Improved Upper Limit on the Neutrino Mass from a Direct Kinematic Method by KATRIN.

We report on the neutrino mass measurement result from the first four-week science run of the Karlsruhe Tritium Neutrino experiment KATRIN in spring 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are energy analyzed by a high-resolution MAC-E filter. A fit of the integrated electron spectrum over a narrow interval around the kinematic end point at 18.57 keV gives an effective neutrino mass square value of (-1.0_{-1.1}^{+0.9}) eV^{2}. From this, we derive an upper limit of 1.1 eV (90% confidence level) on the absolute mass scale of neutrinos. This value coincides with the KATRIN sensitivity. It improves upon previous mass limits from kinematic measurements by almost a factor of 2 and provides model-independent input to cosmological studies of structure formation.

In vivo NMR imaging of tissue sodium in the intact cat before and after acute cerebral stroke.

The first in vivo nuclear magnetic resonance (NMR) images of tissue sodium in the intact animal are presented. The distribution of sodium in the normal cat's head is described. An experimental stroke was surgically induced. Sodium NMR imaging showed a pronounced focal increase in cerebral sodium concentration 9 hr after ligation of the middle cerebral artery. The method appears to be very sensitive for early detection of infarction. The measured increase in the regional sodium NMR signal probably reflects both a true increase in concentration of brain sodium and an increased NMR visibility of the sodium nucleus in the region of the infarction.

Persistent bovine virus diarrhoea virus infection in a bull.

Investigation of a sight defect in a pedigree bull, born as a result of artificial insemination and ovum transplantation, led to the finding that the animal was persistently infected with bovine virus diarrhoea virus. Virus was cultured from blood and from nasal and ocular swabs and was present in semen in high titre. At necropsy, virus was cultured from a wide range of tissues. The pathological findings are described and discussed as are the potential hazards of such infections.

Feasibility of photoelectron sources with sharp lines of stable energy between 20 and 80 keV.

Photo-absorption of γ-rays in thin Al, Co, Ti, and Mo convertors was examined with the aim to produce quasi monoenergetic photoelectrons having an energy spread of 0.5-4.7eV about mean kinetic energies at discrete values between 18632 and 80321eV. The photoelectron rates were estimated for commercial photon sources of (241)Am, (119m)Sn, (125m)Te and (109)Cd with activities of 0.55-3.7GBq. Photoelectrons ejected by (241)Am γ- and X-rays from Co convertors were measured with two different electron spectrometers and obtained energy spectra were compared with Monte Carlo predictions.

Comparison of conventional angioplasty with the Palmaz stent in the treatment of abdominal aortic stenoses from the STAR registry. SCVIR Transluminal Angioplasty and Revascularization.

PURPOSE: To retrospectively compare the safety and short-term efficacy of conventional percutaneous transluminal angioplasty (PTA) and PTA with the Palmaz balloon-expandable intravascular stent for the treatment of infrarenal abdominal aortic atherosclerotic stenoses. PATIENTS AND METHODS: The records of 25 patients with infrarenal aortic stenoses treated by means of percutaneous techniques were retrieved from the SCVIR Transluminal Angioplasty and Revascularization (STAR) Registry and analyzed. Thirteen patients were treated with PTA alone and 12 were treated with the Palmaz intravascular stent. RESULTS: Technical success was achieved in 92% of patients treated with PTA alone and in 100% of those treated with the Palmaz stent. Significant improvements in lesion morphology, hemodynamics, clinical status, and ankle arm indexes were shown in both groups. There was no statistically significant difference in percent stenosis reduction, decrease in trans-stenotic gradient, or initial clinical outcome between the group treated by means of PTA and the group treated by means of PTA with the Palmaz stent. CONCLUSIONS: PTA and intravascular stent placement of atherosclerotic stenoses involving the infrarenal aorta are both safe and efficacious therapeutic modalities. At present, it does not appear that primary stent placement confers any short-term benefits over technically successful PTA in aortic stenoses.

Recanalization of an occluded aortoiliac bypass graft with Palmaz stents.

Four tandem Palmaz balloon-expandable vascular stents were used to recanalize the completely occluded limb of an aortoiliac bypass graft after failure of thrombolysis and conventional angioplasty. The resting peak-systolic pressure gradient across the occluded limb was reduced from 68 to 13 mm Hg. The patient's rest pain resolved, and the ankle-brachial index rose from 0.54 to 0.78. No embolization or stent-related complications occurred. The graft remains patent as determined with noninvasive studies obtained 8 months later.

