Connecting structurally and dynamically detected signatures of supramolecular Debye liquids.

The monohydroxy alcohol 2-ethyl-1-hexanol mixed with the halogen-substituted alkyl halides 2-ethyl-1-hexyl chloride and 2-ethyl-1-hexyl bromide was studied using synchrotron-based x-ray scattering. In the diffraction patterns, an oxygen-related prepeak appears. The concentration dependence of its intensity, shape, and position indicates that the formation of the hydrogen-bonded associates of monohydroxy alcohols is largely hindered by the halogen alkane admixture. Using dielectric spectroscopy and high-resolution rheology on the same liquid mixtures, it is shown that these structural features are correlated with the relaxation mechanisms giving rise to supramolecular low-frequency dynamics.

Gelation Dynamics upon Pressure-Induced Liquid-Liquid Phase Separation in a Water-Lysozyme Solution.

Employing X-ray photon correlation spectroscopy, we measure the kinetics and dynamics of a pressure-induced liquid-liquid phase separation (LLPS) in a water-lysozyme solution. Scattering invariants and kinetic information provide evidence that the system reaches the phase boundary upon pressure-induced LLPS with no sign of arrest. The coarsening slows down with increasing quench depths. The g2 functions display a two-step decay with a gradually increasing nonergodicity parameter typical for gelation. We observe fast superdiffusive (γ ≥ 3/2) and slow subdiffusive (γ < 0.6) motion associated with fast viscoelastic fluctuations of the network and a slow viscous coarsening process, respectively. The dynamics age linearly with time τ ∝ tw, and we observe the onset of viscoelastic relaxation for deeper quenches. Our results suggest that the protein solution gels upon reaching the phase boundary.

[Radical prostatectomy: open or "minimally invasive"? Our experience with open surgery and related comments]. / Prostatectomie radicale: voie ouverte ou "mini-invasive"? Expérience en chirurgie ouverte et point de vue.

Radical prostatectomy remains the gold standard for treatment of localised prostate cancer. Standardisation of the open retro-pubic anatomic prostatectomy by P Walsh allows skilled but not expert surgeons to achieve a high standard of performance. Learning curve is short with this technic, with minor morbidity. Rates of incontinence are low and impotency is now rather uncommon in the younger patient while oncological control is optimal for histologicaly organ confined cancer. "Mini invasive technics", laparoscopy and robot-assisted laparoscopy, have a longer learning curve, including a higher rate of complications that are unusual with open surgery. Operating time remains longer, costs are superior to the open technic and oncological control is not yet clearly validated while rates of classical late complications are not lower. Consequently, most urologist still prefer the open approach

Kinetics of cellular viability in warm versus cold ischemia conditions of kidney preservation. A biometric study.

We have determined the kinetics of the cellular viability ratio (CVR), defined as the number of living cells over the total cell count, in pig kidneys using propidium iodide and fluorescein diacetate staining, as a function of time and preservation conditions. The kidneys were preserved in warm or cold ischemia in order to mimic the conditions of transplantation from non-heart-beating donors or multiple removal with optimal preservation of the graft, respectively. To determine the CVR, the cells were obtained by a fine-needle aspiration biopsy, which minimizes the damage to the graft. A biometric analysis by regression enabled the determination of the time dependence for warm ischemia (CVR(t) = 80.0 x e(-0.733-t)(+2.7/-0.36)) and for cold ischemia (CVR(t) = 80.0 x e(-0.022-t)(+1.57/-0.64)) with a confidence interval of 95%. These master curves allow us to predict, under the described conditions, the CVR after a given ischemia time. The half-life of the cells can be deduced from the time-dependent CVR(t), and is 0.64 hr (38 min) for warm ischemia and 21.4 hr for cold ischemia. Further, the CVR for a given kidney can be used to assess its condition at removal: if the CVR is below 48% at 2 hr after removal, one can conclude that the organ has suffered a period of warm ischemia.

High incidence of ectopic nucleolar organizer regions in human testicular tumors.

Eight primary testicular germ cell tumors, one teratocarcinoma cell line, and one Leydig cell tumor were studied to determine the importance of modifications of the nucleolar organizer regions (NORs) in human testicular tumors. Cytogenetic analysis after silver staining showed active ectopic NORs in two primary embryonal carcinomas (EC) in the cell line and in single cells of each of two seminomas (S). In one EC, an ectopic NOR was localized to chromosomal region 1q4; the others were on unidentified rearranged chromosomes. All tumors in which ectopic NORs were observed were hyperdiploid and possessed marker chromosomes typical of human germ cell tumors. Quantitative DNA analysis was performed on three tumors: a teratocarcinoma (TC) and the Leydig cell tumor, which had provided no analyzable mitoses, and a seminoma which was cytogenetically diploid. In all three cases, the major populations were hyperdiploid. The results, in combination with those of an earlier study, provide evidence that active ectopic NORs are common in human testicular tumors.

