Real-Time Quantitative Measurements of Foot Perfusion in Patients With Critical Limb Ischemia.

INTRODUCTION: Current methods of evaluating adequacy of endovascular procedures are imperfect and do not always predict which patients will do well. The purpose of this study was to evaluate the role of real-time quantitative measurements of perfusion among patients with critical limb ischemia. MATERIALS AND METHODS: Thirty-four patients with critical limb ischemia undergoing endovascular treatment were recruited. Perfusion Images of the foot were obtained pre and post successful angioplasty using an SPY Elite System (Novadaq Technologies, Ontario, Canada). Patients were followed for 6 months. Subsequently a logistic regression was performed to determine whether intraprocedural perfusion parameters predicted the odds of wound healing. RESULTS: Twenty-nine patients had successful angioplasty. Median age was 69.5% ± 8.3; 75% were men and 64% were diabetic. Rutherford stages were (4%-39%, 5%-57%, 6%-4%), and the average target limb ankle-brachial index (ABI) was 0.58 (SD 2.24). There was no significant correlation between the ABI and perfusion parameters. Inflow perfusion rate correlated significantly with Rutherford stage (Spearman rho 0.398, P = .036). After successful angioplasty 39% had a decrease in inflow rate and 57% had a decreased total inflow. In all, 25 patients completed 6 months of follow-up. Resolution of rest pain and/or healing of the ischemic wound occurred in 10 (40%) patients at 1 month, 4 (16%) at 3 months, and 2 (8%) at 6 months. One patient underwent a major amputation at 2 months. Eight (32%) patients never healed or had persistent rest pain. None of the real-time perfusion variables were significant predictors of wound healing. CONCLUSION: Many patients experience a paradoxical decrease in perfusion following successful angioplasty suggesting perfusion may not correlate with angiographic outcome, possibly due to microemboli, microvascular disease, or vasospasm. Real-time perfusion imaging following intra-arterial infusion of indocyanine green does not predict the odds of wound healing.

Which G-Tube to Use in Pullers: Assessment of Pull Pressures on Skin Models to Determine Optimal Catheter Choice in Patients with Recurrent Pulled Gastrostomy Tubes.

INTRODUCTION: Pulled or dislodged gastrostomy catheters represent a common complication associated with percutaneous gastrostomy and are a common cause of recurrent visits in patients with altered mental status. We intended to perform an experiment to compare the pull forces required to dislodge different commonly used gastrostomy catheters. MATERIALS AND METHODS: We used a digital force gauge device to measure the pull forces required to dislodge three types of 20 French gastrostomy catheters in double-layer skin models. These included the Flow 20 Pull Method (Cook Medical, Bloomington, IN, USA), Entuit Gastrostomy BR Balloon Retention feeding tube (Cook Medical, Bloomington, IN, USA), and Ponsky Non-Balloon Replacement Gastrostomy Tube (CR Bard Inc, Salt Lake City, Utah, USA). The catheters were inserted into the skin model using the same technique as would be utilized in a patient. RESULTS: The mean forces measured to dislodge the per-oral Flow 20 Pull Method, Entuit Thrive Balloon Retention, and button-type retention Ponsky replacement catheters were 35.6, 22.8, and 20.6 Newtons, respectively. The pull method per-oral gastrostomy catheter required significantly more pull force to dislodge than both the Ponsky button-type retention catheter and the Entuit balloon retention catheters. There was no significant difference in the pull force required to dislodge the Ponsky replacement catheter and the Entuit balloon retention catheter. CONCLUSIONS: Per-oral image-guided gastrostomy with pull-method button-type retention catheters may be the ideal choice in patients at high risk of tube dislodgment.

Fractional Quantum Hall States in a Ge Quantum Well.

Measurements of the Hall and dissipative conductivity of a strained Ge quantum well on a SiGe/(001)Si substrate in the quantum Hall regime are reported. We analyze the results in terms of thermally activated quantum tunneling of carriers from one internal edge state to another across saddle points in the long-range impurity potential. This shows that the gaps for different filling fractions closely follow the dependence predicted by theory. We also find that the estimates of the separation of the edge states at the saddle are in line with the expectations of an electrostatic model in the lowest spin-polarized Landau level (LL), but not in the spin-reversed LL where the density of quasiparticle states is not high enough to accommodate the carriers required.

