Immune complex glomerulonephritis in patients coinfected with human immunodeficiency virus and hepatitis C virus.

Human immunodeficiency virus-associated nephropathy (HIVAN), characterized by heavy proteinuria, rapidly progressive renal failure, "collapsing" glomerulopathy, and tubulointerstitial abnormalities, is the most common finding in HIV-infected patients undergoing a renal biopsy and predominantly affects blacks. We describe the clinical features and renal pathologic findings of 12 intravenous drug users (IVDUs) coinfected with HIV and hepatitis C virus (HCV) who were selected for renal biopsy because they presented with features different from typical HIVAN, including hypertension, microscopic hematuria, and cryoglobulinemia. There were seven black and five Hispanic patients.

Larval locomotion of the lancelet.

The ontogeny of locomotion in the Florida lancelet (Branchiostoma floridae) is described for the early developmental stages through to metamorphosis. Recently hatched larvae swam at speeds up to 1 mm s-1 using their epidermal cilia; this speed decreased to approximately 0.2 mm s-1 by 60 h after fertilization.

Premature failure of battery-powered syringe pumps.

Failure of battery-powered equipment during the interhospital transfer of patients is potentially life threatening. The time to failure of 60 fully-charged identical syringe pumps (20 from each batch purchased in 1992, 1994 and 1995) was measured. Older pumps were associated with less predictable charge capacity, with 40% of the 1992 pumps failing within 60 min.

Routine suxamethonium in children. A regional survey of current usage.

This survey aimed to assess the extent and pattern of use of suxamethonium for elective tracheal intubation in children and the occurrence of major complications. A postal questionnaire was sent to 280 consultant anaesthetists and senior registrars in the West Midlands Region. Of the 180 replies received, 84% of respondents use suxamethonium routinely.

Pathological changes associated with short-term nasal intubation.

In order to define the incidence and anatomical site of nasal damage following nasotracheal intubation, we investigated 100 consecutive patients undergoing dental extractions under general anaesthesia. Patients were questioned pre-operatively about the physiological function of their noses and examined by anterior rhinoscopy for anatomical abnormalities. Examinations were repeated postoperatively, looking specifically for haemorrhage, mucosal tears and septal and turbinate disruption.

Cardiorespiratory effects of laparoscopy with and without gas insufflation.

Background: Patients who are undergoing laparoscopic procedures can present with a number of ventilatory and circulatory problems. The use of a gasless technique for performing a laparoscopy by using a mechanical lifting device may potentially avoid such problems.

Objective: To compare the cardiorespiratory effects of laparoscopy with and without gas insufflation.

Ciliary Hovering in Larval Lancelets (=Amphioxus).

Larvae of lancelets (=amphioxus) are of special interest because they figure prominently in debates about vertebrate origins (1), can sometimes grow into a giant "amphioxides" form (2, 3), have a puzzling right-left asymmetry (4), and constitute a major zooplankton resource in parts of the Atlantic (5). By using improved methods (6, 7) to culture and observe healthy pre-metamorphic larvae in relatively deep containers, we demonstrated a prominent hovering behavior. The larvae spend most of their time suspended in midwater by metachronal beating of epidermal cilia.

Anesthesia for stereotactic radiosurgery in children.

The development of stereotactic radiosurgery has been a major advance in the treatment of intracranial lesions. By using a stereotactic head frame attached to the skull, large doses of radiation can be delivered precisely to the lesion while sparing surrounding tissues. Although adults can usually undergo this procedure with local anesthesia or conscious sedation alone, children frequently require general anesthesia.

Ultrasonography of masseter muscle size in normal young adults.

The present study was planned to determine the relationship between linear dimensions of human masseter muscle cross-section and cross-sectional area (CSA), and to assess symmetry between the two sides in normal young adults. Cross-sectional images of the masseter muscle were measured bilaterally by real-time ultrasound imaging in 39 healthy dentate subjects, 19 males and 20 females, aged 21-47. From stored images, CSA and two linear measurements of muscle cross-section were obtained (the shortest and the longest distance through the muscle group).

Nitric oxide in the management of persistent pulmonary hypertension of the newborn--an unusual cause of failure.

A diagnosis of persistent pulmonary hypertension of the newborn should be reviewed if there is a failure to respond to appropriate treatment. We report a case in which both conventional therapy and inhaled nitric oxide failed to break the cycle of right-to-left shunting. Reassessment revealed a massive pulmonary arteriovenous malformation for which surgery was successfully performed in the neonatal period.

