Tangential extreme ultraviolet and soft x-ray diagnostic system for time-resolved temperature measurement on the High Beta Tokamak-Extended Pulse.

The High Beta Tokamak-Extended Pulse has recently incorporated a tangential multi-energy extreme ultraviolet and soft x-ray diagnostic system. This system enables measurements of the electron temperature and the examination of mode dynamics within the tokamak. While other systems have been built for poloidal views over similar temperature ranges, this is the first multi-energy tangential-view system designed to work in a temperature range below 200 eV in a tokamak. To facilitate these measurements, a filter wheel comprising five distinct groups of dual-filters has been developed and implemented. By employing a combination of 0.1 µm aluminum and 0.2 µm titanium filters, the system allows estimation of electron temperature profiles through reconstruction of the emission profile using the standard "double-foil" technique. The influence of impurities and filter oxide layers on measurement outcomes is examined. Results reveal that, while the absolute electron temperature values may exhibit some deviations, key characteristics like the electron temperature profile shape and inversion radius during sawtooth events remain consistent. This consistency confirms the system's suitability for core plasma studies. This system has proven effective in detecting and analyzing internal magnetohydrodynamic phenomena, such as sawteeth.

Pediatric and adolescent sports medicine.

The majority of pediatric sports-related injuries are relatively benign and are easily treated with conservative measures. When surgical intervention is required, it is usually effective in returning the athlete to participation within a reasonable time frame. Effective care of pediatric athletes, however, involves not only knowledge of the many types of injuries and their treatments but also insight into the demands of the various sports and the needs of individual athletes. Treatment and resumption of participation recommendations frequently vary depending on the patient's sport, level of participation, and willingness to substitute alternative sports for his or her primary one. As always, individualizing treatment leads to greater patient satisfaction and improved results.

Malignant granular cell tumor mimicking herniated nucleus pulposus.

Peripheral nerve tumors may arise in any nerve, large or small. Their presence is readily apparent when they are superficial, but when they are located in a deep nerve, symptoms can mimic+ the nerve root pain of herniated nucleus pulposus. This case of malignant granular cell tumor, probably of Schwann cell origin, involved the sciatic and tibial nerves in the popliteal fossa. Originally the pain was assumed to be produced by a herniated nucleus pulposus. The discovery of the mass thus +was delayed. The mass gave a heterogeneous signal on magnetic resonance imaging studies. A peripheral origin of nerve pain should be considered whenever pain radiates to a limb. A complete physical examination that includes palpation of the nerve to which pain is referred gives the best clue as to the true cause of pain when a peripheral nerve tumor is present.

Contemporary magnetic resonance imaging of the knee. The orthopedic surgeon's perspective.

This article discusses the current applications of MR imaging in the practice of orthopedic surgery and sports medicine. When is MR imaging helpful to the treating surgeon, and when is it not? In what specific areas will future improvements in technical acquisition and interpretation be helpful in determining appropriate treatment? This article explores these questions.

Radiopacity of household deodorizers, air fresheners, and moth repellents.

Household deodorizers and moth repellents are common agents implicated in many childhood poisonings. Their ingredients usually include either paradichlorobenzene or naphthalene compressed into a solid ball or another shape, sometimes with added essential oils and fragrances. Because medically naphthalene is a more important toxin than paradichlorobenzene, with hematologic and nervous system effects, clinicians often seek to discern which product has been ingested. We discovered fortuitously that a mothball swallowed by a retarded adult was radiopaque, and so designed an in vitro experiment to study the radiopacity of a variety of household deodorizers and products. Of 10 products screened for radiopacity by two radiologists, those containing paradichlorobenzene were consistently strongly radiopaque; those containing naphthalene were radiolucent. A third alternative ingredient which is used in some toilet bowl deodorizers, cetrimonium bromide, was also radiopaque. Radiopacity of paradichlorobenzene or cetrimonium bromide-containing products did not dissipate with time. We speculate that the halogen within the chemical structure of these compounds accounts for their radiopacity. We conclude that paradichlorobenzene-containing commercial products can be distinguished clinically from those containing naphthalene by the performance of an abdominal radiograph.

Homeless women. The context of an urban shelter.

