Splenogonadal fusion in an 18-month-old.

BACKGROUND: Splenogonadal fusion is rare abnormal congenital connection of splenic tissue and gonad. It commonly presents with either cryptorchidism or as a palpable mass. As a benign anomaly, orchiectomy is often unnecessary. Removal of the splenic component may be accomplished with preservation of the testicle. METHODS: An 18-month-old boy presented with right cryptorchidism and left retractile testicle. Laparoscopic examination found a viable right testicle, and a successful orchiopexy was performed. The left testicle demonstrated splenogonadal fusion. Discontinuous accessory splenules were noted along the path of testicular descent. After confirmation from a radionucleotide liver-spleen scan the patient was brought back to the operating room for open excision of the adherent splenic tissue and orchiopexy of the testicle via an open inguinal approach. CONCLUSION: Splenogonadal fusion is a rare condition, but may be suspected in children with cryptorchidism or palpable peri-testicular mass. As with the present patient, in most cases the splenic tissue may be successfully excised without injury to the testicle.

Physicochemical properties and aroma volatile profiles in a diverse collection of California-grown pomegranate (Punica granatum L.) germplasm.

Colorful antioxidant-rich fruits often convey astringency and sourness that juice consumers may not appreciate. We assessed properties in juices from a collection of California-grown pomegranate from the National Clonal Germplasm Repository. The goal was to evaluate overall differences in germplasm with quality traits classified as sweet, sweet-sour and sour. Previous relationships noted in sweet and sour cultivar attributes were observed. Wonderful generally clustered with sweet-sour and sour cultivars. Sweet low acid cultivars occasionally clustered closely with Wonderful which is hard to rationalize. The dominant compounds were 3-hexenol and 1-hexanol which allowed separation of Kara Gul, Haku-botan and Wonderful. Aldehyde and terpene content can be used to characterize cultivars. The study represents the first data on variation in juice qualities in different sweet, sweet-sour and sour cultivars, grown in California, compared with Wonderful. Data may help the juice industry better select raw juice materials in order to ultimately satisfy consumers.

Nanoparticle catalysts for proton exchange membrane fuel cells: can surfactant effects be beneficial for electrocatalysis?

Platinum (Pt) nanoparticles were prepared in aqueous dispersion using the non-ionic surfactant nonylphenolethoxylate (NP9) and the cationic surfactant tetradecyltrimethylammonium bromide (TTAB). The surfactants were added to give colloidal stability. Such species are generally considered to block electrochemical active sites and to be undesirable for the oxygen reduction reaction (ORR). However, the procedures used to remove them are likely to cause particle aggregation. The purpose of this work was to investigate the effect of surfactants on Pt ORR performance. The nanoparticles prepared using NP9 showed good oxygen reduction performance when compared with the commercial Pt/C catalyst TKK, without removing the surfactant. In contrast, Pt nanoparticles prepared using the cationic surfactant TTAB showed very poor ORR performance, exemplifying the importance of careful surfactant selection in catalyst synthesis.

Configuration of microbially synthesized Pd-Au nanoparticles studied by STEM-based techniques.

Bimetallic Pd-Au particles synthesized using Desulfovibrio desulfuricans bacteria are characterized using scanning transmission electron microscopy (STEM) with a high-angle annular dark field (HAADF) detector combined with energy dispersive x-ray (EDX) silicon drift detector (SDD) elemental mapping and plasmon electron energy-loss spectroscopy (EELS). When combined with EDX, theoretical considerations or EELS, the atomic-number contrast (Z-contrast) provided by HAADF-STEM is effective in characterizing the compositional configuration of the bimetallic nanoparticles. Homogeneous mixing and complex segregations have been found for different particles in this work. The EELS study has also found different behaviours corresponding to surface plasmon resonances in different regions of a single particle due to its heterogeneity and anisotropy. HAADF-STEM tomography has been performed to obtain three-dimensional (3D) visualization of the nanoparticles.

Vascular programming in twins: the effects of chorionicity and fetal therapy for twin-to-twin transfusion syndrome.