Fermentation and utilization of grass silage.

The decision to utilize particular forages in support of dairy production should be based on a number of key factors, such as available land base, type of manure management, soil type and topography, climate, and availability of purchased forages and feeds. Because of the complexity and environmental concerns existing in the dairy industry today, decisions about forage and manure management should include whole farm analysis with the aid of computer software. The chemical composition and digestibility of grass are affected more by stage of maturity than by other management factors, such as species, DM, or type of harvest system.

Evoked potential monitoring of the upper extremities during thoracic and lumbar spinal deformity surgery: a prospective study.

We prospectively investigated the usefulness of somatosensory evoked potential (SEP) monitoring to detect clinically significant peripheral nerve or brachial plexus compression in the upper extremities during spinal deformity surgery. All patients had bilateral median and ulnar nerve SEPs evaluated as a baseline, both intermittently throughout the surgical procedure and at termination of surgery. This information was correlated with pre- and postoperative upper extremity neurologic examinations.

A preliminary study on the radon concentrations in water in Hong Kong and the associated health effects.

Tap water, flushing water and drinking water including natural mineral water, artificial mineral water and distilled water have been investigated for their radon concentrations. It has been found that the radon concentration in natural mineral water samples is the highest and that in tap water is the second highest, while other categories have values very near to the detection limit. From these the corresponding annual effective doses for the stomach and the lung are determined.

A season of football injuries.

All rugby and soccer players presenting to the Accident & Emergency department during the football season 1992-1993 (a total of 871) were prospectively studied to compare the injuries sustained in the two sports. The nature and site of injury, treatment required, age, fitness, experience and position of the player, situation giving rise to injury, and medical attention at the grounds were all analysed. The results show that rugby and soccer players had the same number of injuries, and while there were some differences in the nature of the injuries, there was no difference in overall severity.

Load-induced inflexion of the surface electromyographic signal during isometric fatiguing activity of normal human paraspinal muscle.

In twelve normal subjects (aged 21-57 years) changes in surface electromyographic (EMG) activity of the paraspinal muscles were examined during "unloaded" and "weight-loaded" fatigue tests. These comprised 60 second isometric holds against gravity with the upper body unsupported in a horizontal and prone position while the lower body was firmly secured to a couch. During one of the tests sand bags, representing 10% of subjects' body weight, were placed between the scapulae.

Effects of enzyme-inoculant systems on preservation and nutritive value of haycrop and corn silages.

Third-crop mixed grass-legume forage and corn were ensiled in 70-tonne bunker silos to evaluate the effects of a commercial carbohydrase enzyme-inoculant mixture (220 ml/tonne) and an experimental enzyme-inoculant mixture (264 ml/tonne) on silage fermentation and composition, ruminal degradation, and milk production. Twelve Jersey and 24 Holstein early lactation cows were fed one of four TMR at 32.5:32.

Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain.

The effect of low back pain on the size of the lumbar multifidus muscle was examined using real-time ultrasound imaging. Bilateral scans were performed in 26 patients with acute unilateral low back pain (LBP) symptoms (aged 17-46 years) and 51 normal subjects (aged 19-32 years). In all patients, multifidus cross-sectional area (CSA) was measured from the 2nd to the 5th lumbar vertebrae (L2-5) and in six patients, that of S1 was also measured.

Audit of complete axillary dissection in early breast cancer.

The role of complete axillary dissection (CAD) in the management of breast cancer is controversial and largely unresolved. Acceptance of the results of trials incorporating CAD assumes that the axillary dissection is truly complete. To address this point, and also to define quality control criteria for this operation within our unit, we audited 100 consecutive axillary dissections as follows: the primary surgeon performed what he/she felt to be a thorough CAD and submitted separately the contents of level I, II and III for pathological evaluation; a second surgeon then independently assessed the dissection and arbitrarily labelled any further excised tissue as level IV.

Normal paraspinal muscle electromyographic fatigue characteristics in patients with primary fibromyalgia.

Paraspinal muscle fatigue mechanisms were compared in 14 primary fibromyalgia patients and 14 age and sex matched normal subjects using a standardized 60-s isometric endurance test of the paraspinal muscles, during which surface integrated electromyographic (IEMG) activity was recorded. Fatigue-induced IEMG increases were similar for both groups during the initial 40 s (up to 112 +/- 20% and 111 +/- 6% of initial values in patients and normal subjects respectively). Thereafter, IEMG fell significantly in patients (P < 0.