Traumatic rupture of the urinary tract in a patient presenting nephrogenic diabetes insipidus associated with hydronephrosis and chronic renal failure: case report and review of the literature.

We report the case of a 34-year-old Japanese man suffering from a nephrogenic diabetes insipidus (NDI) associated with bilateral hydronephrosis, hydroureters and enlarged trabeculated bladder without obstruction. He also presented with chronic renal failure which has rarely occurred in similar cases. The patient was admitted after a traumatic rupture of the left urinary tract which had never been described until now in NDI. He was treated successfully by transient peritoneal and vesical drainages. This paper focuses on the very rare complication of chronic renal failure secondary to hydronephrosis in cases of NDI. The literature of this association is reviewed.

Coping with grief in response to caring for persons with AIDS.

AIDS has or will affect virtually every professional health care provider. Occupational therapists are in a key position to identify and intervene with the social and occupational changes and losses commonly experienced by this patient population. Suggestions are provided to assist occupational therapists in helping patients with AIDS maintain meaning in their lives. Strategies to help occupational therapists prevent burnout resulting from the emotional stress related to caring for patients with AIDS are suggested as well.

[Neonatal infection caused by the beta-hemolytic streptococcus of group B: review]. / Infection néonatale par le streptocoque bêta-hémolytique du groupe B: bilan.

This review of the literature on the pathogenicity of B group beta-haemolytic streptococcal infection in perinatology first describes the clinical symptomatology of the illness in the newborn and its incidence. One per cent of all babies born to mothers with the infection are seriously affected themselves. Between one and three infants per thousand births die of it. B Group beta-haemolytic streptococcus is, together with E. Coli, the principal cause of neonatal death from infection. The techniques for identifying the bacteria are more reliable when the appropriate transport media and the selected culture media described in the text are used. The different therapies that have been put forward by different authors are described together with their results. In the conclusions reached the essential features that can be used to serve as a guide for the clinician in his choice of preventive or curative therapy are pointed out.

Supporting the deliverers of care: strategies to support nurses and prevent burnout.

AIDS, with the number of cases and death toll increasing every day, puts caregivers at great risk for burnout. In order to prevent the detrimental consequences of burnout and to meet the challenge of this catastrophic illness, strategies need to be implemented. This overview not only explores the sources of stress related to AIDS but also presents strategies for the prevention of burnout. It is the author's belief that through solidarity caregivers will be better equipped to overcome the stress of caring for people with AIDS without experiencing burnout in the process.

A new oral contraceptive based on the normophasic method.

62 women were treated for 554 cycles with normophasic oral contraceptive Fisioquens. A treatment cycle consists of 7 tablets of 0.05 mg ethinyloestradiol, followed by 15 tablets with a combination of 0.05 mg ethinyl-oestradiol and 1 mg lynestrenol. No pregnancies occurred. Both tolerance of the preparation and cycle control were good. Irregular bleeding occurred sporadically. Various side-effects diminished during treatment and even disappeared completely. Fisioquens appears to be a reliable contraceptive with a minimum of side-effects.

PIP: A trial involved 62 women for over 554 cycles during which time a new normophasic oral contraceptive, Fisioquens, was administered. The preparation was tested with particular reference to the following parameters: contraceptive reliability, cycle control, frequency of possible side effects, and drug tolerance. A treatment cycle consisted of 7 tablets of .05 mg ethinyl estradiol followed by 15 tablets of a combination .05 mg ethinyl estradiol and 1 mg lynestrenol. Pregnancies were absent and irregular bleeding occurred sporadically. Various side effects diminished during treatment. The number of dropouts which could probably be attributed to the preparation itself was 4 (6.4%). These data indicate that Fisioquens appears to be a reliable contraceptive with a minimum number of side effects.

[Renal tumors in the elderly patient: therapeutic dilemma]. / Tumeur rénale du patient âgé: dilemme thérapeutique.

We present a retrospective study of 17 elderly patients (older than 75 years) suffering from renal carcinoma, Robson I to III. 12 patients underwent surgical treatment (radical nephrectomy). Peroperative morbidity was low (10%), mean hospitalisation period was 12 days. 60% of patients returned home directly. Mean survival was 5 years. In the 8 patients group with Robson stage I-II, only one death was due to tumor progression. 5 patients underwent a conservative approach (no treatment at all). In this group, two deaths were due to tumor progression. The difference in outcome of these two groups shows a significant advantage for a surgical approach, even in the elderly.

[Renal angiomyolipoma: benign tumor?]. / L'angiomyolipome rénal: tumeur bénigne?