We assessed vascular programming in genetically identical monochorionic twin pairs with twin-to-twin transfusion syndrome (TTTS) treated differently in utero by serial amnioreduction or fetal laser arterial photocoagulation. This case-control study re-assessed four twin groups at median 11 years comprising 20 pairs of monochorionic diamniotic twins: nine treated by amnioreduction (TTTS-amnio) and eleven by laser (TTTS-laser) with seven monochorionic and six dichorionic control pairs. Outcome measures were current blood pressure (BP), brachio-radial arterial stiffness derived from pulse wave velocity (PWV), resting microcirculation (Flux) and response to heating and post-occlusive reactive hyperaemia measured using laser Doppler. Potential confounders [PWV and BP at first study, current height, weight, heart rate and twin type (ex-recipient, ex-donor or heavier/lighter of pair)] were accounted for by Mixed Linear Models statistical methodology. PWV dichorionic > monochorionic (P = 0.024); systolic and diastolic BP dichorionic > TTTS-amnio and TTTS-laser (P = 0.004, P = 0.02 and P = 0.005, P = 0.02, respectively). Within-twin pair pattern of PWV discordance was similar in laser treated and dichorionic controls (heavier-born > lighter), opposite to TTTS-amnio and monochorionic controls. Flux monochorionic > dichorionic (P = 0.044) and heavier > lighter-born (P = 0.024). TTTS-laser and dichorionic diamniotic showed greatest hyperaemic responses (dichorionic > TTTS-amnio or monochorionic controls (P = 0.007, P = 0.025). Hyperaemic responses were slower in heavier-born twins (P = 0.005). In summary, monochorionic twins had lower BP, arterial stiffness and increased resting vasodilatation than dichorionic twins implying shared fetal circulation affects vascular development. Vascular responses in laser-TTTS were similar to dichorionic and opposite to TTTS-amnio suggesting a lasting effect of fetal therapy on vascular health.

Chemical manipulation by X-rays of functionalized thiolate self-assembled monolayers on Au.

The chemical modification caused by prolonged exposure to X-rays on a series of para-substituted phenyl moieties (-NO2, -CN, -CHO, -COOH, -CO2Me, and -CO2(1)Bu) at the surface of thiolate-Au self-assembled monolayers (SAMs) has been investigated by X-ray photoelectron spectroscopy (XPS). Furthermore, the influence that the phenyl group has on the chemical modification induced by the X-ray irradiation on the SAMs was investigated by comparing the XPS results obtained from irradiation on a NO2-aromatic-terminated SAM (6-(4-nitro-phenoxy)-hexane-1-thiolate (NPHT)) and NO2-aliphatic-terminated SAM (thioacetic acid S-(12-nitrododecyl) ester (TNDDE)). The NPHT and TNDDE SAMs have been shown to behave differently to X-ray exposure. The irradiation of the NPHT SAM led to the reduction of the nitro (-NO2) moiety to the amine (-NH2) moiety, as shown by the decrease in the intensity of the N 1s photoelectron peak for -NO2 (406 eV) in the XPS spectra with the concomitant increase in the N 1s photoelectron peak for -NH2 (399 eV). On the TNDDE SAM, XPS showed the -NO2 photoelectron peak again decreasing with prolonged X-ray irradiation whereas no peak was observed at 399 eV; therefore, the -NO2 moieties are selectively cleaved. No change was observed on the other functionalized monolayers apart from the -CO2(t)Bu-functionalized monolayer, where after 100 min of X-ray irradiation approximately 11% of the carbon content was lost. The S 2p and O 1s spectra remained unchanged during the irradiation suggesting the conversion of the -CO2(t)Bu to the -COOH moiety, although the conversion was not complete because the tertiary butyl moiety contributes 25% to the total carbon content of the SAM. Also, there was no evidence of the molecules desorbing from the substrate for any of the SAMs studied during the X-ray irradiation as shown by no change in the S 2p and C 1s XPS spectra taken during the X-ray irradiation.

The influence of surface lubricity on the adhesion of Navicula perminuta and Ulva linza to alkanethiol self-assembled monolayers.

The settlement and adhesion of Navicula perminuta and Ulva linza to methyl-terminated alkanethiol self-assembled monolayers (SAMs) of increasing chain length has been investigated. Organisms were allowed to settle onto the monolayers and were subsequently exposed to hydrodynamic shear stress in order to determine their adhesion strength. Results show that as the SAM structure changes from amorphous to crystalline (C14), there is a marked change in the adhesion of N. perminuta and U. linza. Given that the SAMs in the series all exhibit similar contact angle behaviour and surface energy, it is hypothesized that the lubricity of the surface plays a role in determining the surface adhesion.

Electrostatically stabilised nanoparticles: self-organization and electron-beam patterning.

The self-organisation of citrate- and magnesium oleate-stabilised gold nanoparticles on SiO2/Si substrates was investigated. In drop deposition, nucleation of citrate-stabilised gold nanoparticles was observed at the rim of the droplet, symmetric or multibranched dendroid gold structures were found in the area between the rim and the central part of the droplet, depending on the drying temperature. Homogeneous submonolayer nanoparticle coverage was obtained by immersion of amineterminated SiO2/Si surfaces into a citrate-stabilised colloidal gold acidic solution. Drop deposition of magnesium oleate-stabilised gold nanoparticles onto the SiO2/Si surfaces resulted in the formation of uniformly close-packed nanoparticle arrays. Under electron beam irradiation, no apparent changes were found for monolayer films of citrate-stabilized particles, but sintering of the nanoparticles was observed in multilayer films. In contrast, coalescence of magnesium oleate-stabilised gold nanoparticle occurred in monolayer films after electron irradiation.