The role of the nurse in a shelter has just begun to emerge. The prevalence of homeless women is escalating, and nurses are playing primary roles in teaching, health care, social support, and case finding for women in shelters. This article describes some of the health, social, and psychologic issues facing women in a large urban shelter from the perspective of a senior nurse psychologist at Boston's Long Island Shelter.

Poisoning prevention knowledge and practices of parents after a childhood poisoning incident.

This study investigated the effectiveness of a poison center-initiated mailed intervention on improving the preventive practices of families whose preschool child had recently experienced a poisoning incident. A low-cost, mailed poisoning prevention packet consisting of telephone stickers, a +f41 coupon for syrup of ipecac, one slide-style cabinet lock, a nine-step checklist for "poison-proofing" the home, pamphlets, and a cover letter was tested prospectively on a population of parents calling a poison center for advice about possible poisoning exposures involving their preschool children. Parents without ipecac 1 week after the incident were randomized so that half received the mailed intervention. A "blind" follow-up telephone interview was conducted 3 months later. Of the 336 original families enrolled in the study, 301 (90% retention) completed the follow-up interview. Those who had received the intervention were more likely to have a telephone sticker than control families (78% vs 39%; P < .0001) and were more likely to be using at least one slide lock in the home (59% vs 40%; P < .001). However, intervention families were no more likely to have ipecac on hand than control families (57% vs 52%; P = not significant) and did not indicate a higher rate of compliance with suggested changes in other behaviors and practices to prevent poisonings. A poisoning recurrence rate of 3.7% was seen in the total sample during the 3-month period of surveillance; there was no difference between groups in recurrence rate. Even after a poisoning event, parents may not be sufficiently motivated to take poisoning prevention measures on their own.(ABSTRACT TRUNCATED AT 250 WORDS)

The anterior cruciate ligament-deficient knee: a diagnostic and therapeutic algorithm.

The anterior cruciate ligament (ACL) of the knee is a common site of sports-related injury. The natural history of chronic instability, reinjury, and further intra-articular damage is well documented. Appropriate management of ACL insufficiency must be based upon a knowledge of the available diagnostic and therapeutic options, their indications, and their effectiveness. At the same time, the treatment plan must be tailored to the demands and expectations of the individual patient.

Interleukin 1 beta mediates stress-induced immunosuppression via corticotropin-releasing factor.

Intracerebroventricular (icv) infusion of human interleukin 1 beta (IL-1) into intact and adrenalectomized rats impairs immune function. Using antibody to IL-1 as well as an inhibitor of IL-1 action, we sought to determine if endogenous IL-1 in the central nervous system has a physiological role in mediating the immunosuppressive effects of stress. Compared with freely moving controls, rats given intermittent electric shock to the tail for 40 min exhibited a fall in T lymphocyte proliferation and natural killer (NK) cell cytotoxicity of 33% and 38%, respectively; however, when pretreated with icv human IL-1 monoclonal antibody, which significantly crossreacts with rat IL-1, the decrement was attenuated to 14.6% and 15%, respectively. When rats were pretreated with icv alpha-MSH, which blocks many IL-1 effects, shock-induced suppression of 42% in both T lymphocyte proliferation and NK cytotoxicity were blunted to 33% and 31%, respectively. Similar results were found in adrenalectomized rats. These findings suggest that endogenous IL-1 is a physiologically relevant mediator of the immune response to stress. As IL-1 has been reported to release CRF, which we have shown always plays a significant role in stress-induced immunomodulation, we then assessed the relationship of IL-1 and CRF in immunosuppression. Infusion of icv IL-1 caused a decrease of 35% in T lymphocyte proliferation and 34% in NK activity, but pretreatment with CRF antibody icv attenuated IL-1 suppression of T lymphocyte proliferation and NK activity to 10% and 8%, respectively. Comparable results were observed in adrenalectomized rats. These findings suggest that CRF antibody is able to block the immunosuppressive effects of IL-1. To further examine the interaction of CRF in mediating stress-induced immunosuppression, we found that animals pretreated with icv CRF antibody, shocked and then given icv IL-1, had a decrement in T lymphocyte proliferation and NK cytotoxicity of 24% and 21%, respectively, demonstrating that the immunosuppressive effect of icv IL-1 is blocked when central CRF has been neutralized by prior administration of icv CRF antibody. In contrast, animals pretreated with icv IL-1 antibody, shocked and then given icv CRF, had decrements of 38% and 40%, respectively, showing that icv CRF does act even when central IL-1 has been neutralized by prior administration of icv IL-1 antibody. Thus, we conclude there is a sequential relationship between two of the known mediators of stress-induced immunosuppression, with release of central IL-1 followed by that of CRF.

