation between stone, tissue, and endoscope components. Consequently, pulse emissions were only emitted when stone material was detected. We believe that target monitoring will minimize the risk of laser-induced urothelial damage and decrease energy release into the upper urinary tract allowing adequate temperature management.

New functional pavements for pedestrians and cyclists.

When many fields of pedestrian and cyclist safety have been extensively studied, the surfacing has long been left unquestioned, despite being developed for another mode of transport and being one of the main causes for falls and fall injuries. In this project new surfacing materials for pedestrian and cyclist safety have been produced. Focusing on augmenting previously largely disregarded parameters as impact absorption, comfort and visibility at the same time as avoiding deteriorating of crucial parameters as friction and wear resistance. Rubber content, binder type, and pigment addition have been varied and evaluated. The results demonstrate that by increasing rubber content of the mixtures the head injury criterion (HIC) value and injury risk can be decreased while maintaining frictional properties according to existing criteria. Assembly of test-lanes demonstrate that some developed materials experience lower flow and component separation than standard materials due to rubber addition, calling for further optimisation of construction procedure linked to content development. Initial trials on the test-lanes indicate that a polyurethane (PU) based material has high cycling comfort, visibility and can be modified with phosphorescence properties. For standard asphalt, impact absorption might be inflicted by modification of bitumen alone but is mostly augmented by rubber addition. The results also indicate that rubber content can decrease ice formation on the materials.

Growth promoting hormonal implant pellets coated with a polymeric, porous film promote weight gain by grazing beef heifers and steers for up to 200 days.

Two studies evaluated growth promoting effects of implant pellets (IP), each containing 3.5 mg estradiol benzoate (EB) and 25 mg trenbolone acetate (TBA), to which a polymeric, porous coating was applied. Trial 1 evaluated performance of heifers (n = 70/treatment, initial BW = 188 ± 2.2 kg) and steers (n = 70/treatment, initial BW = 194 ± 2.2 kg) implanted subcutaneously in the ear with 0 (SC), 2 (2IP), 4 (4IP), or 6 (6IP) pellets that delivered EB/TBA (mg/mg) doses of 0/0, 7/50, 14/100, and 21/150, respectively, over grazing periods of 202 d (heifers) or 203 d (steers). Animals received experimental treatments on d 0 and over the grazing period were managed as single groups by sex in a rotational grazing system. When pasture forage availability became limited, cattle were supplemented with preserved forage but not concentrate supplements. Weight gains by heifers treated with 2IP, 4IP, and 6IP were greater (P < 0.05) than SC heifers but not different from each other. Weight gains by steers treated with 2IP, 4IP, and 6IP were greater than SC steers (P < 0.05), and ADG by steers treated with 6IP was greater (P < 0.05) than steers given 2IP or 4IP. Trial 2 was a multisite grazing study performed with heifers and steers to compare ADG after treatment with one 6-pellet, coated implant delivering 21 mg EB and 150 mg TBA (6IP) to sham treated negative controls (SC) over a grazing period of at least 200 d. A completely random design was used at each site, with the goal to treat 70 cattle per site, treatment, and sex; data were pooled across sites. Heifers (n = 558, initial BW = 229 ± 16 kg) and steers (n = 555, initial BW = 235 ± 20 kg) grazed in rotational programs consistent with regional practices for an average of 202 d. When necessary, cattle were supplemented with preserved forage, but no concentrate supplements were fed. Over 202 d, ADG by heifers treated with 6IP was 11.3% greater (P = 0.0035) than SC heifers (0.64 ± 0.06 kg/d), and ADG by steers treated with 6IP was 17.2% greater (P = 0.0054) than SC steers (0.66 ± 0.08 kg/d). In neither study was there evidence that concurrent therapeutic treatments or abnormal health observations were influenced by experimental treatments. These studies demonstrated that a 6-pellet implant with a polymeric, porous coating that delivers 21 mg EB and 150 mg TBA improved ADG by grazing heifers and steers for at least 200 d compared to sham-implanted negative controls.