A sharp debridement procedure devised by specialist nurses.

In the clinical governance era, self-education is not adequate training for nurses to carry out sharp debridement, which is a risky process. Specialist nurses in south-east London drew up a workable procedure for training and practice.

Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial.

BACKGROUND: Depression is a major individual and public-health burden throughout the world and is managed mainly in primary care. The most effective strategy to reduce this burden has been believed to be education of primary-care practitioners. We tested this assumption by assessing the effectiveness of an educational programme based on a clinical-practice guideline in improving the recognition and outcome of primary-care depression. METHODS: We carried out a randomised controlled trial in a representative sample of 60 primary-care practices (26% of the total) in an English health district. Education was delivered to practice teams and quality tested by feedback from participants and expert raters. The primary endpoints were recognition of depression, defined by the hospital anxiety and depression (HAD) scale, and clinical improvement. Analysis was by intention to treat. FINDINGS: The education was well received by participants, 80% of whom thought it would change their management of patients with depression. 21409 patients were screened, of whom 4192 were classified as depressed by the HAD scale. The sensitivity of physicians to depressive symptoms was 39% in the intervention group and 36% in the control group after education (odds ratio 1.2 [95% CI 0.88-1.61]). The outcome of depressed patients as a whole at 6 weeks or 6 months after the assessment did not significantly improve. INTERPRETATION: Although well received, this in-practice programme, which was designed to convey the current consensus on best practice for the care of depression, did not deliver improvements in recognition of or recovery from depression.

Total bed management: the way forward in pressure sore prevention.

King's College Hospital, London, is the first trust to implement total bed management (TBM) to assist in the reduction and prevention of pressure sores. TBM is a new concept, whereby the tissue viability, manual handling and therapy needs of the trust are met at reduced costs through a partnership with a contractor. The introduction of a large number of electric bed frames and foam mattress replacements, with the availability of dynamic pressure-relieving equipment and a service agreement, has led to an expected trust saving of 86,000 Pounds in 1998/1999 and 100,000 Pounds in 1999/2000 onwards. This article outlines the perceived benefits of this approach.

Heterosupramolecular chemistry: programmed pseudorotaxane assembly at the surface of a nanocrystal.

Gold nanocrystals, stabilized by thiols covalently bound to a dibenzo[24]crown-8 moiety, have been programmed to recognize and selectively bind dibenzylammonium cations in solution. This results in a self-organization process at the surface of a nanocrystal with the assembly of a pseudorotaxane (see picture).

Growth and development of male gymnasts, swimmers, soccer and tennis players: a longitudinal study.

Elite adult athletes are known to have physical and physiological characteristics specifically suited to their sport. However, it is not clear whether the observed adult differences arise because of training or whether the sport selects the individual with the appropriate characteristics. The purpose of this prospective study was to compare and contrast the physical development of young athletes (8-19 years), and in so doing provide a possible response to this question. Development of anthropometric characteristics and sexual maturation were assessed in a group of 232 male athletes for three consecutive years. Parental heights were used to predict target heights. The subjects were a randomly selected group of young British athletes, from four sports: soccer, gymnastics, swimming and tennis. Using a linked longitudinal cohort study design (age cohorts 8, 10, 12, 14 and 16 years) it was possible to estimate a consecutive 11-year development pattern, over the 3-year testing period. The adjusted mean (ANCOVA) height, accounting for age and pubertal status, of male swimmers (161.6 +/- 0.6 cm) was found to be significantly greater (p < 0.01) than gymnasts (150.7 +/- 0.8 cm) and soccer players (158.7 +/- 0.6 cm), and their adjusted mean body mass (51.3 +/- 0.6 kg) significantly greater (p < 0.01) than the other groups. When testicular volumes were compared, it was found that swimmers had significantly larger volumes than gymnasts and tennis players from 14 to 16 years of age (p < 0.05). Gymnasts' growth curve of testis size was characteristic of late maturers, the swimmers' curve was characteristic of early maturers. As all the young athletes started training prior to puberty the observed late sexual maturation of gymnasts and early maturation of swimmers suggests some form of sports-specific selection. Training did not appear to have affected these young athletes' growth and development; rather their continued success in sport appeared to be related to inherited traits.