Evaluation of trace element levels in muscles, liver and gonad of fish species from São Francisco River of the Paraná Brazilian state by using SR-TXRF technique.

This study is focused on the analysis of an accumulation of inorganic elements in muscles, liver and gonad of seven fish species from São Francisco River located in the Paraná state of Brazil. Concentrations of the elements were determined using the SR-TXRF technique. In the muscles of fish species, negative length dependent relationships were observed for chromium and zinc ion absorption. The obtained results showed that accumulated Cr ions values are above the limits defined in the Brazilian legislative norm on food.

Managed care relationships made helpful.

Managed care is a people business. There are lots of people, data, and relationships involved. Knowing those people and keeping those relationships is incredibly valuable. Understanding your own practice, what it offers to the network, and how it interacts with the customers of the payer are also important. All of these things give you leverage, and leverage means higher rates and better access.

Bimetallic-induced tail-to-tail dimerization and C-H activation of methyl acrylate.

An organometallic complex resulting from tail-to-tail dimerization and C-H activation of methyl acrylate (MA), [Mo(CO2Cp(eta 3-(MeO2C)CH[symbol: see text]CH[symbol: see text]CHCH2(CO2Me)] 2, has been fully characterized from the reaction of the heterobimetallic complex [Cp*Ni=Mo(mu-CO)(CO)2Cp] with MA and an exclusively eta 3-allyl bonding mode of the coupled ligand was established for the first time by X-ray diffraction; formation of 2 is accompanied by that of the mu 3-alkylidyne-capped cluster [NiMo2(mu 3-CCH2CO2Me)(CO)4Cp*Cp2] 3 which results from a double C-H activation of the CH2 group of MA; none of these reactions occur with the corresponding homodinuclear complexes.

[Cholesterol embolism: an often unknown disease; a report of two cases]. / La maladie à embols de cholestérol: une pathologie souvent méconnue; à propos de deux cas.

We report on a case of post-invasive acute renal insufficiency and a case of acute necrotizing pancreatitis, both histologically proven to have been caused by cholesterol embolisms. A survey of the literature with discussion of diagnostic and therapeutic options is given.

Cerebral vasculitis associated with acute post-streptococcal glomerulonephritis.

The following is a case study involving a 13-year-old girl who presented initial symptoms of an upper respiratory infection. One week later she experienced a short seizure and hours later a grand mal seizure. MRI examination of the brain demonstrated multiple changing abnormal foci of increased density in white and gray matter suggestive of a vasculitic inflammatory pattern. As a result of proteinuria and red cell casts on urinalysis, a renal biopsy was performed resulting in a diagnosis of acute post-streptococcal glomerulonephritis (APSGN). We concluded on the basis of the MRI that vasculitis was secondary to APSGN. The following paper is a description of our findings in this case and a review of the literature supporting this new interpretation of CNS disease due to APSGN.

The effects of nitric oxide on electron transport complexes.

The effect of nitric oxide on mitochondrial electron transfer complexes was studied by comparing the activities of nitric oxide-treated and untreated, deoxygenated samples of purified beef heart succinate-cytochrome c reductase, succinate-ubiquinone reductase, and ubiquinol-cytochrome c reductase. More than 90% of succinate-cytochrome c reductase activity is lost during nitric oxide treatment. The activity of the succinate-ubiquinone reductase component of succinate-cytochrome c reductase decreases 95%, while the ubiquinol-cytochrome c reductase component is unaffected by nitric oxide. This inactivation is due primarily to the destruction of iron-sulfur clusters from succinate-ubiquinone reductase. When purified beef heart succinate-ubiquinone reductase was treated with nitric oxide, virtually all activity was irreversibly lost. The electron paramagnetic resonance (EPR) spectra of the treated complex showed typical iron-nitric oxide complex signals, confirming that inactivation is due to destruction of the iron-sulfur clusters. Similar results were obtained with purified Escherichia coli succinate-ubiquinone reductase. Pure beef heart ubiquinol-cytochrome c reductase treated with nitric oxide loses 40% of its initial activity, but regains most of it (90-100 % after 24 h of incubation at 0 degrees C in the absence of nitric oxide. This suggests that ubiquinol-cytochrome c reductase is protected from nitric oxide when complexed with succinate-ubiquinone reductase or that when split from succinate-ubiquinone reductase, ubiquinol-cytochrome c reductase undergoes a conformational change which allows access of nitric oxide to the Rieske iron-sulfur center. Such access is not possible when ubiquinol-cytochrome c reductase is complexed with succinate-ubiquinone reductase. The loss of ubiquinol-cytochrome c reductase activity correlates with a decrease in the Rieske protein EPR signal intensity without formation of any new EPR signal. The Rieske iron-sulfur cluster signal is recovered after 24 h incubation in the absence of nitric oxide.