Peritoneal inclusion cysts: clinical characteristics and imaging features.

OBJECTIVES: To investigate the frequency of patient characteristics, causative factors and imaging features associated with pathology-proven peritoneal inclusion cysts (PICs). METHODS: From a retrospective search of all available hospital records-dating back 19 years-we identified 228 patients with pathology-proven PICs. Descriptive statistics were calculated for patients' demographic and clinical characteristics. Imaging features of pathology-proven PICs were recorded on a total of 77 computed tomography (CT), magnetic resonance imaging (MRI) and/or ultrasound (US) studies from patients who underwent imaging before surgery. RESULTS: PICs occurred over a wide age range (18-89 years); 82.5 % of patients were women and 17.5 % were men. A history of prior insult to the peritoneum was identified in 70.6 % of patients. Imaging appearances of PICs ranged from loculated, simple fluid collections to complex, multi-septated lesions. In the absence of haemorrhage or debris, PICs were never found to have thick walls. The presence of nodularity, papillary excrescences or other solid components also excluded a diagnosis of PIC, as did the presence of more than a physiological amount of ascites, provided the ascites had no alternate explanation. CONCLUSIONS: PICs are more common than suggested by previously published reports. Knowledge of patient characteristics and typical PIC imaging appearances may prevent unnecessary or unnecessarily aggressive therapy.

Mobility spectrum computational analysis using a maximum entropy approach.

A method to calculate a smooth electrical conductivity versus mobility plot ("mobility spectrum") from the classical magnetoconductivity tensor in heterogeneous structures with the help of a "maximum entropy principle" has been developed. In this approach the closeness of the fit and the entropy of the mobility spectrum are optimized. The spectrum is then the most probable one with the least influence of the personal bias of the investigator for any given set of experimental data and is maximally noncommittal with regard to the unmeasured data. The advantages of the maximum entropy mobility spectrum analysis as compared to the conventional mobility spectrum analysis are demonstrated using a synthetic dataset.

Total blood and urine protein of urolithiasis patients with renal calculi of different chemical composition.

We determined total blood protein (TBP) and total urine protein (TUP) in healthy subjects and urolithiasis (UL) patients with renal calculi of different chemical composition: phosphate (CaP), oxalate (CaOx) and urate (HUr). We discussed the peculiarities of TBP and TUP distribution curves obtained and showed that the data on TBP and TUP do not make it possible to reliably single out patients with UL or determine the chemical composition of calculi in their kidneys. However, it was established that the comparison of TUP measurement results for UL patients using the Ponseau-S and sulfosalicylic acid methods makes it possible to reliably separate patients with Ca-containing calculi (CaP and CaOx) from those with HUr calculi. The explanation to this phenomenon using the data on the fractional composition of TUP and the organic matrix of those patients' calculi is given.

[The phenotypes of blood haptoglobin in urolithiasis patients]. / Fenotipy gaptoglobina krovi u bol'nykh urolitiazom.

Haptoglobin Hp phenotypes were determined in 104 patients with uroliths of different chemical composition and in healthy controls. 98 patients showed one of the three main phenotypes Hp (1-1, 2-1, 2-2). Electrophoretic motilities of protein fractions Hp were found out for the main phenotypes. Hp was not registered or its fraction motility was distinct from the main phenotypes in 6 patients. Hp phenotypes distribution obtained for all the examinees was compared to that of the controls. For healthy and total group of urolithiasis patients, for healthy and having CaPi and HVr nephroliths, the difference was insignificant in contrast to CaOx stones the incidence of which grew in Hp 1-1 carriers (p < 0.05). In view of this, Hp 1-1 phenotype can indicate a risk of oxalate urolithiasis.

[Total urinary protein in different types of nephrolithiasis]. / Obshchii belok mochi pri razlichnykh vidakh nefrolitiaza.