Effects of estradiol benzoate and trenbolone acetate, alone or in combination at dose levels present in Synovex Choice, on performance by feedlot heifers.

Trials were conducted with beef heifers at 4 sites to evaluate feedlot performance and carcass characteristics in response to implants containing 14 mg estradiol benzoate and 100 mg trenbolone acetate (EB/TBA; Synovex Choice, Zoetis LLC, New York, NY), 14 mg estradiol benzoate (EB), 100 mg trenbolone acetate (TBA), or a sham-implanted control (SC). The study design at each site was a randomized complete block with 12 blocks and 4 treatments. Blocks of cattle at each site were harvested in commercial abattoirs when masked personnel estimated at least 60% of animals would yield carcasses with USDA quality grades of Choice or Prime. Data were pooled across sites for statistical analysis. Initial BW averaged 374 kg, and days on feed ranged from 98 to 126 d (mean 112 d). Heifers implanted with EB/TBA, EB, and TBA had greater ADG and G:F (P < 0.05) than SC; ADG and G:F were greater for EB/TBA than EB or TBA (P < 0.05). Heifers treated with TBA had greater G:F than EB (P < 0.05). Feed intake was not affected by treatments. Mean HCW and LM area for EB/TBA were greater than for other treatments (P < 0.05). Mean HCW for TBA was greater than SC (P < 0.05) but not different from EB. Mean LM area for EB and TBA were greater than SC (P < 0.05) but not different from each other. There were no treatment differences (P > 0.05) for KPH, 12th-rib fat thickness, or yield grade. Dressing percent was greater for EB/TBA than SC (P < 0.05) but not different from EB or TBA. Marbling score was decreased by EB/TBA (P < 0.05) compared with other treatments, but no other differences were noted. Despite the effect of EB/TBA on marbling scores, there were no significant (P > 0.05) treatment differences on proportions of carcasses with quality grades ≥ Choice vs. < Choice. With respect to ADG and G:F, implants containing EB, TBA, or EB/TBA produced improved responses over SC. Furthermore, EB/TBA induced greater ADG and G:F responses than EB and TBA. Results confirmed that EB and TBA have additive effects, as evidenced by the observation that calves implanted with EB/TBA had significantly greater ADG and G:F than heifers implanted with either EB or TBA alone or compared with SC heifers.

Synovex Plus implants coated with a polymeric, porous film improve performance of beef steers and heifers fed in confinement for up to 200 days.

Synovex Plus (SP) is a product that delivers 28 mg of estradiol benzoate (EB) and 200 mg of trenbolone acetate (TBA). We studied the impact of a polymeric, porous coating on SP implants (CSP) to prolong release of EB and TBA, and stimulate feedlot performance of feedlot cattle for an extended period. In an explant study, 30 steers were implanted with SP in one ear and CSP in the contralateral ear. Cattle (n = 6/d) were necropsied 40, 81, 120, 160, and 200 d after treatment, and remaining EB and TBA were quantified. Linear regression of EB and TBA remaining as a function of time for each treatment were computed. Rates of EB and TBA depletion from SP were -0.1980 (r(2) = 0.9994) and -1.7073 mg/d (r(2) = 0.9644), respectively, and for CSP rates of EB and TBA depletion were -0.1049 (r(2) = 0.9123) and -0.9466 mg/d (r(2) = 0.9297), respectively. The effect of treatment on depletion rates of each analyte were significant (P < 0.05). Data also showed EB and TBA were delivered from CSP at least 200 d but were delivered from SP about 120 d. Multisite trials with beef-type steers (4 sites) and heifers (4 sites) evaluated feedlot performance and carcass characteristics in response to a CSP implant or when sham implanted (SC). A randomized complete block design with 9 blocks and 2 treatments was used per site within animal gender. Across sites, steers (n = 342, BW = 297 kg) were fed finishing rations for 190 to 202 d (mean 198 d) and heifers (n = 342, BW = 289 kg) were fed finishing rations for 191 to 201 d (mean 198 d). Cattle were harvested and carcasses evaluated. Data were pooled across sites within gender for statistical analysis. Steers and heifers treated with CSP yielded greater (P ≤ 0.003) ADG, DMI, and G:F than SC steers and heifers. Mean BW differences between CSP and SC continued to increase throughout the study, indicating CSP stimulated growth of steers and heifers for 198 d. Mean carcass weights of CSP steers (P = 0.005) and heifers (P = 0.004) were greater than those of SP steers and heifers by 26.2 and 20.6 kg, respectively. The LM area was larger (P < 0.001) in CSP steers and heifers than SC cattle. Marbling decreased with CSP treatment (P ≤ 0.031), which caused reductions (P ≤ 0.006) in proportions of carcasses grading Prime or Choice. Evidence from these studies showed that a single administration of CSP increased feedlot cattle performance for at least 198 d, compared with SC, and may reduce the need to reimplant cattle.