Corticotropin-releasing factor modulates the immune response to stress in the rat.

We examined the role of CRF, a key mediator of the endocrine response to stress, in modulating immunosuppression during the subacute stress of intermittent electrical shock over 1 h. Administration of shock to intact rats resulted in a 74% decrement in T-lymphocyte proliferation and a 59% decrease in natural killer cytotoxicity. Similar suppression of these two parameters of immune function in response to shock was noted in adrenalectomized rats as well. The immunosuppressive effects of this shock were significantly and comparably blunted when both intact and adrenalectomized animals were pretreated 1) iv with either a highly potent polyclonal CRF antibody or a specific CRF antagonist or 2) intracerebroventricularly with either a high affinity monoclonal antibody to CRF or a specific CRF antagonist. An immunomodulatory role for CRF is further supported by the findings that administration of exogenous CRF, either iv (10 micrograms/animal) or intracerebroventricularly (1 microgram/animal), resulted in significant decrements in lymphocyte proliferation and natural killer cytotoxicity, similar to those seen with the stress paradigm. Our observations indicate that CRF plays a significant role in modulating the immune response to subacute stress, largely by adrenal-independent mechanisms.

Strain differences in mouse brain weight gain and spatial-location scores during postnatal development.

Brain weight and performance on a spatial-location test were measured from birth to weaning on mouse strains CD1, Balb/c, and their F1 cross. For CD1, onsets of both the last rapid-brain-growth stage and nonzero scores on the spatial-location test were around age 17 days; asymptotes of both were reached about age 23 days. Balb/c and F1 had at least 5- to 6-day delays of both onsets and asymptotes. For the strains studied, onset of nonzero performance on the spatial-location test may be a provisional indicator of onset of significant and rapid brain growth after age 15 days. The delayed F1 brain growth stage could indicate that control of brain growth about age 20 days resides in an inhibitory factor present in Balb/c but not in CD1.

A controlled study of respite service for caregivers of Alzheimer's patients.

After a baseline interview of 642 caregivers of aged Alzheimer's disease victims, half were offered formal respite care. Over 12 months, families with respite care maintained their impaired relative significantly longer in the community (22 days). Although respite was ineffective for caregiver burden and mental health, satisfaction was very high. Although not a strong intervention, respite care can increase caregivers' quality of life.

Respite services for caregivers: research findings for service planning.

A demonstration respite project for caregivers of older people with Alzheimer's disease was evaluated by a randomized experiment. Three hundred and sixteen volunteer primary caregivers were offered respite services and 315 completed the research portion without the offer of respite. The research indicated that even before the demonstration most families had some respite help in place. Of all those offered respite, 58% availed themselves of the offer. During the project year experimental and control subjects were equal in using slightly more services and there was no evidence that formal services had substituted for informal.

Autoimmune thrombocytopenia and primary biliary cirrhosis with hypoglycemia and insulin receptor autoantibodies. A case report.

A 43-year-old woman with spontaneous episodes of neuroglycopenic hypoglycemia was found to have immune-mediated thrombocytopenic purpura and primary biliary cirrhosis. Hypoglycemia along with hyperinsulinemia suggested insulinoma. Serum c-peptide levels were disproportionately low, raising the possibility of factitious hypoglycemia. The patient's plasma contained circulating insulin receptor autoantibodies, thought to cause hypoglycemia by their insulin-like actions. With prednisone therapy, her other autoimmune features improved, and the hypoglycemia eventually resolved. Hypoglycemia mediated by insulin receptor autoantibodies should be considered in patients with fasting hypoglycemia and features suggesting an underlying autoimmune disorder before pursuing more invasive procedures. High-dose steroids may be life-saving in this disorder.