In 26 healthy individuals and 114 patients with urolithiasis, total urine protein levels were measured in a single sample by using the stain ponceau S. The findings were statistically analyzed. The levels of the protein were found to be 27-80 mg/l in the healthy individuals, while the distribution of the data was asymmetric as viewed from high values. The patients with urolithiasis exhibited their protein levels according to the type of nephrolithiasis. Proteinuria was demonstrated to be less pronounced in patients with oxalate and urate nephrolithiasis than in patients with coral phosphate calculi. There was a substantial asymmetry in the distribution of total urine protein for all the examined groups of urolithiasis patients, as well as great dispersion values, which fails to regard the parameter alone as a diagnostic criterion for the type of nephrolithiasis. At the same time it was noted that simultaneous examination of the levels of total protein, uric acid, potassium, and sodium enabled the type of a concrement (oxalate or phosphate) to be in vivo estimated with approximately 85% probability.

[The use of trimethine dye to stain proteins following cellulose acetate electrophoresis]. / Primenenie trimetinovogo krasitelia dlia okrashivaniia belkov posle élektroforeza na atsetate tselliulozy.

The synthetic trimethine stain PK-144 is recommended for staining the biological fluid proteins after electrophoresis in cellulose acetate films. A good correlation of the values of protein fraction composition determined with the use of this stain and Ponso S stain was observed. The trimethine stain is highly sensitive and may be used in serial electrophoresis analyses in laboratory studies.

[Microflora of the Black Sea mussel Mytilus galloprovincialis L]. / O mikroflore chernomorskikh midii Mytilus galloprovincialis L.

The microbial cenosis in the mantle fluid and stomach of mussels is similar in its biochemical characteristics to the microflora of sea water.

[Genetical aspects of hormonal modification of the stress reactivity. II. Modification in early ontogenesis of the stress reactivity of adult gray rats selected for behavior toward man]. / Geneticheskie aspekty gormonal'noi modifikatsii stressornoi reaktivnosti. Soobshchenie II. Modifikatsiia v rannem ontogeneze stressornoi reaktivnosti vzroslykh serykh krys, selektiruemykh po povedeniiu na cheloveka.

Inherited and modificational changes of the stress reactivity in two outbreed stocks of wild Norway rats trapped in nature and selected for behaviour were studied. During 18 generations the rats of one stock were selected for the lack of defensive behaviour in the glove test (tame), while in another stock the aggressiveness was maintained by the selection (aggressive). Interstock differences in the brain noradrenaline mechanisms were observed. The emotional stress reactivity of the tame animals was decreased, in comparison with the aggressive ones. Definitive stress reactivity of adult rats was modified by injections of hydrocortisone to their mothers on the 16 and 18 days of gestation. Hormonal treatment changed noradrenaline mechanisms and decreased the reaction to emotional stressor in aggressive rats. The modified level of the stress reactivity of aggressive rats was similar to the definitive level of the tame ones. Hormonal treatment did not modify stress reactivity in tame rats. Thus, the phenotype only emerging in aggressive rats, as a result of hormonal modification, is the inherited norm of the tame animals. However, due to rat selection for the lack of defensive behaviour towards the man, high corticosteroid level in the blood of pregnant females, an external developmental factor, in respect to the fetus, loses regulatory function during the development of the neuroendocrine mechanisms of the stress reaction.

[Immediate results of choledochotomy in cholelithiasis, and its complications]. / Neposredstvennye rezul'taty kholedokhotomii pri zhelchnokamennoi bolezni i ee oslozhneniiakh.

An analysis of immediate results of the operative treatment of 186 patients (choledochoduodenoanastomosis - in 86 patients, tight suture of the common bile duct - in 94 patients, external drainage of the hepatocholedocus - in 4 patients, papillosphincterotomy - in 2 patients) showed them to have no substantial difference in using choledochoduodenoanastomosis and tight suture of the common bile duct.

[Role of phenol-decomposing microorganisms in the process of phenol destruction in the Black Sea]. / Rol' fenolrazrushaiushchikh mikroorganizmov v protsesse destruktsii fenola v Chernom more

The number and species of phenol decomposing microorganisms, as well as the activity of their biochemical oxidation of phenol, were studied in waters of the shelf zone of the Black Sea, from the Danube estuary to Batumi. The number of these microorganisms and their phenol decomposing activity were higher in waters near harbours than in regions outside the anthropogenic activity. These parameters were highest in contaminated waters of the river origin. Most of these phenol decomposing microorganisms belong to the genera Pseudomonas and Bacterium, with the predominance of the species of Bacterium album and Pseudomonas desmolyticum (subspecis Pseudomonas rathionis).