Crystallization and preliminary X-ray crystallographic studies of recombinant thermoresistant gluconate kinase GntK from Escherichia coli.

The thermoresistant gluconate kinase GntK from Escherichia coli, an essential enzyme in gluconate metabolism, has been expressed, purified and crystallized. For crystallization, the hanging-drop vapour-diffusion method was used with polyethylene glycol (PEG) 6000 and lithium chloride as precipitants. Three crystal forms belonging to the monoclinic space group C2 or the orthorhombic space groups P2(1)2(1)2(1) and P2(1)2(1)2 were obtained. The unit-cell parameters are a = 75.0, b = 79.3, c = 70.2 A, beta = 105.3 degrees (C2), a = 52.0, b = 79.3, c = 89.8 A (P2(1)2(1)2(1)) and a = 70.1, b = 74.1, c = 78.9 A (P2(1)2(1)2). In all three crystal forms, there are two molecules in the asymmetric unit; the different forms occur in the same crystallization drop. The crystals diffract to at least 2.0 A using synchrotron radiation.

Anterior cingulate metabolism correlates with stroop errors in paranoid schizophrenia patients.

UNLABELLED: Using [O-15]-H(2)O PET Carter et al. (1997) reported that medicated patients with schizophrenia performing computerized single trial Stroop (1935) showed a reduction in the anterior cingulate activation response to the more attention demanding, incongruent Stroop condition. In that study, both patients and controls also showed a direct correlation between anterior cingulate activation and errors committed during incongruent trials of the task. In this study we follow up with an examination of paranoid schizophrenia outpatients and controls with very high resolution positron emission tomography (PET) and the longer half-life tracer [F-18]-fluorinated deoxyglucose (FDG) (Valk et al. 1990). All subjects (10 controls and 9 paranoid schizophrenia patients) were studied with FDG-PET while performing a computerized trial-by-trial version of the Stroop task during the uptake phase of the tracer (Carter et al. 1992). RESULTS: As in previous studies using the single trial Stroop, patients were able to perform the task but made more color-naming errors during incongruent trials than controls. The patients in the present study showed a trend towards increased metabolic activity in the right anterior cingulate cortex. In the patient group, but not in controls, the anterior cingulate glucose metabolic rate correlated positively with the total incongruent trial errors. CONCLUSION: These results are consistent with the hypothesis that the anterior cingulate plays a performance-monitoring role during human cognition. This study does not rule out a reduction in error sensitivity in this region of the brain in schizophrenia, as other studies have suggested, however the data show that in unmedicated patients with the paranoid subtype this function is preserved to some extent.

Augmentation of hormonal activities with antibodies from cattle immunized with a combination of synthetic and recombinant growth hormone peptide.

