A novel measurement system for assessing the nose in patients with cleft lip and palate (CLP).

Objective: The presented study shows a new and innovative method to determine nasal asymmetries in a simple way in patients with cleft lip and palate (CLP) in order to plan corrective surgery. Design: 86 non-syndromic patients with cleft lip and palate were divided into 2 groups: a) patients with unilateral cleft lip and palate b) patients with bilateral cleft lip and palate. Patients: follow-up of hospital records of 86 patients aged 2-18 years. Main outcome: Based on standardised photos of the nose from 3 different directions, the nose symmetry was assessed. A new digital measurement system was used, which is integrated into proven clinical programmes. These were compared with a control group. In addition, a mirror fog test and a standardised questionnaire were used. Result: The overall results showed a good symmetry of the nose postoperatively, as well as a high satisfaction of the patients and their parents. Profile and angle measurements showed a better result. Conclusio: The presented measurement system and especially the Cleft Lip Component Symmetry Index (CLCSI) allows an individual and very effective assessment of the symmetry of the nose as well as a control of the growth in patients with CLP. The method is easy to apply in daily practice, even for untrained practitioners.

Improvement of an Atomic Clock using Squeezed Vacuum.

Since the pioneering work of Ramsey, atom interferometers are employed for precision metrology, in particular to measure time and to realize the second. In a classical interferometer, an ensemble of atoms is prepared in one of the two input states, whereas the second one is left empty. In this case, the vacuum noise restricts the precision of the interferometer to the standard quantum limit (SQL). Here, we propose and experimentally demonstrate a novel clock configuration that surpasses the SQL by squeezing the vacuum in the empty input state. We create a squeezed vacuum state containing an average of 0.75 atoms to improve the clock sensitivity of 10000 atoms by 2.05_{-0.37}^{+0.34} dB. The SQL poses a significant limitation for today's microwave fountain clocks, which serve as the main time reference. We evaluate the major technical limitations and challenges for devising a next generation of fountain clocks based on atomic squeezed vacuum.

Satisfying the Einstein-Podolsky-Rosen criterion with massive particles.

In 1935, Einstein, Podolsky and Rosen (EPR) questioned the completeness of quantum mechanics by devising a quantum state of two massive particles with maximally correlated space and momentum coordinates. The EPR criterion qualifies such continuous-variable entangled states, where a measurement of one subsystem seemingly allows for a prediction of the second subsystem beyond the Heisenberg uncertainty relation. Up to now, continuous-variable EPR correlations have only been created with photons, while the demonstration of such strongly correlated states with massive particles is still outstanding. Here we report on the creation of an EPR-correlated two-mode squeezed state in an ultracold atomic ensemble. The state shows an EPR entanglement parameter of 0.18(3), which is 2.4 s.d. below the threshold 1/4 of the EPR criterion. We also present a full tomographic reconstruction of the underlying many-particle quantum state. The state presents a resource for tests of quantum nonlocality and a wide variety of applications in the field of continuous-variable quantum information and metrology.

High-precision tracking of sperm swimming fine structure provides strong test of resistive force theory.

The shape of the flagellar beat determines the path along which a sperm cell swims. If the flagellum bends periodically about a curved mean shape then the sperm will follow a path with non-zero curvature. To test a simple hydrodynamic theory of flagellar propulsion known as resistive force theory, we conducted high-precision measurements of the head and flagellum motions during circular swimming of bull spermatozoa near a surface. We found that the fine structure of sperm swimming represented by the rapid wiggling of the sperm head around an averaged path is, to high accuracy, accounted for by resistive force theory and results from balancing forces and torques generated by the beating flagellum. We determined the anisotropy ratio between the normal and tangential hydrodynamic friction coefficients of the flagellum to be 1.81+/-0.07 (mean+/-s.d.). On time scales longer than the flagellar beat cycle, sperm cells followed circular paths of non-zero curvature. Our data show that path curvature is approximately equal to twice the average curvature of the flagellum, consistent with quantitative predictions of resistive force theory. Hence, this theory accurately predicts the complex trajectories of sperm cells from the detailed shape of their flagellar beat across different time scales.

Consequences of long-term selenium-deficient diet on the prostacyclin and thromboxane release from rat aorta.