Often incidentally discovered, angiomyolipoma (AML) may be revealed by sudden flank pain secondary to perirenal hemorrhage. Tumoral vessels have an increased fragility, leading to potentially major blood loss. Diagnosis is based on the demonstration of a mass which is hyperechogenic by ultrasound and of partially negative density by CT scan. Our cases from 1979 to 1991 are reviewed. Clinical data, investigation and treatment are discussed. Although benign, this tumor may be associated with high morbidity.

Motional sidebands and direct measurement of the cooling rate in the resonance fluorescence of a single trapped ion.

Resonance fluorescence of a single trapped ion is spectrally analyzed using a heterodyne technique. Motional sidebands due to the oscillation of the ion in the harmonic trap potential are observed in the fluorescence spectrum. From the width of the sidebands the cooling rate is obtained and found to be in agreement with the theoretical prediction.

[Urologic complications of kidney transplants. Geneva cases, 1981-1990--observations on 200 transplantations]. / Complications urologiques des greffes rénales. Casuistique genevoise, 1981-1990--à propos de 200 transplantations.

Between 1981 and 1990, 200 kidney transplantations were performed at the Cantonal Hospital of Geneva. Overall, 11% of patients developed a urological complication in this series. Of these complications, 40.9% were ureteral stenosis, 22.7% urinary leakages, 13.6% infected vesico-ureteral reflux, 13.6% genitourinary tumors and 9.2% other urological complications. The authors compare their series with the literature.

Renal transplantation in the elderly: a long-term, single-centre experience.

BACKGROUND: End-stage renal failure increases with advancing age and renal transplantation should be considered in end-stage renal failure patients older than 60 years. However, there is a paucity of data on long-term patient and graft survival in this population. METHODS: From October 1983 to March 1999, 310 renal transplantations were performed at Geneva University Hospital in 283 patients, of which 49 were done in 48 patients older than 60 years (mean age 65.6+/-4.1 years). The following data were analysed at 1, 5, and 10 years, and compared between the patients >60 years and <60 years old: actuarial patient and graft survival, serum creatinine, causes of graft loss, and patient death. RESULTS: Patient survival at 10 years was 81% for patients <60 years and 44% for patients >60 years. Graft survival at 10 years was 59% for patients <60 years and 32% for patients >60 years. Graft survival at 10 years censored for death with functioning graft was 65% for patients <60 years and 81% for patients >60 years. Main causes of mortality in the older patients were related to cardiovascular events (47%), neoplasia (41%), and sepsis (18%). Overall, recipient and donor age were not predictive factors for graft survival, as shown by multiple logistic regression. CONCLUSIONS: Renal transplantation should be considered in patients older than 60 years, since graft survival is excellent in this population. Although these patients have a shorter life expectancy, they benefit from renal transplantation similarly to younger kidney transplant recipients.

Cyclosporine toxicity in renal transplant recipients detected by nailfold capillaroscopy with Na-fluorescein.

BACKGROUND: Cyclosporine represented a major advance in the medical management of patients with organ transplantation, but its use is limited by the frequent occurrence of hypertension and renal toxicity diagnosed by invasive renal biopsy. Renal histology shows a specific arteriolopathy. It was hypothesized that cyclosporine may also induce subclinical microvascular changes in the skin that might be detected noninvasively by a combination of dynamic capillaroscopy [capillary blood cell velocity (CBV)] with and without intravenous Na-fluorescein (NaF) injection and laser Doppler fluxmetry (LDF). METHODS: The nailfold skin microcirculation was evaluated in 112 consecutive renal transplant recipients (54 +/- 11 years old; 70 males and 42 females) receiving cyclosporine. The investigation was made the same day as a routine renal biopsy performed in all patients more than two years after transplantation. Renal biopsies were blindly classified as positive (N = 33) when significant specific signs of cyclosporine toxicity were clearly observed (AH2-AH3) and were otherwise negative (AH0-AH1, N = 79) according to the Banff classification. RESULTS: Time to fluorescence peak after NaF injection (tpNaF) was significantly longer in patients with positive biopsies than in patients with negative biopsies (13.9 +/- 8.1 vs. 17.5 +/- 9.4 sec, P = 0.009). All patients but three with negative biopsies (93%) had a tpNaF less than 10 seconds (sensitivity 91%, negative predictive value 93%). On the other hand, CBV, LDF, plasma levels of cyclosporine, and endothelin were similar in the two groups. CONCLUSION: Nailfold fluorescence capillaroscopy is an accurate and simple mean to rule out cyclosporine toxicity in renal transplant recipients. A normal test could avoid invasive renal biopsy in about 40% of the patients. Renal biopsy would, however, still be indicated when the test is abnormal.