Antibodies generated against a synthetic growth hormone (GH) peptide in a number of animal species were shown to enhance the efficacy of GH. However, the ability to produce the effective antibodies diminished over time and repeated boosters failed to overcome the hurdle. Therefore, this study was designed to address the issue on the failed antibody responses by employing different GH peptide antigen preparations in cattle. Holstein steers were repeatedly immunized with a synthetic peptide corresponding to an amino acid sequence 54-95 of porcine GH (pGH). The peptide was conjugated to ovalbumin (OVA) as a carrier. Animals initially responded to the antigen well and elicited antibodies specific to the peptide. However, the 4th challenge with the same OVA-peptide antigen rendered animals unresponsive, resulting in a decline in antibody production. This unresponsiveness was overcome by switching the antigen at the 5th immunization from OVA-peptide to a recombinant peptide preparation which was composed of maltose binding protein (MBP) as a carrier. Antibodies generated in cattle after the 5th immunization recognized not only the pGH(54-95) peptide, but also bovine GH (bGH) and pGH. These antibodies were not immunoreactive with an unrelated control peptide. Hypophysectomized (hypox) rats were used for functional analysis and bGH was active in promoting the growth of these GH-deficient rats. The growth-promoting effect of bGH was significantly enhanced by mixing it with bovine anti-peptide antibodies prior to administration. Therefore, the present findings suggest that peptide 54-95 induces cattle to elicit antibodies capable of not only recognizing bGH but also augmenting the somatogenic effectiveness of bGH in hypox rats.

Augmentation of hormonal activities with antibodies from cattle immunized with a combination of synthetic and recombinant growth hormone peptide.

Antibodies generated against a synthetic growth hormone (GH) peptide in a number of animal species were shown to enhance the efficacy of GH. However, the ability to produce the effective antibodies diminished over the time and repeated boosters failed to overcome the hurdle. Therefore, this study was designed to address the issue on the fallen antibody responses by employing different GH peptide antigen preparations in cattle. Holstein steers were repeatedly immunized with a synthetic peptide corresponding to an amino acid sequence 54-95 of porcine GH (pGH). The peptide was conjugated to ovalbumin (OVA) as a carrier. Animals initially responded to the antigen well and elicited antibodies specific to the peptide. However, the 4th challenge with the same OVA-peptide antigen rendered animals unresponsive, resulting in a decline in antibody production. This unresponsiveness was overcome by switching the antigen at the 5th immunization from OVA-peptide to a recombinant peptide preparation which was composed of maltose binding protein (MBP) as a carrier. Antibodies generated in cattle after the 5th immunization recognized not only the pGH(54-95) peptide, but also bovine GH (bGH) and pGH. These antibodies were not immunoreactive with an unrelated control peptide. Hypophysectomized (hypox) rats were used for functional analysis and bGH was active in promoting the growth of these GH-deficient rats. The growth-promoting effect of bGH was significantly enhanced by mixing with bovine anti-peptide antibodies prior to administration. Therefore, the present findings suggest that peptide 54-95 induces cattle to elicit antibodies capable of not only recognizing bGH but also augmenting the somatogenic effectiveness of bGH in hypox rats.

The effects of antipsychotic medication on sequential inhibitory processes.

The authors used a Stroop negative priming paradigm to examine the effects of antipsychotic medication on selective attentional processes. The performance of 14 patients with schizophrenia who were withdrawn from neuroleptic medication was compared with that of 10 medicated patients and 16 matched controls. Results demonstrated an increase in negative priming to normal levels with neuroleptic therapy. In contrast, within-trial interference and facilitation effects appeared to be less sensitive to medication therapy. The sustainment of inhibitory processes over time may differentiate the inhibitory mechanisms of the medication-withdrawn patients from both the medicated patients and the matched controls. The study of sequential inhibitory processes and their response to neuroleptic treatment could be important methods for understanding the temporal parameters associated with inhibition in schizophrenia.

Enhancement of the insulin antagonistic effect of porcine somatotropin in swine using a monoclonal antibody.