It is known that peroxides, which are increased during Se deficiency because of reduced glutathione peroxidase (GSH-Px) activity, can influence the prostacyclin I2/thromboxane A2 (PGI2/TXA2) ratio. In this study we analyzed the PGI2 and TXA2 formation of aortas of long-term Se-deficient rats. Despite low GSH-Px activity in the Se-deficient group, the basal PGI2 and TXA2 formation was not different versus control animals (PGI2: 2295+/-1134 pg/mg vs 2940+/-1134 pg/mg; TXA2: 3.83+/-1.06 pg/mg vs 5.67+/-2.99 pg/mg). However, we checked the capacity of the aortas of Se-deficient rats to compensate for a suddenly increased peroxide concentration. After peroxide stimulation, the PGI2 release was significantly lower in the Se-deficient group compared to the control group (PGI2: 3507+/-1829 pg/mg vs 7986+/-2636 pg/mg). Again, the TXA2 release did not show any differences. The release ratio of PGI2/TXA2 decreased under peroxide stress in Se-deficient animals. Although long-term Se deficiency showed a relatively well-balanced metabolism under resting conditions, sudden stress, accompanied by an excessive radical production, cannot be compensated.

Decreased oxidative stress in patients with idiopathic dilated cardiomyopathy one year after immunoglobulin adsorption.

OBJECTIVES: In a substudy to a recently reported investigation that demonstrated the benefit of immunoglobulin adsorption (immunoadsorption) for patients with idiopathic dilated cardiomyopathy (IDC), we tested whether this benefit is associated with a reduction of oxidative stress. BACKGROUND: The progression of cardiomyopathy is believed to be related to the increase of oxidative stress. Therefore, reduction of oxidative stress could be one of the effects of immunoadsorption for improvement of cardiac performance and clinical status. METHODS: Plasma markers for oxidative stress-thiobarbituric acid-reactive substances (TBARS), lipid peroxides (LPO), anti-oxidized low-density lipoprotein-autoantibodies (anti-oxLDL-AB), thiol groups and vitamin E-were compared in 31 patients, of whom 16 underwent immunoadsorption and 15 received conventional treatment (controls). All patients received a daily supplement of vitamins, minerals and trace elements. RESULTS: After one year, TBARS (p = 0.026), LPO (p = 0.026) and anti-oxLD

Increased level of HSP27 but not of HSP72 in human heart allografts in relation to acute rejection.

BACKGROUND: Increased expression of heat shock proteins (HSPs) was assumed during cardiac allograft rejection. To find evidence for this in man, we quantified HSP27 and HSP72 in cardiac allograft biopsies. METHODS: In parallel to histological assessment of rejection, HSP27 was quantified by Western blotting in a total of 43 biopsies sampled from 3 patients. HSP72 was analyzed in parallel in 30 of the 43 cases. For comparison, HSPs were analyzed in myocardium. RESULTS: HSP27 was significantly higher in rejecting cardiac allografts than in non-rejecting allografts and non-failing myocardium (1.52 +/- 0.25 vs. 0.83 +/- 0.11 vs. 0.50 +/- 0.05 microg/mg protein). Similarity for HSP72 (6.27 +/- 1.54 vs. 4.06 +/- 1.03 vs. 6.27 +/- 0.76 microg/mg protein) was not found. CONCLUSION: For the first time in humans with cardiac allograft rejection, increased expression of HSP27, which could be important for cardiac self-protection, was demonstrated. For the lack of increased HSP72 expression, the influence of the cyclosporine A treatment was discussed.

Results from the use of a preshaped lead for single-pass VDD/DDD stimulation.

Main criticisms about single-pass VDD stimulation in patients with AV block and normal sinus node function concern atrial undersensing in a lead with floating atrial electrodes, and loss of AV synchrony if sinus node dysfunction develops after implantation. We evaluated the concept of a preshaped single-pass lead designed to place the atrial ring electrodes in a constant position close to, or in contact with, the atrial wall. A preshaped lead (Model 2775, Medtronic Inc.) was implanted in 14 patients and followed for up to 2 years. Mean P wave amplitudes (PWAs) were 3.1 mV at implantation, 1.2 mV at predischarge, and 1.3 mV after 12 months. In all patients, minimal PWAs were well above maximal atrial sensitivity of the pacemaker in all body positions during the complete follow-up; atrial undersensing was not observed. Effective atrial stimulation was possible in all patients at implantation (mean stimulation threshold 2.5 V at 0.50 ms), in 11 patients on the first day after implant (mean stimulation threshold 0.22 ms at 5.0 V), in 10 patients after 1 month (mean stimulation threshold 0.57 ms at 5.0 V), and in 10 patients after 1 year (mean stimulation threshold 0.65 ms at 5.0 V). Intermittent phrenic nerve stimulation could be provoked in six patients. In conclusion, the concept of a preshaped single-pass lead facilitated implantation, improved atrial sensing performance, and allowed atrial stimulation in some patients. Still, further improvements are necessary to decrease the atrial stimulation thresholds to acceptable values in all patients.

The ratio of formation of prostacyclin/thromboxane A2 in HUVEC decreased in each subsequent passage.