Biliary-pleural fistulas without biliary obstruction: percutaneous catheter management.

OBJECTIVE: Our purpose was to report the use of percutaneous catheter drainage as a therapeutic option in the management of three patients with biliary-pleural fistulas without biliary obstructions. CONCLUSION: In the proper clinical setting, the CT findings of liver dome laceration or abscess, diaphragm disruption, and pleural effusion should suggest biliary-pleural fistula. Percutaneous catheter management can be curative or serve a temporizing function before surgery.

Enhanced adaptive behavioural response in agoraphobic patients pretreated with breathing retraining.

Patients with clinically diagnosed agoraphobia to whom it had been demonstrated that a standard hyperventilation provocation could produce their feared symptoms were alternately allocated to two treatment groups: 7 patients were treated with two sessions of breathing retraining followed by 7 weekly sessions of real-life exposure to the feared situation, and 5 patients were treated with 9 weekly sessions of real-life exposure without breathing retraining. At discharge and at 1 month's follow-up the two groups of patients showed similar degrees of improvement in frequency of panic attacks and other psychophysiological scores. At 6 months' follow-up the patients treated with real-life exposure alone were beginning to show a fall-off in relearned adaptive behaviour (learning decrement), whereas those given breathing retraining showed further improvement. This suggests that patients pretreated with breathing retraining are less likely to need further treatment.

Placenta accreta: comparison of cases managed with and without pelvic artery balloon catheters.

OBJECTIVE: To describe our experience with the use of prophylactic pelvic artery balloon catheters in cases of placenta accreta diagnosed by antenatal ultrasound and to compare these cases with contemporary controls. METHODS: In this prospective study, all patients seen at our institution between January 1994 and August 1997 with the antenatal sonographic diagnosis of placenta accreta were offered prophylactic preoperative pelvic artery balloon catheterization. Patients who were delivered by cesarean hysterectomy for unsuspected placenta accreta in our institution during the same time interval served as controls. Five patients with the sonographic diagnosis of placenta accreta underwent prophylactic pelvic artery balloon catheterization. Surgical outcomes in patients who received balloon catheters were compared with those managed without them. Statistical analysis was performed using the Mann-Whitney U test. RESULTS: Five patients with placenta accreta or one of its variants were correctly identified with antenatal ultrasonography. Of the five patients who underwent pelvic artery balloon catheterization, all had placenta accreta and four required cesarean hysterectomy. The mean estimated blood loss, transfusion requirement, and length of hospitalization in patients undergoing hysterectomy managed with and without the balloon catheters was not different (P > 0.06). CONCLUSIONS: Antenatal sonographic diagnosis of placenta accreta enables preoperative planning. In our experience, use of pelvic artery balloon occlusion catheters in patients requiring a cesarean hysterectomy for placenta accreta did not improve surgical outcomes compared with patients managed without them. These preliminary findings are based on a small number of patients; therefore, further investigation is needed.

1998 SCVIR Gary J. Becker Young Investigator Award. Endovascular repair of arterial pseudoaneurysms with use of a perfusion balloon catheter.

PURPOSE: Pseudoaneurysms represent contained disruption of the arterial wall. Iatrogenic pseudoaneurysms frequently complicate complex endovascular procedures. With use of an animal model, the authors attempted to determine the safety and efficacy of using a perfusion balloon catheter (PBC) to thrombose surgically created pseudoaneurysms. MATERIALS AND METHODS: An in vitro system measured maximum flow volume through a 5-F PBC. Pseudoaneurysms were created in domestic swine with use of a jugular vein patch anastomosed to a femoral arteriotomy. The PBC was inflated across the pseudoaneurysm neck for 30-minute intervals until thrombosis was confirmed by ultrasound. Completion arteriography was performed to evaluate for vascular complications. RESULTS: Maximum flow through the PBC was 62.6 mL/min measured at a constant pressure gradient of 120 mm Hg. Five pseudoaneurysms were created in four animals. The PBC completely thrombosed all five lesions. The mean treatment duration was 129 minutes (+/- 39 minutes SD). No native arterial injury, in situ thrombus, or distal embolization occurred. Partial recanalization of three of the five treated pseudoaneurysms was identified on follow-up arteriography and gross sectioning (n = 2 and n = 1, respectively). CONCLUSION: The PBC safely and effectively thrombosed surgically created pseudoaneurysms. Partial recanalization of treated pseudoaneurysms was demonstrated. Clinical trials are warranted.