Identification of the ubiquinol-binding site in the cytochrome bo3-ubiquinol oxidase of Escherichia coli.

The cytochrome bo3-ubiquinol oxidase, one of two ubiquinol oxidases in Escherichia coli, is a member of the heme-copper oxidase superfamily. The enzyme contains four protein subunits (I-IV) with apparent molecular masses of 58, 33, 22, and 17 kDa, respectively. Cytochrome bo3 catalyzes the 2-electron oxidation of ubiquinol and the reduction of molecular oxygen to water. Although the primary structures of all four subunits have been determined, the ubiquinol-binding site has not been investigated. The photoreactive radiolabeled azidoubiquinone derivative 3-[3H]azido-2-methyl-5-methoxy-6-geranyl-1,4-benzoquinone (azido-Q), which has been widely used in locating the ubiquinone-binding sites of other enzymes, was used to identify the subunit(s) involved in the binding of quinol to cytochrome bo3. When reduced by dithioerythritol, the azido-Q derivative functioned as a substrate with partial effectiveness, suggesting that azido-Q interacts with a legitimate quinol-binding site. When cytochrome bo3 was incubated with an 8-fold molar excess of azido-Q, illumination by UV light for 10 min resulted in a 50% loss of activity. The uptake of radiolabeled azido-Q by the oxidase complex upon illumination correlated with the photoinactivation. In the presence of the competitive inhibitor 2-heptyl-4-hydroxyquinoline or ubiquinol, the rate of azido-Q uptake and the loss of enzyme activity upon illumination decreased. Analysis of the distribution of radioactivity among the subunits after separation by SDS-polyacrylamide gel electrophoresis showed that subunit II was heavily labeled by azido-Q, but that the other subunits were not. This suggests that the ubiquinol-binding site of the cytochrome bo3 complex is located at least partially on subunit II.

[Treatment of massive arterial thrombosis caused by thrombocytopenia induced by heparin with local thrombolysis]. / Traitement par thrombolyse locale d'une thrombose artérielle massive par thrombopénie induite par l'héparine.

The authors report the case of a patient treated by subcutaneous injection of calcium heparin after deep vein thrombosis with floating thrombus and pulmonary embolism. She was readmitted to hospital after 16 days' treatment because of a massive aorto-iliac thrombosis due to heparin-induced thrombocytopenia (platelet count = 29.000). This thrombosis was treated by local injection of Urokinase (total dose = 7.425.000 U) over 93 hours without any major complications. The aorto-iliac circulation was completely restored to normal after treatment. Thrombotic complications secondary to immuno-allergic heparin-induced thrombocytopenia are relatively common because of the widespread use of heparin. From the therapeutic point of view, it is imperative to stop the heparin, which makes surgery very difficult, and the platelet-fibrin composition of these thrombi suggests that local thrombolysis with Urokinase is the treatment of choice in this syndrome.

Emergency treatment of severe cardiogenic pulmonary edema with intravenous isosorbide-5-mononitrate.