In this study, we analyzed the antioxidative potential (SOD-, GSH-Px-activity) and the basal, H2O2- and ATP-stimulated formation of PGI2 and TXA2 in human umbilical vein endothelial cells (HUVEC) of different passages. The subcultivation of cells partly represents the process of aging. Both subcultivation of the cells and the H2O2 incubation did not significantly influence the activity of SOD and GSH-Px. H2O2 (0.1 mM and 1.0 mM) stimulated the generation of PGI2 and TXA2 in the cell passages time dependently. The formation ratio of PGI/TXA2 changed from 640:1 (0.1 mM H2O2) or 430:1 (1.0 mM H2O2, 40 min incubation) at the 1st passage, to 13:1 and 17:1, respectively, at the 4th passage. This resulted from the reduction of the PGI2 synthesis connected with more pronounced TXA2 formation. The same behavior was found in the basal and ATP-stimulated eicosanoid formation. Based on this, the age-dependent activation of the oxygen radical formation could be responsible for the modified eicosanoid metabolism resulting in vascular complications in the elderly.

Atrial inhibited pacing in the sick sinus node syndrome: clinical value and the demand for rate responsiveness.

A consecutive series of 66 patients (males = 32; mean age +/- SD = 71 +/- 9 years) given atrial inhibited pacemakers for sick sinus nodes were followed to study the incidence of lead failures, chronic atrial tachyarrhythmias, and atrioventricular conduction disturbances. The need for rate responsive pacing was also assessed. Pre and postoperative investigation could include carotid sinus massage, Holter monitoring, exercise testing, and invasive electrophysiology. The mean follow-up time +/- SD was 32 +/- 29 months (median = 26 months). Three patients (5%) had their pacemakers replaced due to lead failures (loss of sensing = 2; exit block = 1). Two pacemakers (3%) were replaced after 5 and 22 months due to atrial fibrillation. Four patients (6%) received new pacemakers because of development of second-degree or complete atrioventricular block after 1, 6, 12, and 31 months, respectively. During exercise, most patients (76%) responded with an increase in sinus rate at least as marked as that achievable with the currently available rate responsive pacemakers. Assuming careful patient selection, atrial inhibited pacing is well suited for many patients with sinus node dysfunction and preserved atrioventricular conduction. There is a limited need for rate responsive pacemakers in these patients.

[Kidney function in the course of compensatory hypertrophy following unilateral nephrectomy in the Wistar rat]. / Nierenfunktion im Verlauf der kompensatorischen Hypertrophie nach einseitiger Nephrektomie von Wistarratten.

Unilateral nephrectomy was performed in 109 male Wistar rats, 35 animals served as controls. Determinations of glomerular filtration rate (GFR) using slope clearance of 99mTc-DTPA and of tubular function using an orally water-loading test were made. The tests were performed 2 and 5 days as well as 2, 4, 5 and 6 weeks after nephrectomy. In all examinations the GFR was more than 50% of the level of two-kidney control animals. Fractional maximum diuresis was increased in the first 2 examinations after nephrectomy from 8.9 +/- 2.1 to 15.4 +/- 4.2% of the GFR and fractional clearance of osmotically free water from 6.8 +/- 1.9 to 10.9 +/- 3.5%. In the fourth and sixth week the proximal tubular reabsorption was increased and the glomerulo-tubular balance had been recovered. However, the minimal urine osmolarity was increased to 107.8 +/- 17.7 mmol/l and the osmotic load of the nephrons remained elevated. Possible clinical implications of the results are discussed.

Rate-responsive pacing by means of activity sensing versus single rate ventricular pacing: a double-blind cross-over study.

The clinical applicability of rate-responsive pacing (RRP) by means of activity sensing has been tested in 15 patients. The patients (ages 24-85) had sinus node dysfunction (2), atrial fibrillation (7), or sinus rhythm (6) combined with complete atrioventricular block. Exercise capacity was investigated on a bicycle ergometer and on a treadmill in a double-blind cross-over study design following one week each of fixed rate ventricular pacing (70 bpm) and rate-responsive pacing (60/125-150 bpm). The patients answered a questionnaire concerning subjective symptoms. A Holter ECG was recorded during 24 hours of all day activity on rate-responsive pacing. During exercise in the rate-responsive mode, heart rate increased more on the treadmill than on the bicycle. A majority of the patients (13 of 15) preferred rate-responsive pacing mainly due to less dyspnea and tiredness. Exercise capacity improved significantly both on bicycle (+7%; p less than 0.01) and on treadmill (+19%; p less than 0.01) during rate-responsive pacing. There were no complications during the follow-up period. In conclusion, the activity-sensing pacemaker is a valuable supplement to existing types of pacemakers. It should be used in patients in whom an atrial electrogram cannot be used for rate triggering.