A validation of the 10-meter incremental shuttle walk test as a measure of aerobic power in cardiac and rheumatoid arthritis patients.

OBJECTIVE: To validate a simple, clinically relevant, and inexpensive test of aerobic power-the 10-meter incremental shuttle walk test (SWT)--in 2 separate patient populations. DESIGN: Two-sample validity study. SETTING: Physiotherapy department of major hospital in the United Kingdom. PATIENTS: Convenience samples of rheumatoid arthritis (RA) patients (n = 10) and cardiac patients (n = 10). INTERVENTION: Subjects were attached to a portable respiratory gas analyzer to measure oxygen uptake. They walked around an oval 10-meter course, starting at 0.5m/s, with velocity gradually increased by .17m/s increments for as long as they could, for up to 12 minutes. MAIN OUTCOME MEASURES: A subject's maximal rate of oxygen uptake during exercise (V(O)(2)max) established with linear extrapolation was regressed against the number of shuttles completed (distance walked). An earlier study (n = 28) showed high levels of reliability and validity with linear extrapolation. RESULTS: No significant linear relationship was found between V(O)(2)max and the number of shuttles completed (R(2); RA subjects = 9.7%, cardiac subjects = .03%, p > .05). CONCLUSION: These results do not support use of the SWT as a representative measure of aerobic power. Despite this finding, the advantages of developing a clinically viable alternative to costly laboratory testing warrants further study of the SWT in patient groups.

Quantification of elastic recoil after balloon angioplasty in the iliac arteries.

PURPOSE: Elastic recoil of the arterial wall has been shown to be responsible for a significant loss of luminal area after balloon angioplasty in the coronary arteries, but it has not been well studied in the peripheral arteries. Because elastic recoil depends on the presence of elastin in the arterial wall, and the amount of elastin varies by artery and proximity to the aorta, the importance of this response to angioplasty may be different in peripheral arteries. The purpose of this study is to document the degree of elastic recoil in the iliac arteries, and analyze variables that might influence the results. MATERIALS AND METHODS: A series of 19 patients with 25 iliac artery stenoses underwent balloon angioplasty followed by placement of a Palmaz stent with the same-sized angioplasty balloon. The minimum luminal diameter of the lesion was measured before treatment, immediately after balloon angioplasty, and again after stent placement. The arterial diameter after stent placement was defined as the diameter of the inflated balloon. The degree of recoil was correlated with nine variables: patient age and sex, lesion location and length, lesion severity (as percent stenosis), the balloon:artery ratio, and three factors related to lesion morphology--complex versus simple, eccentric versus concentric, and calcified versus noncalcified. RESULTS: Elastic recoil averaged 36% +/- 11% and ranged from 19% to 54% in this series of patients. The only variable that significantly influenced the degree of elastic recoil was the balloon:artery ratio (P =.039), which was directly related. CONCLUSION: Elastic recoil is a significant limitation of balloon angioplasty in the iliac arteries. This study illustrates the importance of techniques that limit recoil, such as vascular stents, in angioplasty of the iliac arteries.

Water quality, waterborne disease and enteric disease in Israel, 1976-92.

Israel experienced a large number of waterborne disease outbreaks between 1975 and 1985, followed by a steep decline in the period 1986-92. Large-scale community waterborne disease outbreaks occurred primarily in the late 1970s, and in 1985 (the Krayot, four small towns neighboring Haifa), but substantial outbreaks occurred as late as 1989, with 4 during 1986-90, and 1 during 1991-92. New water standards, including mandatory chlorination of all community water supplies, came into effect in late 1988. Water quality, as monitored by the Ministry of Health, showed a marked improvement even when measured by the more stringent standards of the 1988 regulations. Long-term trends in the total of reported enteric infectious diseases from all sources, including typhoid, hepatitis, Shigella and Salmonella in Israel are examined. Typhoid, which has been declining since the 1960s, peaked in 1985 with the large waterborne disease episode of the Krayot. Shigella and total hepatitis incidence increased slowly up to the mid-1970s, followed by large increases during the 1975-85 period, then by a rapid decline up to 1991. Shigella, from childhood contacts in kindergartens, increased in 1992. Salmonella incidence continues to increase steadily. Mandatory chlorination and more stringent water standards have had an important impact on water quality and on waterborne disease outbreaks in Israel. Empiric evidence suggests that improving water quality may also be a factor in the changing patterns of some enteric diseases and the total burden of enteric disease in Israel.