Conservative Management of an Intraoperative Chyle Leak: A Case Report and Literature Review.

Chyle leaks are a rare but potentially fatal complication of head and neck surgery carrying an incidence as high as 8.3%. The development of a chyle leak carries significant morbidity ranging from delayed wound healing to oropharyngeal fistulas. Presented here is a case of a chyle leak that developed following a left posterolateral neck dissection that was successfully managed with a combination of drain suction, pressure dressing, and a fat-restricted diet. However, the patient's course was complicated by repeated chyle leak recurrences that may have been associated with the initiation of medium-chain triglyceride supplementation. Although further research is required to establish a causal relationship, these findings support the concerns of other investigators about the possible counterproductive role of medium-chain triglyceride supplementation in the management of chyle leaks.

Influences of Green Outdoors versus Indoors Environmental Settings on Psychological and Social Outcomes of Controlled Exercise.

This study addressed a methodological gap by comparing psychological and social outcomes of exercise in green outdoors versus built indoors settings, whilst rigorously controlling exercise mode and intensity. The hypotheses were that greater improvements or more desirable values for directed attention, mood, perceived exertion, social interaction time, intention for future exercise behaviour and enjoyment would be associated with outdoors compared to indoors exercise. Following a baseline session, paired participants completed two conditions of 15 min of cycling on an ergometer placed outside in a natural environment and inside in a laboratory setting in a randomized, counter-balanced order. At pre- and post-exercise, directed attention was measured with the digit span backwards task, and mood was assessed with the Profile of Mood States. During the exercise session, visual and verbal interactions were recorded by means of experimenter observations. After each exercise session, participants provided self-reports of their enjoyment of the exercise, perceived exertion and intention for future exercise in the same environment. Social interaction time was significantly greater during outdoors exercise versus indoors; on average, participants engaged in three minutes more social interaction during exercise outdoors compared to indoors. Social interaction time significantly predicted intention for future exercise in the outdoors condition, but did not in the indoor condition. There was a significant time by condition interaction for directed attention. Scores worsened in the indoors condition, but improved in the outdoors condition. There was no statistically-significant time by condition interaction for mood and no significant difference between conditions for either perceived exertion or intention. Taken together, these findings show that exercise in a natural environment may promote directed attention and social interactions, which may positively influence future exercise intentions.

Isolation and characterisation of the mixed-metal alkyl amide [(TMEDA)Na(mu-Bu)(mu-TMP)Mg(TMP)], an unexpected chelate-trapped intermediate in the formation of inverse crowns.

Only two-fold amination occurs when 3 molar equivalents of TMPH are offered to a 1:1 BuNa-Bu2Mg mixture; adding TMEDA gives the mixed alkyl amide [(TMEDA)Na(mu-Bu)(mu-TMP)Mg(TMP)], which itself affords the phenyl-bridged analogue when reacted with benzene.

Generation of a human IgG3-streptavidin fusion protein. Implications for the inhibition and elimination of auto-reactive B cells.

Antibodies against self-molecules play a significant role in the development and progression of Systemic Lupus Erythematosus, as well as a number of other autoimmune disorders. Immunosuppressive drugs have been used to control this process. However, they are normally not specific to the offending cell, and can actually suppress beneficial immune responses to pathogens. In this paper a genetically engineered targeting molecule is described, which has the capacity to target antigen-specific B cells for inhibition or elimination. The targeting molecule is a fusion of streptavidin subunit to the constant region of human IgG3 (IgG3-Av). It is demonstrated by ELISA and flow cytometry that IgG3-Av binds biotinylated antigen as well as human Fc gamma receptors present on myeloid cells. It is also shown by confocal microscopy and flow cytometry, that IgG3-Av can mediate Fc receptor-dependent phagocytosis of latex microspheres adsorbed with biotinylated antigen. Furthermore, the IgG3-Av construct can modulate Ca++ flux, characteristic of B cell inhibition as well as ADCC of B cells in an antigen-specific manner. In summary, these studies describe an approach, which has the potential to be used as a treatment to inhibit or remove antigen-specific (auto-reactive) B cells.

Hydride encapsulation in s-block metal inverse crown chemistry.

A new category of 'inverse crown' complex has been established through the synthesis of the disodium-dimagnesium diisopropylamide [Na2Mg2(N(Pri)2)4(mu-H)2.(toluene)2], the first such complex to exhibit hydride encapsulation, a non-planar octagonal 'host' ring or solvent stabilisation.