[Kidney function in spontaneously hypertensive rats under minoxidil treatment]. / Nierenfunktion bei spontan hypertonen Ratten unter Minoxidilbehandlung.

In 25 spontaneously hypertensive rats the blood pressure was lowered from 192 +/- 11.6 to 130 +/- 11.7 mm Hg and in 26 normotensive Wistar rats from 129 +/- 9.1 to 107 +/- 6.7 mm Hg by applying 1 mg/kg body weight minoxidil twice a day orally. 19 spontaneously hypertensive and 21 normotensive rats served as untreated control groups. During the treatment the glomerular filtration rate, determined by the slope clearance of Tc-99m-DTPA, remained unchanged. Under maximal water diuresis the excretion fraction of sodium was diminished compared with the control data. The Na+ and water reabsorption was increased in the proximal tubules (not an aldosterone effect) only in the treated spontaneously hypertensive rats. The potassium clearance was increased in this group, but decreased in the treated normotensive group. The different reactions of the renal tubular function to the treatment with minoxidil in spontaneously hypertensive compared with normotensive rats were discussed in connection with changes of membrane transport in essential hypertension.

Long-term performance of endocardial leads with steroid-eluting electrodes.

During a three-year period, 48 steroid-eluting leads (Medtronic 4003 and 4503) have been implanted in 39 patients. 23 were implanted in the atrium and 25 in the ventricle. 36 patients with 45 leads have been observed for more than 12 months. Stimulation thresholds have been followed using pulse generators with variable output (vario): 12 atrial and 11 ventricular leads, 4 atrial leads and 11 ventricular leads have been followed using pulse generators with variable pulse-width (auto-threshold), P-waves have been followed using telemetry or sensitivity programming (23 atrial leads). R-waves have been followed using telemetry in 11 ventricular leads. Mean stimulation thresholds after 2 years are 0.7 V +/- 0.2 in the atrium and 0.8 V +/- 0.3 in the ventricle. P-waves after 2 years are of magnitudes allowing a sensitivity setting of 2.5 mV in 12 cases and of 1.5 mV in 2 cases; R-waves have in all cases been high enough to permit lowest programmable sensitivity setting. During the observation time, two patients have died from nonpacing-related causes. The results obtained from this investigation document low stimulation thresholds and good sensing levels in both ventricle and atrium using the steroid-eluting electrode with no significant changes after 6 weeks postimplant.

[Kidney function and bacteriological and histological research in the therapy of experimental E. coli pyelonephritis using trimethoprim-sulfamethoxazole (TMP-SMO)]. / Nierenfunktion, bakteriologische und histologische Untersuchungen bei Therapie der experimentellen E.-coli-Pyelonephritis mit Trimethoprim-Sulfamethoxazol (TMP-SMO).

40 uninephrectomized male Wistar rats with an experimental E.-coli-022-pyelonephritis (PN) were treated twice daily for 9 days with 30 mg trimethoprim and 150 mg sulfamethoxazole (TMP-SMO) i.p. Bacteriologically most of the kidneys became sterile. Histologically a significant reduction of the frequency of severe PN was found in the treated group. The biologic half-life of 131I-hippuran indicated a decrease of excretory function which was reversible. Urine osmolality and osmotic clearance were increased after oral water loading in 10 untreated control animals with PN but not in the treated group. The 9 day treatment had a favourable effect bacteriologically, histologically and also on renal function.

[Bacteriologic, histologic and functional studies of the kidney in 5 days' therapy of experimental E. coli pyelonephritis with gentamycin. Comparison with 9 days' therapy]. / Bakteriologische, histologische und Funktionsuntersuchungen der Niere bei 5tägiger Therapie der experimentellen E.-coli-Pyelonephritis mit Gentamycin. Vergleich mit 9tägiger Therapie.

Short-term antibiotic treatment is recommended in infections of the lower urinary tract but its effectiveness is questioned in the upper urinary tract infections. We compared a 5 and a 9 day treatment of experimental E. coli 022 pyelonephritis after unilateral nephrectomy in 127 mal Wistar rats. We used 9 mg gentamycin per kg b.w. twice daily. I131 hippurat excretion was not decreased during the 5 day treatment but was only temporarily diminished during the 9 day treatment. Histologically the severe acute pyelonephritis was decreased after the 9 day treatment but not after 5 days of treatment. Bacteriologically almost all the kidneys were sterile after the 9 day treatment but the majority of the kidneys showed the injected strain of E. coli after the 5 day treatment. The results indicated that the shortened treatment was much less effective in our acute experimental pyelonephritis.