Stability of flocculated particles in concentrated and high hydrophilic solid layer-by-layer (LBL) emulsions formed using whey proteins and gum Arabic.

The objective of the present study was to investigate flocculation in layer-by-layer (LBL) emulsion systems with high total solids content and deflocculation at various pH conditions, and the effects of whey protein isolate (WPI) concentration and total solids content on the stability of LBL emulsions. WPI (1.96% (1WPI) or 10.71% (10WPI), w/w in water) was prepared in water and high-pressure homogenized with sunflower oil (10%, w/w, of total emulsion). Gum Arabic (0.15%, w/w, in total emulsion) was added to assemble electrostatically on WPI at oil particle interfaces at pH3.5 using aqueous citric acid (10% w/w) forming LBL emulsion. The ζ-potential measurements showed charge reversal upon addition of gum Arabic solution into single layer (SL) emulsion confirming the formation of LBL interface. Trehalose:maltodextrin mixture (1:1, w/w, total emulsion, 28.57% (28) or 57.14% (57), w/w, in water) was used in the continuous phase. The high total solids content of the system results in depletion flocculation of the particles leading to bridging flocculation without coalescence as deflocculation into individual particles occurred with increasing pH from pH3.5 to pH6.5 in 10WPI systems. Deflocculation was evident in 10WPI-28 and 10WPI-57 as found from a decreased ζ-average diameter and visually under microscope. Coalescence was observed in 1WPI systems. Viscosity of the systems was significantly (P<0.05) increased with higher total solids content. Accelerated destabilization test showed that systems at higher WPI and total solids contents exhibited the highest stability against creaming. Deflocculation in LBL systems can be controlled by pH while high solids in the aqueous phase provide stability against creaming.

Comparison of novel 6.5 Fr sheathless guiding catheters versus 5 Fr guiding catheters for transradial coronary intervention.

AIMS: To assess the safety and efficacy of a novel sheathless (SH) 6.5 Fr (French) hydrophilic-coated guiding catheter (GC) compared to the standard 5 Fr GCs in transradial coronary interventions (TRI). METHODS AND RESULTS: Patients undergoing TRI with 6.5 Fr SH or 5 Fr GCs were included. Baseline characteristics and in-hospital outcomes were recorded. Primary endpoints were procedural success and presence of radial pulse at discharge. Secondary endpoints were successful GC support, in-hospital adverse events, access-site complications, procedural duration and contrast load. There were 269 patients with 146 procedures in each group. The SH GC group had more non-ST elevation MI, in-stent restenosis, high-risk and bifurcation lesions. Procedural success in both arms was 95.2%. One patient in each group (0.7%) experienced radial artery occlusion (RAO) after TRI, without clinical sequelae. One access-site haematoma and one minor stroke occurred in the 5 Fr group (none in the SH group, both p=ns). Mean procedure time (52±21 vs. 45±21 minutes, p=0.004) and contrast load (160±45 ml vs. 140±45 ml, p=0.003) were greater in the SH group. CONCLUSIONS: Both 6.5 Fr SH GCs and 5 Fr GCs achieved high procedural TRI success with low RAO rates. The SH GC eliminated the disadvantages of the 5 Fr GC whilst maintaining the advantage of low RAO rates, and may become the GC of choice in TRI.

Coronary-pulmonary arteriovenous fistula used as proximal anastomotic site for saphenous vein grafts in patient with porcelain aorta.

Coronary artery bypass grafting in patients with porcelain aorta and calcified great vessels is associated with a high risk of systemic embolism. Various techniques have been suggested to minimize that risk. We describe the case of a patient with left main coronary disease and a severely calcified ascending aorta, who could not undergo cardiopulmonary bypass. To the best of our knowledge, this is the 1st reported use of a congenital coronary-pulmonary arteriovenous fistula as a proximal anastomotic site for saphenous vein grafts, to achieve optimal revascularization in a patient with porcelain aorta.

Treatment of refractory symphysitis pubis with intravenous pamidronate.