Intravenous isosorbide-5-mononitrate (IS-5-MN) was administered to 24 patients, mean age 73, with severe respiratory distress after pulmonary edema and acute left heart failure. The condition was due to ischemic cardiopathy in 18 patients (4 with acute myocardial infarctions), congestive cardiomyopathy in 3, hypertensive cardiopathy in 2, and mitral valvular disease in 1. Therapy consisted of an intravenous (i.v.) bolus dose of IS-5-MN, followed by a continuous infusion (mean 8 mg/hour over 24 hours) of i.v. furosemide and additional oxygen. Clinical data were recorded as well as blood gas values and repeated chest radiographs. All patients survived and improved markedly; only 6 needed mechanical ventilation. Most patients had fast respiratory relief, with no untoward reaction, except a brief decrease of blood pressure in a ventilated patient taking morphine. These data indicate that i.v. IS-5-MN is effective and safe for the management of severe acute cardiogenic pulmonary edema.

[Are the home structure, staff and residents adaptable--how far should they be?]. / Sind Heimstrukturen, sind Mitarbeiter und Bewohner anpassungsfähig--wie weit sollen sie es sein?

This paper deals basically with the question: Should residents adapt unconditionally to homes or should homes be structured such as to be able to adapt to needs and abilities of the residents? Depending on the image officials, planners und the staff have of elderly people, one can arrive at different answers to this question. In particular, based on different images, the paper discusses consequences and design requirements in respect to a) the planning und the management of homes, b) the behavior of the staff and c) the preservation and deterioration respectively of abilities of the residents.

[Acute treatment of severe cardiogenic pulmonary edema. Effect and tolerability of ISDN as bolus and continuous infusion]. / Die Akutbehandlung des schweren kardialen Lungenödems. Wirksamkeit und Verträglichkeit von ISDN als Bolus und als Dauerinfusion.

Isosorbide dinitrate (ISDN) was administered intravenously to 21 patients with severe cardiogenic pulmonary edema. In 15 cases the condition was due to coronary heart disease (3 of them had arterial hypertension additionally), and 3 patients due to cardiomyopathy. In the remaining 3 valvular disorders were prevailing. The ISDN solution was administered as an i.v. bolus followed by continuous i.v. injection from an automatic perfusion device. Oxygen, furosemide, and in some cases digitalis were given in addition. Monitoring consisted of clinical surveillance, blood gas analyses, and repeated X-ray control. The results obtained confirm the efficacy and safety of this mode of ISDN administration. This applies particularly for patients in whose therapy is aimed at fast control of life-threatening hypoxia. Despite extreme asphyxia, only three patients needed artificial respiration, one died in cardiogenic shock, while all others were rapidly improved. It could thus be demonstrated that this type of therapy may be safely and efficiently handled by careful clinical supervision, without invasive hemodynamic monitoring.

[Total gastrectomy. Primary esophagojejunal anastomosis, the organ in place, using linear mechanical suture staplers]. / Gastrectomie totale. Anastomose oeso-jéjunale première, pièce en place, utilisant les pinces à suture mécanique linéaire.

In "mechanical" surgery, continuity of the digestive tract may be re-established with either circular (E.E.A. - I.L.S.) or linear stapled anastomosis (G.I.A. - T.A.). For oesophago-jejunal anastomosis, the authors prefer the second method which provides wider anastomosis without the risk of stenosis attached to circular sutures. The stomach is kept for traction, thus facilitating the procedure, which can be performed through the abdominal incision.

[Gastrectomy with "primary" gastro-jejunal anastomosis. A new way of using mechanical suture instruments (author's transl)]. / Gastrectomie avec anastomose gastro-jéjunale "première". Technique originale d'emploi des procédés de suture mécanique.

A new way of performing Billroth II-type gastrectomy using mechanical suture instruments is described. After section and closure of the duodenum with a TA 55 stapler,, the stomach is exteriorized and the jejunal loop is brought into contact with its posterior surface. A GIA stapler is introduced into stab wounds in the stomach and jejunum, and the gastrectomy is performed. The anastomotic suture is included in the "secondary" gastric resection suture with one single application of a TA 90 stapler. This original resection technique, which ensures primary establishment of gastro-intestinal continuity, has been used on 52 occasions since 1973. There was no increase in mortality and no postoperative haemorrhage or fistula. The perfect quality of the anastomis was confirmed by control radiographic and endoscopic examinations.