Gravity Probe B: final results of a space experiment to test general relativity.

Gravity Probe B, launched 20 April 2004, is a space experiment testing two fundamental predictions of Einstein's theory of general relativity (GR), the geodetic and frame-dragging effects, by means of cryogenic gyroscopes in Earth orbit. Data collection started 28 August 2004 and ended 14 August 2005. Analysis of the data from all four gyroscopes results in a geodetic drift rate of -6601.8±18.3 mas/yr and a frame-dragging drift rate of -37.2±7.2 mas/yr, to be compared with the GR predictions of -6606.1 mas/yr and -39.2 mas/yr, respectively ("mas" is milliarcsecond; 1 mas=4.848×10(-9) rad).

Sclerosing peritonitis associated with bilateral luteinized thecoma, linked to anticonvulsant therapy.

OBJECTIVE: To present a new case of sclerosing peritonitis associated with bilateral luteinized thecoma of the ovaries, linked to anticonvulsant therapy. CASE: A 22-year-old patient, receiving carbamazepine for seizures and anxiety attacks presented with shortness of breath, abdominal pain, nausea and vomiting. Clinical and imaging examinations revealed bilateral ovarian masses with massive ascites. At emergency surgery, bilateral ovarian luteinized thecoma with sclerosing peritonitis was found. Due to recurrent, postoperative episodes of small bowel obstruction she was treated with nasogastric suction, intravenous fluids and electrolyte replacement. Total parenteral nutrition was introduced. Since only partial improvement was achieved tamoxifen was administered with resolution of the bowel obstruction. CONCLUSIONS: This is the 19th case of sclerosing peritonitis associated with luteinized thecoma of the ovaries and the 3rd to be associated with anticonvulsant therapy. Treatment should be aimed at relief of bowel obstruction symptoms, preferably with conservative methods. Tamoxifen for downregulation of TGF-beta production should be considered as a treatment modality, as it proved to be very helpful in the presented patient.

Evaluation of use of a new chromogenic agar in detection of urinary tract pathogens.

CHROMagar Orientation, a new chromogenic medium, was evaluated for the detection and differentiation of gram-positive and gram-negative pathogenic microorganisms in 900 urine samples from hospitalized patients. Performance characteristics of the medium were evaluated in comparison to those of 5% sheep blood and MacConkey agars by direct inoculation of the urine samples on the three media. Four gram-negative and two gram-positive strains as well as one yeast control strain from the American Type Culture Collection were used to ensure quality control. CHROMagar Orientation succeeded in detecting all the urine pathogens that were detected by the reference media, including gram-negative bacilli, staphylococci, streptococci, and yeasts. Colony color and morphology on CHROMagar Orientation accurately differentiated Escherichia coli, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, and Acinetobacter spp. Owing to the similarity in the pigmentation produced by Klebsiella, Enterobacter, and Citrobacter isolates, the medium failed to distinguish among them; however, these isolates were easily recognized as coliforms because of their metallic blue coloration. Staphylococci were clearly perceptible: S. aureus and S. epidermidis grow in regular-size colonies that range from opaque white to yellowish, and S. saprophyticus produces opaque pink colonies. All streptococcus strains, including those from groups B and C, were detected. They grow as undifferentiated flat dry diffused colonies, and additional tests were required for identification. Enterococci were easily discriminated by their strong turquoise pigmentation and their typical growth on the agar's surface. Yeast grow in typical creamy wet convex colonies. The accuracy of antibiotic susceptibility determinations according to standard methods was also tested by picking isolates directly from CHROMagar Orientation. The results showed excellent correlation with those obtained with microorganisms picked from reference media. Owing to the ease in differentiating mixed flora on CHROMagar Orientation, antimicrobic susceptibility tests were performed directly from primary isolates in all cases without the need for subcultures.

Leading change, overcoming chaos--making change succeed in your organization.

The recent emphasis on reengineering has brought a lot of attention to the need to create a compelling vision. It has also forced management to face the realities of making a grand vision a concrete reality. This article focuses on the pragmatic elements--strategic tools and practical solutions--of implementing the change necessary to make your organization succeed.

Intraosseous regional anesthesia as an alternative to intravenous regional anesthesia.

A series of 109 orthopedic operations was performed under intraosseous regional anesthesia on the upper and lower limbs. Anesthesia was satisfactory in 106 of the cases; in the other three, inadequate anesthesia was caused by faulty technique. The spread of lidocaine into the bone and venous network was demonstrated by radiography, and the blood levels after tourniquet release were below the toxic level. Intraosseous regional anesthesia proved to be a valuable technique to be used whenever intravenous anesthesia fails or is not feasible. Injection into cancellous bone (osteoclysis) is easily and quickly performed under aseptic conditions, and there were no systemic complications.

Short pancreas in polysplenia syndrome.

Two cases with the polysplenia syndrome also had a short pancreas. To the best of our knowledge the radiologic characteristics of this anatomic anomaly have not yet been reported. Both cases were asymptomatic with regard to their anomaly-complex. The radiologic findings of the short "pancreas" are similar to the only pathologic description of this association. The awareness of this association led to the diagnosis of the second case after a few months only. A physician performing ERCP in the polysplenia syndrome should keep in mind the possible presence of the "short pancreas" when the whole length of the pancreatic duct is not visualized.

Air in vagina. Indicator of intrapelvic pathology on CT.

Computed tomography of the normal female pelvis may show the presence of a tiny air bubble within the vagina. Among 2,800 female abdomino-pelvic CTs, 27 were found to contain large amounts of intravaginal air. Twenty-three patients suffered from pelvic malignancy while in 4, non-tumorous pelvic pathology was present. Detection of air bubbles in the vagina is abnormal and indicates, in the majority of cases, an intrapelvic malignancy.

Rapid method for determination of isocenter of radiation gantry and alignment of laser beams for stereotactic radiosurgery.

A simple technique has been designed which identifies the gantry isocenter and aligns the laser beams to the isocenter of the gantry within 3-5 min with an error of less than 0.75 mm, depending upon the accuracy of gantry rotation.

Stereotactic radiosurgery for fractionated radiation: a proposal applicable to linear accelerator and proton beam programs.

A stereotactic radiosurgery technique is described which allows stereotactic radiation therapy to be easily fractionated on a daily or weekly basis. This permits adequate and safe radiation therapy to lesions larger than 2.5 cm, such as large arteriovenous malformations, and possibly safer radiation to smaller lesions near crucial intracranial structures. The technique utilizes external scalp landmarks and avoids the need for standard stereotactic head devices.

Carotid control for intracranial aneurysms. Technical note.

A new clamp with a flexible cable control mechanism for temporary intraoperative occlusion of the cervical internal carotid artery is described.

Cerebral vasospasm: a theoretical relationship between systolic thrust and pia-arachnoid fibers.

It is postulated that the repetitive thrust of a sensitized blood vessel, at the peak of systole, against a taut pia-arachnoid fiber may produce or accentuate vasospasm.