Combined Alkali-Organoammonium Structure Direction of High-Charge-Density Heteroatom-Containing Aluminophosphate Molecular Sieves.

The charge density mismatch concept was applied to the synthesis of high-charge-density silicoaluminophosphate SAPO-69 (OFF) and SAPO-79 (ERI) and zincoaluminophosphate PST-16 (CGS), PST-17 (BPH), PST-19 (SBS), and ZnAPO-88 (MER) molecular sieves. Combined alkali-organoammonium structure direction in these systems is thus enabled. Structure direction is treated from the perspective of stabilizing an ionic framework, the relationships between reaction charge density (OH- /H3 PO4 ), alkali and organoammonium content, and ionicity of tetrahedral framework atoms in successful structure direction are presented.

Subcortical and cortical morphological anomalies as an endophenotype in obsessive-compulsive disorder.

Endophentoypes, quantifiable traits lying on the causal chain between a clinical phenotype and etiology, can be used to accelerate genomic discovery in obsessive-compulsive disorder (OCD). Here we identify the neuroanatomic changes that are shared by 22 OCD adult and adolescent patients and 25 of their unaffected siblings who are at genetic risk for the disorder. Comparisons were made against 47 age and sex matched healthy controls. We defined the surface morphology of the striatum, globus pallidus and thalamus, and thickness of the cerebral cortex. Patients with OCD show significant surface expansion compared with healthy controls, following adjustment for multiple comparisons, in interconnected regions of the caudate, thalamus and right orbitofrontal cortex. Their unaffected siblings show similar, significant expansion, most marked in the ventromedial caudate bilaterally, the right pulvinar thalamic nucleus and the right orbitofrontal cortex. These regions define a network that has been consistently implicated in OCD. In addition, both patients with OCD and unaffected siblings showed similar increased thickness of the right precuneus, which receives rich input from the thalamic pulvinar nuclei and the left medial temporal cortex. Anatomic change within the orbitofrontostriatal and posterior brain circuitry thus emerges as a promising endophenotype for OCD.

The prognostic significance of peritoneal cytology for stage I endometrial cancer.

A retrospective study of 567 patients treated for surgical stage I endometrial cancer was undertaken to resolve the controversy over the significance of malignant peritoneal cytology findings in early-stage disease. Twenty-eight women (4.9%) had peritoneal cytology positive for malignant cells. Comparisons were made between the groups with positive and negative cytology. Subgroups used in analysis included stage according to the International Federation of Gynecology and Obstetrics, treatment regimen, histology, grade, depth of myometrial invasion, and cervical Papanicolaou smear results. Cervical smear status was the only subgroup in which a statistically significant difference was found, with the positive peritoneal cytology patients having a higher incidence of positive Papanicolaou smears (P = .01). Forty-nine women (8.6%) developed recurrent tumor, 7% of the negative-cytology group and 32% of the positive-cytology group (P = .0002). The progression-free survival rate was lowered significantly by positive peritoneal cytology (P less than .0001); patients with negative peritoneal cytology had a significantly better 5-year survival rate, 96 versus 84% (P = .0001). When multivariate analysis was performed on the 477 cases that had no missing values, peritoneal cytology remained significant for both survival rate (P = .01) and progression-free interval (P = .002). Positive peritoneal cytology is a poor prognostic factor for patients with surgical stage I endometrial cancer.

Point-of-care training: strategies for success.

In most cases, the resources and time required for training staff in a POC integrated computer system are underestimated. Based on the authors' consulting and training experiences, particularly with an early POC installation at a large VNA, key strategies for the design, implementation, and evaluation of a POC training program are presented.

Women's and men's responses to sex-segregated work.

Research on the consequences of sex segregation at work has focused mainly on economic consequences rather than affective outcomes. This chapter discusses how the sex composition of women's and men's work settings affects their psychological well-being and job satisfaction. Research discussed here shows that sex composition can affect satisfaction directly rather than simply serving as a proxy for rewards and working conditions.

Lateral and anterior plating of intra-articular distal femoral fractures treated via an anterior approach.

Thirty-five patients with 36 displaced distal femoral fractures (16 AO-type C2 and 19 AO-type C3) were treated with an anterior approach and double plating and followed for an average of 7 (3-44) months. Bone grafting with allograft and demineralized bone matrix was used. Postoperative therapy included immediate ROM and non-weight bearing for 12 weeks. Two patients died during hospitalization and one was lost to follow-up. Reductions were near anatomic in all but three patients. Uneventful healing by 16 weeks occurred in 24/36 fractures. Double plating via the anterolateral approach minimized stripping of the medial side and improved controlled access to the distal femur.

Reliability of the peroneal latency in normal ankles.

The aim of this study was to determine the reliability of peroneal latency between trials and to compare the right and left sides in healthy subjects. A dual platform trapdoor was constructed to tilt the right or the left ankle by 30 degrees in the frontal plane. Electromyography recorded the onset of peroneal activity in response to this perturbation, and an accelerometer detected the onset of trapdoor movement. Peroneal latency was determined algorithmically as the time difference between the onset of trapdoor movement and the onset of peroneal activity. Twenty trials were recorded from 31 right leg dominant, healthy subjects. Peroneal latency was measured successfully for 613 trials (99% success rate). A repeated measures analysis of variance showed a main effect for side with the right, dominant side recording a longer latency. Intertrial reliability of the peroneal latency was high (intraclass correlation coefficients for the right and left legs were .91 and .82, respectively). Thus, peroneal latency is a reliable measure of the polysynaptic reflex ares involved in the response of these muscles to a sudden inversion stress.

Psychotropic medication use in patients with epilepsy: effect on seizure frequency.

Physicians are often reluctant to use psychotropic medications in epilepsy patients with psychiatric disorders because of concern over the potential risk for lowering seizure threshold. This study assesses retrospectively the impact of psychotropic medications on seizure frequency in 57 patients seen consecutively at an epilepsy center. During psychotropic drug therapy, seizure frequency decreased in 33% of patients, was unchanged in 44%, and increased in 23%. Mean seizure frequency was not statistically different between pre-treatment and treatment periods (t = 0.23, df = 56). Simultaneous adjustments in antiepileptic drug regimen could not account for the findings. Results support the position that psychotropic medications, introduced slowly in low to moderate doses, can be safely used in epilepsy patients with comorbid psychiatric pathology during the regular course of clinical care.

Ultrastructural localization of IgE in peripheral blood monocytes from atopics.

Monocyte-enriched preparations derived from peripheral blood leukocytes of atopics were probed via a cocktail comprising peroxidase-conjugated (Fab1)2 fragments of two monoclonal antibodies against human IgE. Reaction product indicative of intracellular IgE was identified by electron microscopy in both large and small vacuoles, and at high magnification exhibited a characteristic granular deposition pattern consistent with highly concentrated (perhaps insolublized) material. IgE-containing vacuoles were observed with comparable frequency to those containing IgG, despite the greater than 10,000-fold relative excess of the latter in serum suggesting highly selective uptake of IgE by the monocytes. These results are similar to those reported recently for IgA in human milk macrophages.