A monoclonal antibody (mAb), PS-7.6, to porcine somatotropin (pST) significantly enhanced the growth responses to pST injections in hypophysectomized (hypox) rats but could not be tested in pigs because of the large quantity of antibody required for a growth trial. Because pST inhibits the hypoglycemic effects of insulin, an insulin tolerance test procedure was established to measure pST activity in jugular-catheterized pigs. Doses of 0, 30, 100, and 300 micrograms/kg per day of pST were split and administered subcutaneously (sc) in equal portions twice daily for 2 d. After a 17-hr fast, plasma samples were obtained at 10-min intervals for 30 min before an intravenous injection of insulin (0.08 IU/kg) and then for an additional 50 min. Because pST increased fasting plasma glucose concentrations, preinsulin glucose values were used as a covariate to adjust the postinsulin concentrations. pST caused a dose-dependent increase in resistance to the insulin injection in these pigs. The areas under the curves (AUC), for plasma glucose were 22.1, 29.0, 39.0, and 47.2 mg/dl per min for the 0, 30, 100, and 300 micrograms/kg pST doses, respectively. Because different doses of pST could be detected, the PS-7.6 enhancement of pST treatment was evaluated. In the first experiment, five pigs/group each received sc injections of either vehicle, pST (75 micrograms/kg; approximately 3.0 mg/d), pST (75 micrograms/kg) + PS-7.6 at 3.75 mg/kg, or pST (75 micrograms/kg) + PS-7.6 at 15 mg/kg for 2 d before the insulin test. The pST and PS-7.6 were combined and incubated for at least 1 hr at room temperature before being injected. The injection of pST alone did not significantly change insulin tolerance activity (23.1 vs. 21.1, AUC), but insulin resistance was enhanced when this dose of pST also included PS-7.6 (27.4 and 29.5, AUC, respectively; P < 0.05). In a second experiment, the effects of PS-7.6 and PS-4.2, a mAb that did not potentiate the pST-stimulated growth of hypox rats, were compared. The five pigs/treatment received either vehicle, pST (75 micrograms/kg), pST (75 micrograms/kg) + PS-7.6 (3.75 mg/kg), or pST (75 micrograms/kg) + PS-4.2 (3.75 mg/kg) for 2 d. The administration of pST increased the resistance to insulin (26.7 vs. 18.8, AUC; P < 0.01), which was markedly potentiated by PS-7.6 (54.3, AUC, P < 0.001) but not affected by PS-4.2 (27.6 AUC). The injection of PS-7.6 at 7.5 mg/kg without exogenous pST did not alter the sensitivity to insulin. These results indicate that PS-7.6, but not PS-4.2, enhanced the insulin antagonistic activity of pST in swine, suggesting that an enhancement of pST-stimulated growth would also occur in PS-7.6-treated pigs.

Immunological effect of a synthetic growth hormone peptide on the growth performance in swine.

A mouse monoclonal antibody (mAb), designated PS-7.6, was previously shown to enhance the activity of porcine growth hormone (pGH) in promoting the growth of hypophysectomized (hypox) rats. Epitope mapping studies indicated that the region recognized by PS-7.6 resided within an amino acid sequence 54-95 of pGH. A peptide corresponding to this sequence was synthesized and found to induce swine antibodies capable of augmenting pGH activity in hypox rats. On the basis of these previous observations, an attempt was made in this study to determine whether or not the peptide pGH(54-95) could be used as a vaccine to elicit antibodies functionally similar to PS-7.6 mAb, thus potentiating the efficacy of endogenous GH in swine. Young pigs (15-20 kg) were immunized with pGH(54-95) that had been conjugated with ovalbumin (OVA) and boosted twice at 4-week intervals. Control animals were similarly immunized with OVA. The weight gains and feed consumption of these animals were closely monitored throughout the trials. A number of carcass parameters were also examined when these animals reached 110-120 kg, at which time they were killed. Results indicated that immunization with peptide significantly accelerated the daily weight gain during the growing phase of growth. However, this effect disappeared during the finishing phase of growth. The failure to prolong the initial growth effect by the peptide immunization apparently correlated with the kinetics of antibody production, because antibodies immunoreactive to the peptide and pGH were detected in these animals after immunization but gradually diminished. This idea was supported by the fact that antibodies obtained from pigs 5 and 9 weeks after the initial immunization potentiated the activity of pGH in hypox rats, whereas antibodies harvested at week 16 did not. Furthermore, carcass evaluation was performed at time of killing and showed that the leaf fat and loin eye muscle were also significantly improved by peptide immunization. Taken together, the present findings suggest that pGH(54-95) peptide can be employed as a potential growth-promoting vaccine to improve the performance of swine.