Osteitis pubis is a noninfectious painful inflammatory disorder of the symphysis pubis. Etiologic factors include urologic procedures, abdomino-perineal and gynecological surgery, and spondyloarthropathies, although many cases are idiopathic. Most respond to conservative measures consisting primarily of rest and analgesic/antiinflammatory agents. We describe 3 cases, 2 with idiopathic osteitis pubis and one that was associated with a spondyloarthropathy, that failed to respond to conservative measures but experienced clinical remission with 3 to 6 monthly courses of intravenous pamidronate. Remission was also evident in 2 patients on isotope bone scan. Followup has revealed no recurrence. Intravenous pamidronate may constitute a safe and effective treatment option for patients with refractory osteitis pubis.

Human adjuvant disease revisited: a review of eleven post-augmentation mammoplasty patients.

OBJECTIVES: We have reviewed 11 women post-augmentation mammoplasty who were referred to our clinic with diffuse rheumatic complaints. All patients had undergone mammoplasty with silicone gel-filled implants prior to the onset of their locomotor symptoms (mean latency time 7.8 years). One physician interviewed and examined each of these patients following a standardized format for clinical retrieval. RESULTS: Of the patients reviewed, 6 patients had clinical fibromyalgia based on the ACR criteria, and the remaining 5 patients had symptoms consistent with the "chronic fatigue syndrome." None of our patients were found to have evidence of a defined connective tissue disease. Antinuclear antibodies were detected in 4 (36%) patients and low level titres of extractable nuclear antigens in only 2 (18%). CONCLUSIONS: Previously a causal relationship between the use of silicone gel-filled breast implants and the subsequent development of symptoms referred to as human adjuvant disease (HAD) has been proposed. On the basis of currently accepted criteria we have preferred to diagnose our post-mammoplasty patients without specific connective tissue disease, as having chronic fatigue syndrome (CFS), or when tender points are present, as having fibromyalgia (FMS), rather than implying that such cases represent a separate and unique rheumatological disease entity. In the light of our current understanding of CFS and FMS, a relationship between them and the previous silicone mammoplasty seems possible.

Successful reversal of neutropenia in Felty's syndrome with recombinant granulocyte colony stimulating factor.

We report two patients with Felty's syndrome and chronic skin ulcers treated successfully with recombinant granulocyte colony stimulating factor (GCSF). In both cases granulocytes returned to the normal range within days of starting treatment, and their cutaneous ulcers improved. In one patient granulocytes were maintained at normal levels with a regimen of GCSF 3 micrograms/kg twice weekly for 14 months.

Laboratory tests in the rheumatic disease.

Because the pathophysiologic relationship between laboratory and clinical abnormalities in many of the rheumatologic diseases is still not clearly understood, the use of the investigations dealt with in this article is based only upon statistics. The interpretation of these tests is therefore highly dependent on the result of the initial clinical assessment. Having accepted this limitation, however, the rheumatologist has available a number of powerful tools which may be used to diagnose, classify, or prognosticate.

Comparison of an EMG-controlled prosthesis and the normal human biceps brachii muscle.

An electromyographically-controlled elbow prosthesis, the "Boston arm", was tested with constant and sinusoidally-modulated inputs under different loading conditions. These tests were used to determine the frequency response of the EMG amplifier, the range of motor speeds, the force-velocity curve, and the frequency response of the prosthesis for cyclic movements. Human biceps muscle was tested during movements under similar loads, and under isometric conditions using random, electrical stimuli to determine its frequency response. The results were compared to evaluate the performance of the prosthesis and contrast its characteristics to those of the physiological system it replaces. The prosthesis minimizes quiescent power drain, and the possibilities of instability or "tremor" by employing velocity control, an overdamped mechanical system, and an electrical "dead-band". These factors limit the ability of the prosthesis to follow rapidly changing inputs or to move rapidly and accurately to a desired position. These comparisons should provide a useful supplement to the usual clinical evaluations, and a starting point for further improvements in prosthesis design.