Growth failure in children with inflammatory bowel disease: a prospective study.

BACKGROUND: Growth failure frequently complicates the clinical course of inflammatory bowel disease (IBD) in children. This study was designed to investigate the role of disease activity versus steroid therapy on growth faltering in this disorder. METHODS: We studied growth failure and its relationship to disease activity and steroid therapy in 69 children who have IBD by prospectively monitoring height for a maximum of 3 years. Disease activity and steroid use were recorded at entry into the study. RESULTS: The prevalence of growth failure was 24%, 23%, and 39% by height velocity, Z score, and height-for-age criteria, respectively; deficits were equally prevalent regardless of the stage of pubertal development. A delay in linear growth persisted throughout puberty and was not reversed after surgery. Patients who had Crohn's disease were twice as likely to have growth abnormalities than patients who had ulcerative colitis. We detected significant negative associations between linear growth and disease activity but not steroid therapy. CONCLUSIONS: In a unique group of children, growth failure is an early, "prepatterned" manifestation of IBD. The inflammatory process, rather than steroid use, has a predominant influence on the development of growth faltering.

Development and validation of the Perinatal Nursing Self-Efficacy Scale.

Self-efficacy, a central construct of Bandura's social cognitive theory, provided the framework for developing a measure of perinatal nursing knowledge and skills. The 24-item Perinatal Nursing Self-efficacy Scale (PNSE) encompasses knowledge and skills required of nurses practicing in family-centered single room maternity care (SRMC) settings. Response data from 188 registered nurses were evaluated to assess the reliability and construct validity of the instrument. The instrument demonstrated strong factorial validity and subscales derived from the factor analysis generated high alpha reliabilities. A MANOVA produced results consistent with the propositions of self-efficacy theory and supported construct validity. Since self-efficacy expectations are situation specific and have significant predictive value, they provide both an important adjunct to needs assessment data for educational planning and helpful baseline data for outcome evaluation of perinatal nursing educational programs and transitions to SRMC settings.

Cervical synapse-dependent somatosensory evoked potential following posterior tibial nerve stimulation.

We have demonstrated the presence of a localized, synapse-dependent negativity (N29) recorded over the upper cervical spine after bilateral stimulation of the posterior tibial nerves at the ankle. The amplitude of N29 is maximal at the level of the second cervical spine and decreases at more rostral and caudal levels. The peak latency of N29 remains constant at all levels. N29 has a long refractory period when compared with the refractory period of the afferent volley recorded at either the sacral or thoracic level. N29 is most likely generated by activation of the nucleus gracilis by the afferent volley. The cervical N13 after median nerve stimulation probably has multiple generator sites, including the nucleus cuneatus.

Effect of movement on human spinal and subcortical somatosensory evoked potentials.

Sensory transmission in dorsal column nuclei is inhibited during voluntary movement in experimental animals. We have studied the human response by recording spine and scalp somatosensory evoked potentials. Finger movement attenuated the amplitude and duration of the cervical N13 and the scalp N18 and N20 waves. Foot movement did not alter the lumbar N22 after foot stimulation, but the scalp P38 was attenuated. N22 results solely from activation of interneurons in the dorsal gray of the cord at the root entry zone, but N13 may receive contributions from the nucleus cuneatus. Therefore, the movement-induced attenuation of N13 is attributed to decreased contribution from the nucleus cuneatus.